PLASTIC SURGERY RESIDENTS HANDBOOK

PLASTIC SURGERY RESIDENTS HANDBOOK I. PLASTIC SURGERY REQUIREMENTS a. AACPS Post Interview Communication Guidelines b. General Competencies c. Plastic Surgery Goals & Objectives d. ACGME Required Index Case Mappings II. PLASTIC SURGERY STATISTICS a. Past Resident Fellowship b. Past Resident Current Positions c. Resident Presentations, Publications and Awards d. Faculty Awards III. IV. RESEARCH ROTATIONS a. Rotation Schedules b. Conference Schedule V. EVALUATION PROCESS a. New Innovations b. Sample Evaluations VI. SIU RESIDENT POLICIES a. Resident Fact Sheet b. Institutional Policy for Resident Duty Hours c. Plastic Surgery Policy for Resident Duty Hours d. Late Start Policy e. Closure Reduction Policy f. Impairment Policy g. Licensing Examination Policy h. Selection & Promotional Policy i. Employment Authorization Policy(Visa Status Policy) j. Vacation and Other Leaves of Absence Policy k. Delinquent Medical Record Policy l. Academic Deficiency Policy m. Due Process & Resident Complaint Policy VII. SAMPLE DOCUMENTS a. Affiliated Hospital Benefit Package & Agreements with Physician

PLASTIC SURGERY REQUIREMENTS AACPS Post Interview Communication Guidelines General Competencies Plastic Surgery Goals & Objectives ACGME Required Index Case Mappings

Accreditation Council for Graduate Medical Education (ACGME) General Competencies Patient Care Medical Knowledge Practiced Based Learning Interpersonal & Communication Skills Professionalism System-Based Practice Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of heath. Resident must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social behavioral) sciences and the application of this knowledge of patient care. Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices. Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patient families, and professional associates. Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. Residents must demonstrate an awareness of and responsiveness to the large context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM - GOALS & OBJECTIVES PGY 1, 2 & 3 - GENERAL SURGERY SERVICE 1. Learn pre and post-operative care of the general surgical patient. 2. Learn about surgical problems in general related to patient management, evaluation and diagnosis, medical and surgical management 3. Learn the care of fluid and electrolytes in the surgical patient. 4. Participate actively in surgical problems 5. Develop basic surgical techniques including suturing, dissection and resection 6. Learn anatomy and pathophysiology of general surgical procedures 7. Participate in planning and selection of surgical procedures. 8. Actively participate in surgical procedures as the primary surgeon. 9. Oversee the first year residents regarding patient management; provide educational direction for those residents as well as medical students. 10. Learn advanced techniques of general surgical care and general surgical procedures including endoscopy. 11. Supervise first and second year general surgery residents and medical students. 12. Perform advanced and increasing complex general surgical procedures. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 5) Surgery Skills Lab to gain expertise prior to direct patient contact. 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 4) General Surgery Grand Rounds 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) General Surgery M & M s 4) General Surgery Grand Rounds 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations

Competency Sub Competency Assessment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 1, 2 & 3 - VASCULAR SURGERY SERVICE 1. Learn the pre and post-operative care of vascular surgery patients. 2. Learn the management and care of patients with vascular problems in an intensive care unit. 3. Learn the management of patients with arterial and venous problems including trauma and obstruction. 4. Participate in vascular surgical procedures. 5. Develop skills in vessel repair and dissection. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 5) 5) Surgical Skills Lab to gain expertise prior to patient contact 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) General Surgery M & M s 4) General Surgery Grand Rounds 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 1, 2 & 3 - PEDIATRIC SURGERY SERVICE 1. Learn the pre and post-operative clinical management of pediatric patients. 2. Learn the principles and management of pediatric fluids and electrolytes and homeostasis 3. Learn the anatomy and pathophysiology of the pediatric patient. 4. Develop skills in the surgical techniques utilized in pediatric patients. 5. Teach and guide medical students on the service. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan A) Technical ability, i.e. procedures B) Apply information technology to optimize patient care C) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals A) Counsel and educate patients and families B) Maintain appropriate records documenting practice activities and outcomes C) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) General Surgery M & M s 4) General Surgery Grand Rounds 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM - GOALS & OBJECTIVES PGY 1, 2 & 3 - HEAD & NECK SERVICE 1. Learn the principles and techniques of basic head and neck surgery. 2. Learn and become proficient in laryngoscopy. 3. Learn to become proficient in triple endoscopy. 4. Learn the principles of medical management of head and neck cancer patients. 5. Learn to evaluate and diagnose head and neck cancer patients. 6. Participate actively in head and neck cancer surgery, particularly resection and node dissection. 7. Learn the anatomy of head and neck surgeries. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) Otolaryngology M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committee 4) Otolaryngology M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 1, 2 & 3 - ORAL SURGERY SERVICE 1. Learn the pre and post-operative management of patients with jaw and maxillary problems. 2. Learn the evaluation, diagnosis and management of oral surgical problems. 3. Learn the basis for the use of cephalometric analysis. 4. Participate actively in the oral surgical operative procedures. 5. Learn the anatomy and pathophysiology of oral surgical procedures. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of Cephalographics x-rays II: Medical Knowledge A) Know current medical information of maxillomandibular surgery B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) Oral Surgery M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Discuss cost effective work-up of patients with oral occlusion

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 1,2 & 3 - DERMATOLOGY SERVICE 1. Learn the evaluation, diagnosis and treatment of dermatologic problems. 2. Learn the principles of Mohs micrographic surgery. 3. Understand the treatment of patients with Mohs micrographic surgery and pos-operative reconstruction. 4. Recognize various types of surgical lesions and their treatment. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) Dermatology M & M s V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 3) Dermatology M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM - GOALS & OBJECTIVES PGY 1, 2 & 3 - TRAUMA / CRITICAL CARE SERVICE 1. Learn the principles and management of trauma patients. 2. Learn the primary and secondary initial assessment of the trauma patient. 3. Learn the principles of ventilator management. 4. Learn advanced life support skills. 5. Learn skills such as chest tube insertion and intubation. 6. Develop skills and become proficient in venous and arterial catheterization. 7. Participate in the critical care and sub-acute homeostatasis of the trauma patient. 8. Participate in surgical procedures in trauma. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) General Surgery M & M s 4) General Surgery Grand Rounds 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM - GOALS & OBJECTIVES PGY 1, 2 & 3 BURN SERVICE 1. Learn the evaluation, diagnosis and stabilization of the burned patient. 2. Learn the critical care management of burn patients. 3. Learn the management of pre and post-operative care of burn patients. 4. Participate actively in the surgical management of burn patients. 5. Evaluate burn patients in the Emergency Department and on acute admission. 6. Participate in and learn the principles of burn scar management and reconstruction. 7. Learn fluid resuscitation of burn patients. 8. Develop skills in skin grafting and burn excision. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 4) In-Service Examination 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s 4) Multidisciplinary Burn Rounds 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Multidisciplinary Burn Rounds 4) Hospital Committees 5) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 1, 2, 3, 4, 5 & 6 RESEARCH SERVICE 1. Choose and organize a plastic surgery research project under the supervision and direction of a plastic surgery faculty member. 2. Progress toward completion of the project and literature search to prepare for publication. 3. Learn the principles of basic science and clinical research in plastic surgery 4. Participate in the laboratory methodology and animal handling. 5. Develop a working awareness of statistical analysis. 6. Learn guidelines for the presentation of research. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician.

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 1, 2 & 3 OCCULAR PLASTICS SERVICE 1. To become familiar with periorbital surgery from ophthalmologic perspective 2. Learn the assessment of periorbital pathology including post traumatic and congenital conditions. 3. Participate in aesthetic and reconstructive periorbital surgery. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 1, 2 & 3 TRANSPLANT SURGERY SERVICE 1. Learn pre & post-operative care of transplant surgery patients. 2. Learn principles of immunosuppresion and management of complications related to treatment of transplant surgery. 3. Participate in transplant surgery procedures. 4. To develop skills in vessel repair and dissection. Competency Sub Competency Assessment I: Patient Care E) Develop and implement patient care plan F) Technical ability, i.e. procedures G) Apply information technology to optimize patient care H) Evaluation of diagnostic studies II: Medical Knowledge C) Know current medical information D) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement E) Communicate with other healthcare professionals F) Counsel and educate patients and families G) Maintain appropriate records documenting practice activities and outcomes H) Function as team member/leader C) Commitment to practice lifelong learning D) Analyze personal practice outcomes V: Professionalism E) Maintain high standards of ethical behavior F) Demonstrate continuity of care (pre-op, operative, post-op) G) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect H) Demonstrate honesty, dependability, and commitment VI: System Based Practice C) Practice cost-effective care without compromising quality (value) D) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 5 Pediatric Plastic Surgery (1) Rotation - Children's Memorial Hospital - Chicago, IL 1. Learn the pre and post-operative evaluations of children with congenital anomalies. 2. Learn principles of cleft lip & palate surgeries. 3. Learn management of patients with a multi-disciplinary craniofacial team. 4. Teach and mentor medical students. 5. Learn the embryology, pathophysiology of children with congenital anomalies. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 4) In-Service Examination 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 1 PLASTIC SURGERY SERVICE 1. Learn the basics of wound care management and healing. 2. Participate in the care of plastic surgery patients in the trauma facility. 3. Develop eye-hand coordination appropriate for plastic surgical suture techniques. 4. Develop expertise in the management and techniques of tissue handling. 5. Learn the principles of skin grafts, flaps and tissue transfers. 6. Learn the anatomy and pathophysiology of plastic surgery procedures. 7. Learn skin pathology and surgical management Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 4) In-Service Examination 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 2 PLASTIC SURGERY SERVICE 1. Learn more advanced wound care management and healing. 2. Participate in the care of plastic surgery patients in the trauma facility. 3. Develop skills in basic flap transfer. 4. Develop eye-hand coordination appropriate for plastic surgical suture techniques. 5. Develop expertise in the management and techniques of tissue handling. 6. Learn the principles of skin grafts, flaps and tissue transfers. 7. Learn principles of microsurgery. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 4) In-Service Examination 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 3 PLASTIC SURGERY SERVICE 1. Learn more advanced plastic surgery procedures 2. Learn more complex management of plastic surgery patient care. 3. Supervise first and second year residents and medical students in the surgical and clinical management of patients. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 4) In-Service Examination 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 4 PLASTIC SURGERY SERVICE 1. Take primary call for plastic surgery trauma with chief resident and faculty supervision. 2. Progress to more complex plastic surgical procedures including flaps, free tissue transfer and wound care. 3. Supervise PGY I, II & III year residents and medical students. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 4) In-Service Examination 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM GOALS & OBJECTIVES PGY 5 PLASTIC SURGERY SERVICE 1. Provide emergency and acute care to plastic surgery surgical patients under the supervision of the plastic surgery faculty. 2. Progress through more complex plastic surgical procedures, such as, flaps, replants, cleft lip & palate care. 3. Supervise and teach junior residents, rotating residents and medical students. 4. Prepare presentations for regional and national meetings. 5. Maintain learning in plastic surgery through reading plastic surgery journals and text, plus assigned topics to the educational program assigned by the chief administrative resident. 6. Develop graduated skills in surgical procedures to teach junior residents. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 4) In-Service Examination 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M & M s

Administrative Resident (Six Months) SIU SCHOOL OF MEDICINE - PLASTIC SURGERY RESIDENCY PROGRAM - GOALS & OBJECTIVES PGY 6 PLASTIC SURGERY SERVICE 1. Learn patient management relating to plastic surgery. 2. Refine management and care of cosmetic surgical patients and refine surgical techniques 3. Learn and perform procedures for repair of cleft lip and palate and maxillofacial disorders. 4. Organize conferences and supervise junior residents in plastic surgery and other residents and medical students rotating on our service. 5. Organize conferences for the educational program of plastic surgery 6. Assign plastic surgery cases to best utilize patient care for resident learning commensurate with level of training. 7. Assign cases and fill in gaps in the residents' surgical experience with less common procedures. 8. Perform complex plastic surgery procedures independently. Senior Resident (Six Months) 1. Learn patient management relating to plastic surgery 2. Refine management and care of cosmetic surgical patients and refine surgical techniques 3. Learn and perform procedures for repair of cleft lip and palate and maxillofacial disorders. 4. Assist the administrative resident in the preparation of conferences, case assignments and call schedule. 5. Supervise and teach junior residents and medical students in the management of plastic surgery procedures. 6. Present at the Plastic Surgery Senior Resident Conference. 7. Perform complex plastic surgery procedures independently. Competency Sub Competency Assessment I: Patient Care A) Develop and implement patient care plan B) Technical ability, i.e. procedures C) Apply information technology to optimize patient care D) Evaluation of diagnostic studies II: Medical Knowledge A) Know current medical information B) Critically evaluate scientific information III: Interpersonal Skills & Communication IV: Practice Based Learning & Improvement A) Communicate with other healthcare professionals B) Counsel and educate patients and families C) Maintain appropriate records documenting practice activities and outcomes D) Function as team member/leader A) Commitment to practice lifelong learning B) Analyze personal practice outcomes 1) Monthly rotations with an attending physician 2) Operative Log 3) Operative and clinical supervision 4) Monthly Evaluations 1) Medical knowledge will be obtained through core conferences 2) Literature review 3) Monthly Evaluations 4) In-Service Examination 1) Faculty Evaluation will ascertain communication with the health care professionals. 2) The resident to counsel and educate patients families 3) The residents will function as team leaders and answer directly to the chief residents or to the faculty. 4) Monthly Evaluations 1) Rounds will be utilized to analyze personal practice outcomes to fulfill Practice Based Learning & Improvement competency. 2) The PSOL and clinical follow-up and literature review will be utilized. 3) M & M s

Competency Sub Competency Assessment V: Professionalism A) Maintain high standards of ethical behavior B) Demonstrate continuity of care (pre-op, operative, post-op) C) Sensitivity to age, gender, cultural, etc. differences in an atmosphere of mutual respect D) Demonstrate honesty, dependability, and commitment VI: System Based Practice A) Practice cost-effective care without compromising quality (value) B) Know how different practice systems operate to deliver care 1) Professionalism will be evaluated though the faculty. 2) Patient questionnaires as well as case scenarios are discussed at morning conferences. 3) These will be utilized to make sure that the residents maintain a high standard of ethical behavior, demonstrate continuity of care and are sensitive of age, gender, cultural differences in patients. 4) Monthly Evaluations 1) All residents are expected to practice cost effective care in keeping with the System Based Practice. 2) Appropriate radiographs, lab tests, other imaging studies and diagnostics will be following by the attending physician. 3) Hospital Committees 4) M s

ACGME PLASTIC SURGERY INDEX CASE MAPPINGS Index Category Required Required Minimum Total by Number Category Breast 40 Reduction 10 Reduction Augmentation 10 Augmentation Reconstruction 20 Reconstruction Free Tissue Reconstruction Myocutaneous Flap Reconstruction Nipple/Areolar Reconstruction Secondary Breast Procedures Reconstruction with Implant or Tissue Expander Other (Breast) 0 Gynecomastia Other (Breast) Burns 12 Operative 5 Operative Treatment Non-Operative 2 Non-operative Reconstructive 5 Reconstructive Congenital Defects of the Head and Neck 24 Cleft Lip (primary) 6 Cleft Lip Nasal Deformity Cleft Lip Repair Primary, bilateral repair Cleft Lip Repair Primary, unilateral repair Cleft Palate (primary) 6 Cleft palate Bilateral Primary Repair Cleft palate Unilateral Primary Repair Cleft Lip or Palate (secondary) 6 Cleft Lip Secondary repairs Cleft Palate Secondary repairs Other (Congenital Defects) 6 Craniomaxillofacial Major Craniofacial Reconstruction Craniomaxillofacial Mandible Craniomaxillofacial Maxilla Cysts, Sinuses, Angiomas and Hygromas Other (Congenital Defects of H&N) Otoplasty Reconstruction of Ear

ACGME Plastic Surgery Index Case Mappings Page 2 Cosmetic 45 Facelift 7 Brow Lift Face Lift Blepharoplasty 8 Blepharoplasty Rhinoplasty 6 Rhinoplasty Body Contouring: Abdominoplasty 5 Abdominoplasty: Contouring Body Contouring: Suction Lipectomy 10 Suction Lipectomy Other (Cosmetic) 9 Other (Cosmetic) Skin Resurfacing Head and Neck Trauma 30 Nasal Fractures 3 Facial Bone Fractures Frontal Sinus/Nasoethmoid Facial Bone Fractures Nasal Mandibular Fracture 4 Facial Bone Fractures Mandible Alveolar Ridge Facial Laceration 5 Soft Tissue Acute Repair Zygomatic, Orbital Fractures 6 Facial Bone Fractures Zygomatic Orbit Maxillary Fractures 3 Facial Bone Fractures Maxillary / Mid-face Other (Facial Trauma) 9 Eyelid Facial Nerve Soft Tissue Lymph Node Resection Soft Tissue Scar Revision (including Dermabrasion) Soft Tissue Revision or Reconstruction Eyelid Soft Tissue Revision or Reconstruction Grafts Head and Neck Neoplasms 15 Other (Head & Neck Neoplasms) 15 Other (Head & Neck Neoplasms) Reconstruction Eyelid Reconstruction Flap, Multiple Tissue Reconstruction Flap, Skin Reconstruction Free Tissue Transfer Reconstruction - Nose Resection Antral / Orbital Resection Endoscopy Resection Lip Resection Lymph Node Resection Resection Oropharyngeal Resection Other (Exclude Skin Cancer) Resection Salivary

ACGME Plastic Surgery Index Case Mappings Page 3 Upper Extremity 115 Skin Repair 10 Skin Repair Fingertip Injury 5 Fingertip Injuries and Reconstruction Tendon, Flexor 15 Tendon Repair Extensor Tendon Repair Flexor Tendon Repair Tendon Transfer Nerve Repair 5 Nerve Repair Nerve Repair Major Fracture / Dislocation 15 Fractures and Dislocations Release Contracture, Joint & Tendon 5 Contracture Release Amputation 5 Amputation Dupuytren s 2 Dupuytren s Nerve Decompression 5 Decompression (Nerves) Other (Hand) 48 Arterial Repair Digital Congenital Other (Upper Extremity) Replant, Revascularization, Free Transfer Tumors Benign Tumors Malignant Lower Extremity 20 Flap 10 Flap Other (Lower Extremity) 10 Other (lower extremity) Skin and Soft Tissue Neoplasm 30 Malignant 20 Malignant Non-malignant 10 Benign Trunk Genitalia 25 Pressure sore, flap 5 Pressure sore Debridement Pressure sore Direct Repair Thoracic or abdominal flaps 10 Thoracic Abdominal Defects Debridement Thoracic Abdominal Defects Repair, Direct Thoracic Abdominal Defects Repair, Flap

Other (Trunk) 10 Hidradenitis Male / Female Genitalia Hypospadias Male / Female Genitalia Other Male / Female Genitalia Penile Replantation and Re Male / Female Genitalia Repair, flap ACGME Plastic Surgery Index Case Mappings Page 4 Methods Groups 0 Free Tissue Transfer 10 Laser 5 Flap 40 Graft, Bone 2 Graft, Skin 10 Graft, Other 3 Implant 5 Tissue Expansion 5 Total required number of procedures for entire program is 900. The technique groups will be doubled counted, i.e. in the total number of operative procedures listed above the technique group section and in the technique group section, to ensure that these additional technical skills required of the plastic surgeon have been documented.

PLASTIC SURGERY STATISTICS Past Resident Fellowships Past Resident Current Positions Faculty Awards Resident Presentations, Publications & Awards

SIU School of Medicine Plastic Surgery Resident Post-Training Fellowships Year Graduated Resident Name Fellowship Location 1998 Samira Bayati, MD Hand Loma Linda University Loma Linda, CA 2002 Nicole Z. Sommer, MD Breast/Aesthetic The Plastic Surgery Center Nashville, TN 2003 Reuben Bueno, MD Hand Ortho Hospital for Special Surgery New York, NY 2003 Reuben Bueno, MD Pediatric Plastic Surgery Hospital for Sick Children Toronto, Canada 2008 Minh-Doan Nguyen, MD Aesthetic/Breast Beth Israel Deaconess/Harvard Medical Boston, MA 2009 Damon Cooney, MD Microsurgery University of Pittsburgh Pittsburgh, PA 2009 David Megee, MD Hand Washington University St. Louis, MO 2010 Nada Berry, MD Hand Mayo Clinic Rochester, MN 2010 Brooke French, MD Craniofacial Hospital for Sick Children Toronto, Canada 2012 Erika Henkelman, MD Pediatric Plastic Surgery Hospital for Sick Children Toronto, Canada 2014 Brian Derby, MD Aesthetic & Oculoplastic 2014 Brian Derby, MD Aesthetic Surgery Mark Codner Plastic Surgery Atlanta, GA Grotting Plastic Surgery Birmingham, AL

SIU School of Medicine Plastic Surgery Residency Graduates Year Graduated Resident Name Type of Practice Current Location 1997 Melinda Haws, MD Group Nashville, TN Joel Williams, MD Group Dalton, GA 1998 Semira Bayati, MD Group Newport Beach, CA Evan Manolis, MD Private Chicago, IL 1999 Michael Smock, MD Group St. Louis, MO Sean Lille, MD Private Scottsdale, AZ 2000 Brent Rubis, MD Group Tulsa, OK Todd Williams, MD Group Farmington, NM 2001 Allan Parungao, MD Private Chicago, IL 2002 Marcos Ortega, MD Private Pensacola, FL Charles Chalekson, MD Group Torrence, CA Nicole Z. Sommer, MD Academic Springfield, IL 2003 Reuben Bueno, MD Academic Springfield, IL Tammy Wu, MD Private Modesto, CA 2004 Ryan Naffziger, MD Group Durango, CO Arian Mowlavi, MD Private Laguna Beach, CA 2005 Kosta Lekkas, MD Group Des Moines, IA Garth Meldrum, MD Private Eugene, OR 2006 John Houle, MD Group St. Cloud, MN Paige Cornette, MD Group Bloomington, IL 2007 Brad Medling, MD Group Murfreesboro, TN Jessica Gillespie, MD Private Indianapolis, IN 2008 Minh-Doan Nguyen, MD Academic Cincinnati, OH Pradeep Mohan, MD Private Abilene, TX 2009 Damon Cooney, MD Academic Baltimore, MD David Megee, MD Academic Cincinnati, OH

SIU School of Medicine Plastic Surgery Residency Graduates Year Graduated Resident Name Type of Practice Current Location 2010 Nada Berry, MD Academic Springfield, IL Brooke French, MD Academic Denver, CO 2011 Ryan Diederich, MD Private Edwardsville, IL Margo Herron, MD Private Ashland, OR 2012 Erika Henkelman, MD Joel Wietfeldt, MD Fellowship Private Toronto, Canada Springfield, IL

SIU School of Medicine Plastic Surgery Faculty Awards Teaching Outstanding Scholar 2011 Michael W. Neumeister, MD Excellence in Teaching 2001 Elvin G. Zook, MD Excellence in Teaching of Residents 2003 Michael W. Neumeister, MD Elvin G. Zook, MD 2004 Michael W. Neumeister, MD 2005 Michael W. Neumeister, MD Elvin G. Zook, MD 2006 Michael W. Neumeister, MD Elvin G. Zook, MD 2007 Michael W. Neumeister, MD 2008 Michael W. Neumeister, MD Elvin G. Zook, MD Reuben A. Bueno, MD 2009 Michael W. Neumeister, MD Elvin G. Zook, MD Reuben A. Bueno, MD Robert C. Russell, MD 2010 Michael W. Neumeister, MD Elvin G. Zook, MD Nicole Z. Sommer Reuben A. Bueno, MD Robert C. Russell, MD

SIU School of Medicine Plastic Surgery Faculty Awards Excellence in Teaching of Residents (cont d) 2011 Michael W. Neumeister, MD Reuben A. Bueno, MD 2012 Nada Berry, MD Michael W. Neumeister, MD Excellence in Teaching of Medical Students 2003 Elvin G. Zook, MD 2004 Elvin G. Zook, MD Nicole Z. Sommer, MD 2005 Michael W. Neumeister, MD 2006 Elvin G. Zook, MD 2007 Elvin G. Zook, MD Reuben A. Bueno, MD 2008 Elvin G. Zook, MD Michael W. Neumeister, MD 2009 Elvin G. Zook, MD 2010 Elvin G. Zook, MD 2012 Nada Berry, MD Michael W. Neumeister, MD Faculty Teacher of the Year for Residents 2004 Elvin G. Zook, MD 2005 Michael W. Neumeister, MD 2009 Reuben A. Bueno, MD Faculty Teacher of the Year of Medical Students 2008 Michael W. Neumeister, MD

SIU School of Medicine Plastic Surgery Faculty Awards Student Teaching of the Year Award 2004 Nicole Z. Sommer, MD 2 nd Annual Faculty Teaching Award 2006 Michael W. Neumeister, MD Research Outstanding Researcher Award 2002 Michael W. Neumeister, MD Research Mentor of the Year 2003 Michael W. Neumeister, MD 2004 Michael W. Neumeister, MD 2005 Michael W. Neumeister, MD Junior Faculty Researcher of the Year 2007 Reuben A. Bueno, MD Senior Faculty Researcher of the Year 2008 Michael W. Neumeister, MD Clinical Excellence Excellence in Clinical Practice 2005 Nicole Z. Sommer, MD 2006 Nicole Z. Sommer, MD Michael W. Neumeister, MD Elvin G. Zook, MD 2007 Reuben A. Bueno, MD

RESIDENT PRESENTATIONS, PUBLICATIONS & AWARDS Podium Presentations ASPS Denver, CO September 2011 Cocaine-Induced Full Thickness Skin Necrosis Presented by: Ashley Amalfi, MD AAHS/ASPN/ASRM Red Rock Resort Las Vegas, NV January 2012 Cocaine Induced Full Thickness Skin Necrosis of the Upper Extremities Presented by: Ashley Amalfi, MD Sr Resident Conference Tampa, FL January 2012 The Optimal Buffering of Local Anesthetics with Sodium Bicarbonate Presented by: Erika Henkelman, MD Cocaine Induced Full Thickness Skin Necrosis of the Upper Extremities Presented by: Joel Wietfeldt, MD 51 st Annual Midwest Association of Plastic Surgeons (MAPS) Chicago, IL April 2012 Adipose-derived Stem Cell to Skin Stem Cell Transdifferentiation: A Mechanism to Improve Understanding of Fat Grafts Skin Regenerative Potential Presented by: Brian Derby, MD AWARD: 1 st Place Basic Science ($500) A Side-to-Side Nerve Bridge Preserves Muscle Viability Following Peripheral Nerve Injury Shaun D. Mendenhall, MD; Jared W. Garlick, BS; Jill Shea, PhD; Linh A. Moran, BS; Mohamed E. Salama, MD; Jayant P. Agarwal, MD Presented by: Shaun Mendenhall, MD AWARD: 2 nd Place Basic Science ($250) Retrospective Review of Octogenarian Burn Patient Mortality Presented by: Cedar Helen Malone, MD AWARD: 1 st Place Clinical Research ($500) Cocaine Induced Full Thickness Tissue Necrosis Presented by: Ashley Amalfi, MD Multidrug-Resistant Acinetobacter in a Burn Intensive Care Unit: Epidemiology, Progression, and Containment Protocol Presented by: Megan Henderson, MD

Podium Presentations cont. Herpes Simplex Virus Type 1 Infection in Burn Patients Presented by: Kelli Webb, MD Patient Satisfaction with 3D Imaging Technology in Cosmetic Breast Augmentation: A Pilot Study Presented by: Cedar Helen Malone, MD 11 th Annual Department of Surgery Resident Research Day April 2012 Adipose-derived Stem Cell to Skin Stem Cell Transdifferentiation: A Mechanism to Improve Understanding of Fat Grafts Skin Regenerative Potential Presented by: Brian Derby, MD AWARD: 1st Place Basic Science ($500) A Side-to-Side Nerve Bridge Preserves Muscle Viability Following Peripheral Nerve Injury Shaun D. Mendenhall, MD; Jared W. Garlick, BS; Jill Shea, PhD; Linh A. Moran, BS; Mohamed E. Salama, MD; Jayant P. Agarwal, MD research conducted at Univ of Utah Presented by: Shaun Mendenhall, MD AWARD: 2 nd Place Basic Science ($250) Pressure Characteristics of Hospital and Non-Hospital Mattresses Presented by: Erika Henkelman, MD AWARD: 1 st Place Clinical Research ($500) Retrospective Review of Octogenarian Burn Patient Mortality Presented by: C. Helen Malone, MD AWARD: 2 nd Place Clinical Research ($250) The Optimal Buffering of Local Anesthetics with Sodium Bicarbonate Presented by: Erika Henkelman, MD Integra Application on Exposed Bone with Fibrin: An Animal Model Presented by: Theresa Hegge, MD SIU-SOM 22 st Annual Trainee Research Symposium April 2012 Integra Application on Exposed Bone with Fibrin: An Animal Model Presented by: Theresa Hegge, MD, MPH AWARD: 2 nd Place Illinois Society of Plastic Surgeons (Sr Resident Paper Presentation & Competition) Chicago, IL June 2012 Pressure Characteristics of Hospital and Non-Hospital Mattresses Presented by: Erika Henkelman, MD AWARD: 2 nd Place Overall ($200)

Podium Presentations cont. American Burn Association Annual Meeting Seattle, WA April 2012 Herpes Simplex Virus Type 1 Infection in Burn Patients Presented by: Kelli Webb, MD Aesthetic Meeting Vancouver, Canada May 2012 Skin Regenerative Potential of ADSC s in An In-Vivo Nude Mouse Model Presetnted by: Brian Derby, MD PSRC Ann Arbor, MI June 2012 Retrospective Review of Octogenarian Burn Patient Mortality Presented by: Cedar Helen Malone, MD Herpes Simplex Virus Type 1 Infection in Burn Patients Presented by: Shaun Mendenhall, MD for Kelli Webb, MD Publications Book chapters Neumeister MW, Zook EG, Sommer NZ, Hegge TA. Nail and Fingertip Reconstruction Plastic Surgery Third Edition Neligan Chang Chapter 6:Section 2:Volume 6 pp117-137 Elsevier 2012 Research Awards 51 st Annual Midwest Association of Plastic Surgeons (MAPS) Chicago, IL April 2012 Derby -- 1 st Place Basic Science ($500) Mendenhall -- 2 nd Place Basic Science ($250) Malone -- 1 st Place Clinical Research ($500) 11 th Annual Department of Surgery Resident Research Day April 2012 Derby -- 1st Place Basic Science ($500) Mendenhall -- 2 nd Place Basic Science ($250) Henkelman -- 1 st Place Clinical Research ($500) Malone -- 2 nd Place Clinical Research ($250) SIU-SOM 22 st Annual Trainee Research Symposium April 2012 Hegge -- 2 nd Place ($250) Illinois Society of Plastic Surgeons (Sr Resident Paper Presentation & Competition) Chicago, IL June 2012 Henkelman -- 2 nd Place Overall ($200)

Resident Teaching Awards SIU-SOM Resident Excellence in Teaching Award for Medical Student Teaching Brian Derby, MD Theresa Hegge, MD Shaun Mendenhall, MD Kelli Webb, MD SIU- SOM Resident Teacher of the Year for the Medical Students Kelli Webb, MD

RESEARCH

Plastic Surgery Resident Research Experience Research experience with dedicated time in the lab is an integral part of our training program. There are multiple on-going projects that residents can get involved with, from basic science projects to clinical trials to retrospective reviews. Residents also have the opportunity to design and complete new projects if they wish. During the PGY-2 year, residents spend 1 month on research, gathering information for potential projects and applying for a Department of Surgery research grant. During the PGY-3 year, residents have 3 continuous months to complete their project. Presentation of their research is done at local, regional, or national meetings. Presentation at a regional or national meeting and publication in a peer-reviewed journal or textbook is a requirement for graduation from the training program.

Research Personnel Michael W. Neumeister, MD Vice Chair of Research Department of Surgery Hui Dai, MD, PhD Assistant Professor of Research Mai Yang, MD, PhD Research Associate Lisa Cox Researcher III Carrie Harrison Researcher III Joel Reichensperger Researcher II Jenny Koechle Clinical Research Specialist Urooj Imtiaz Clinical Data Analyst

Resident Research Projects BASIC SICENCE RESEARCH Contribution of EGR-1 Skeletal Muscle Ischemia-Reperfusion Injury 2004 Will Buried De-epithelialized Dermal Flap Lose Its Re-epithelialization Potential Over Time 2005 The Therapeutic Dose and Dose-Response Curve for Botulinum Toxin Type A For the Induction of Vasodilatation 2006 The Therapeutic Dose & Dose Response Curve for Botulinum 2006 Induction Tolerance in Rat Hindlimb Allotransplantation 2007 Modulation of Adult Derived Stem Cells by Notch Signaling 2007 The Use of Rapamycin to Reduce the Severity of Breast Capsular Contracture Formation after Augmentation Mammoplasty: A Rat Model 2007 Chemokines CCL2 and CCL22 Induction of Treg Migration 2008 Evaluation of Peripheral Nerve Regeneration Using Dorsal Root Ganglia and Adult Adipose Stem Cells with a PGA Conduit 2008 Microsurgical Education: Using Rat Hindlimb Transplantation to Improve Resident Microsurgical Competency 2009 Directing T Regulatory Cell Migration Based on Regional Lymph Nodes 2009 Early Growth Response Factor-1 (EGR-1) Expression in a Rabbit Flexor Tendon Scar Model 2009 Is Nerve Growth within a Conduit Enhanced by the Presence of Adipocyte Derived Stem Cells? 2009 Integra Application on Denuded Tendon in an Animal Model 2009 Tissue Engineered Skin for Upper Extremity Wounds 2010 Skin Regenerative Potential of Adipose Derived Stem Cells (ADSCs) in an In Vivo Nude Mouse model 2010 HBO Hindlimb Transplants in Rats 2010 To Evaluate the Role of Botox in the Treatment and Prevention of Painful Neuromas 2012 Knotless Hand Flexor Tendon Repair: Reducing Friction Could Improve Outcomes 2012

BASIC SICENCE RESEARCH (cont d) The Salvageable Time Window for Ischemic Postconditioning on Skeletal Muscle 2012 Ischemia Reperfusion Injury Model The Role of Botulinum Toxin in Nerve Injury 2012 A Microbiologic Comparison of Acellular Dermal Matrices as an Aseptic Reconstructive Material and a Scaffold for Stem Cell In- growth 2012 CLINICAL RESEARCH The Effective Methods for Teaching Microsurgical Skills 2005 The Effect of Resection of the Dorsal Lip of the Radius Row 2006 Anatomical Relationships in the Human Palm During Endoscopic Carpal Tunnel Surgery 2007 Anatomical Landmarks for the Nerve Branch in the Master Muscle in Facial Reanimation 2007 Correlation of Scratch Collapse Test with Electromyography and Nerve Conduction Study in Evaluation of Upper Extremity Nerve Compression Syndromes 2008 Uses, Safety, and Efficacy of Local Anesthetics for the Treatment of Pain Associated with Botox Injection 2009 Patient Outcomes after Hand Fractures 2010 Therapeutic Use of Botulinum Toxin Type A to Treat Ischemia and Pain 2010 Related to Raynaud s Phenomenon Use of 3-Dimensional Ultrasound in the Evaluation of Flexor Tendon Injuries 2011 Prospective, Randomized, Double Blind Placebo controlled Crossover Clinical Trial of Botulinum Toxin A for Neuroma 2011 Patient Satisfaction with 3D Imaging Technology in Cosmetic Breast Augmentation: A Pilot Study 2011 Simple Nailbed Lacerations - Are Functional and Cosmetic Outcomes of Surgical Repair Equivalent to Observation Alone? 2011 Incidence of Herpes Simplex Virus in Burn Patients 2011 Review of Octogenarian Burn Patient Mortality 2012

Resident Grants Resident Grant Title Funding Source Amount Funding Year(s) Josh Hammel Knotless Hand Flexor Tendon Repair: Reducing Friction Could Improve Outcomes SIU Surgery Grant $2,500 07/2012-07/2013 Brian Derby Brian Derby Megan Henderson Kelli Webb Natasha Luckey Simple Nailbed Lacerations -- Are Functional Cosmetic Outcomes of Surgical Repair Equivalent to Observation Alone? The Salvageable Time Window for Ischemic Postconditioning on Skeletal Muscle Ischemia Reperfusion Injury Model The Role of BotulinumToxin in Nerve Injury A Two-Part Study of Botulinum Toxin Type A Therapy for Raynaud's Phenomenon Tissue Engineered Skin for Extremity Wounds SIU Surgery Grant $2,500 07/2012-07/2013 SIU Surgery Grant $2,500 07/2012-07/2013 SIU Surgery Grant $2,500 07/2012-07/2013 American Foundation for Surgery of the Hand $20,000 08/2011-08/2012 SIU Surgery Grant $2,500 02/2010-02/2011 Theresa Hegge 3-D Ultrasound/Flexor Tendo Memorial Medical Center Foundation Kelli Webb Best Practices Hand Fractures Memorial Medical Center Foundation $10,150 02/2010-02/2011 $63,307 02/2010-02/2011 Kelli Webb Therapeutic Use of Botulinum Toxin Type A to Treat Ischemia and Pain Related to Raynaud s Phenomenon Memorial Medical Center Foundation $48,300 2/2010-2/2011 Theresa Hegge Integra Application to Exposed Bone: An Animal Model Memorial Medical Center Foundation $10,630 2/2010-2/2011 Natasha Luckey Tissue Engineered Skin for Upper Extremity Wounds American Association for Hand Surgery (AAHS) $5,000 1/2010-1/2011 Brian Derby Early Growth Response Factor-1 (EGR- 1): Expression in a Rabbit Flexor Tendon SIU Dept. of Surgery $2,500 12/2009-12/2010

Resident Grant Title Funding Source Amount Funding Year(s) Damon Cooney Microsurgical Education: Using an Animal Microsurgery Teaching Protocol to Improve Resident Microsurgical Competency SIU Dept. of Surgery $2,500 12/2009-12/2010 Damon Cooney Damon Cooney Induction of Immune Tolerance in a Rat Model of Composite Tissue Allograft Transplantation Microsurgical Education: Using an Animal Microsurgery Teaching Protocol to Improve Resident and Medical Sudent Microsurgical Competency EAM (Excellence in Academic Medicine, SIU SOM Memorial Medical Center Foundation $40,000 12/2009-12/2010 $22,069 2/2009-1/2010 Brian Derby Early Growth Response Factor-1 (EGR- 1): Expression in a Rabbit Flexor Tendon Plastic Surgery Education Foundation (PSEF) $10,000 8/2009-7/2010 Brooke French, Theresa Hegge The VECTRA Volumetric 3D Surface Imaging System: Improving Patient Outcomes by Bridging the Communication Gap between Patients and Surgeons Memorial Medical Center Foundation $37,000 8/2009-7/2010 Theresa Hegge Ryan Diederich Using the Nintendo Wii TM to Improve Recovery and Compliance in Hand Therapy Integra Application on Denuded Tendon in an Animal Model Memorial Medical Center Foundation Memorial Medical Center Foundation $3,209 8/2009-7/2010 $10,833 4/2008-9- 2009 Joel Wietfeldt Is Nerve Growth within a Conduit Enhanced by the Presence of Adipocyte Derived Stem Cells? SIU Dept. of Surgery $2,500 12/2008-12/2009 Damon Cooney Induction of Immune Tolerance in Rat Hindlimb Allotransplantation by Over Expression of IL-10 and TGF-beta within the Transplant Graft American Association for Hand Surgery $5,000 2/2008-1/2009 Damon Cooney Hindlimb Allograft Immune Tolerance Induced by IL-10/TGF-beta Memorial Medical Center Foundation $22,433 8/2007-8/2008 Damon Cooney Hindlimb Allograft Immune Tolerance Induced by IL-10/TGF-beta Plastic Surgery Education Foundation (PSEF) $4,000 11/2007-10/2008

Resident Grant Title Funding Source Amount Funding Year(s) Damon Cooney Hindlimb Allograft Immune Tolerance Induced by IL-10/TGF-beta SIU Dept. of Surgery $2,500 2007 Brad Medling The Effect of Activated Protein C on Ischemia-Reperfusion Injury Memorial Medical Center Foundation $18,749 2/2006-2/2007

ROTATIONS Resident Rotation Curriculum Plastic Surgery Rotation Schedule Plastic Surgery Monthly Conference Schedule

CHANGES IN PLASTIC SURGERY RESIDENT CURRICULUM (PGY-1 to PGY-3) PGY-1 Rotation Months Gen Surgery 5 Vascular 1 Plastic Surgery 2 Burn 2 Orthopedic Trauma 1 Oculoplastic 1 PGY-2 Rotation Months Gen Surgery 2 Vascular 2 Plastic Surgery 2 Burn 2 Oral Surgery 1 Ortho Hand 1 Research 1 Head and Neck 1 PGY-3 1st six months of the year: Rotation Months Vascular 1 Pediatric Surgery 2 Head and Neck 2 Dermatology 1 2 nd six months of the year: Plastic Surgery/Burn 2 Oculoplastic 1 Research 3

2012-2013 PLASTIC SURGERY RESIDENT ROTATION SIU SCHOOL OF MEDICINE JULY AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY JUNE Chief Resident DERBY LUCKEY DERBY LUCKEY DERBY LUCKEY DERBY LUCKEY DERBY LUCKEY DERBY LUCKEY DERBY #5593 BERRY MWN BERRY BUENO MWN RUSSELL SOMMER BERRY SOMMER MWN SOMMER MWN LUCKEY #5594 MWN SOMMER MWN BERRY BUENO SOMMER BERRY RUSSELL BERRY SOMMER MWN SOMMER SHUHATOVICH #1316 HAND HAND HAND HAND HAND HAND HAND HAND HAND HAND HAND HAND PGY -5 HEGGE #5647 BUENO RCR/CMH CMH MWN BERRY BERRY MWN SOMMER RUSSELL BUENO RUSSELL NIGHTS WEBB #5648 SOMMER BERRY BABY RUSSELL SOMMER BUENO RUSSELL MWN BUENO NIGHTS BERRY BERRY PGY-4 AMALFI #4908 NIGHTS BUENO SOMMER BERRY RUSSELL MWN PLS BUENO PLS BERRY BUENO RUSSELL MALONE #4909 CMH CHM/RCR BUENO SOMMER PLS PLS BUENO PLS MWN RUSSELL NIGHTS BUENO PGY-3 HENDERSON #6087 ENT BURN NIGHTS ENT PEDS # PEDS # RESEARCH RESEARCH RESEARCH VASC DERM OCULOPLS MACIOLEK #6096 OCULOPLS NIGHTS RUSSELL DERM RESEARCH RESEARCH RESEARCH VASC VASC * PEDS # ENT ENT PGY-2 HAMMEL #6594 BURN/PLS ORAL SIU VASC * SIU BURN/PLS BURN/PLS VASC VASC RESEARCH STJ BURN/PLS MENDENHALL #6618 ORAL STJ BURN/PLS RESEARCH PEDS # STJ VASC BURN/PLS BURN/PLS VASC BURN/PLS SIU PGY-1 SCHMUCKER #5450 PLS ORTHOTR VASC STJ TRAUMA BURN OCULOPLS VASC BURN SIU/TXP PLS STJ SNIDER #5451 ORTHOTR PLS TRAUMA SIU/TXP BURN STJ VASC OCULOPLS SIU BURN SIU PLS Rotating Residents QUERY-ENT # 5438 PLS TIEU, C.-ENT # 5439 PLS ILLINGWORTH-ORTH #5437 BURN LEWIS-ORTHO # 1331 BURN PATTON-ORTHO # 1332 BURN SULAVER-URO # 5484 PLS TIEU, T-URO # 5485 PLS KOCH-VASC # 6613 PLS CMH Childrens Memorial Hospital MWN Neumeister SIU SIU General Surgery CRS Colal Rectal Surgery RCR Russell SPC Springfield Clinic GS General Surgery STJ St John s General Surgery 10/19/2012

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Plastic Surgery Monthly Conference Schedule 06:30A Core Resident Conference 06:30A MMC/SJH Hospital Faculty Meeting 06:30A Dr Zook's Board Review Conference 06:30A Pla/Ortho Combined Hand Conference 06:30A Photo Conference 06:30A Core Resident Conference 06:30A Dr Zook's Board Review Conference 06:30A Core Resident Conference 06:30A Photo Conference 06:30A Core Resident Conference 06:30A Division of Plastic Surgery Faculty Meeting 06:30A Dr Zook's Board Review Conference 06:30A Pla/Ortho Combined Hand Conference 06:30A Photo Conference 06:30A Core Resident Conference 06:30A Dr Zook's Board Review Conference 06:30A Core Resident Conference 06:30A Photo Conference Jr. Blues PGY 1-3's try to meet weekly with Dr. Neumeister to discuss requested topics. Topics are commonly those that are covered in Core Curriculum Conferences.

EVALUATION PROCESS New Innovations Sample Evaluations

PLASTIC SURGERY EVALUATION PROCESS New Innovations Residency Management System New Innovations is an internet-based residency management system adopted by SIU School of Medicine. It facilitates scheduling, attendance taking, faculty evaluation of residents, rotation evaluations, and resident s evaluation of faculty. At the end of each month the faculty will be asked to evaluate each resident that rotated through their service. If you did not work with a particular faculty member listed for you to evaluate they will select *NET (not enough time) box. All evaluations, including narrative comments will be strictly confidential. You can access your own evaluations through New Innovations and your Advisor will have access to your evaluations as well. Patients and paramedical staff will be asked to evaluate the residents on a quarterly basis. The Residency Program and staff will be evaluated by the residents and faculty on a semi-annual basis. This is a requirement of the ACGME and RRC and will help the program make appropriate changes to meet the needs of the residents.

SIU SCHOOL OF MEDICINE SEMI ANNUAL RESIDENT EVALUATION MEETING SUMMARY OF PERFORMANCE PHOTO HERE NAME: PGY LEVEL: DATE: MEDICAL SCHOOL: AOA: YES NO AREA OF INTEREST: CORE COMPETENCY EVALUATION: MEETS EXPECTATIONS SERIOUS PROBLEM 1) PATIENT CARE 2) MEDICAL KNOWLEDGE 3) PRACTICE-BASED LEARNING 4) INTERPERSONAL & COMMUNICATION 5) PROFESSIONALISM 6) SYSTEM-BASED PRACTICE CONFERENCE ATTENDANCE CATEGORY Plastic Surgery Core Conference Plastic Surgery Photo Conference Plastic Surgery Teaching Rounds Journal Club Plastic Surgery M&M Conference Department General Surgery Research Day Combined Ortho/Hand Conference # CONFERENCES PRESENT EXCUSED % ATTENDED COMPLETION OF MEDICAL RECORDS DELINQUENT PROBATION SUSPENSION INSERVICE PERCENTILE (percent of residents at particular year level whose scores were lower than individual resident) PGY-1 % PGY-2 % PGY-3 % PGY-4 % PGY-5 % PGY-6 % RESIDENT PRESENTATIONS Topic:

TEACHING EVALUATION 2008-2009 CLERKSHIP A B C D MEAN (POSSIBLE 5) STUDENT COMMENT S 2008 RECOMMENDATION: I. Advancement with statement of exemplary performance with areas that need development II. Advancement with statement of deficiencies to be improved III. Advancement with notification of one year probation and statement of deficiencies to be improved IV. No advancement with one year of probation and discussion of alternative career choices V. Unsatisfactory performance and dismissal from Program Final Summary: Reuben Bueno, M.D. Program Director Date Resident Name PGY Date Michael W. Neumeister, MD Division Chairman Date

New Innovations RMS Evaluations Faculty Evaluation of Resident Evaluator: Subject: Status: Rotation: Program: Please evaluate the performance of this resident during this rotation. Comments and suggestions about the resident's performance during this rotation will be provided to the resident verbatim. Degree of Observation 1) This evaluation is based on (2 = extensive observation, 1 = limited observation): Extensive Observation of Resident's Performance Limited Observation of the Resident's Performance Comparison to Performance of Other Residents at the Same Level of Training 2) Comparison with other house staff (5=EX,4=VG,3=G,2=F,1=P) 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor Overall Clinical Performance 3) Clinical Performance (5=EX,4=VG,3=G,2=F,1=P) 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor Clinical Performance Comments and Suggestions 4) Comments and Suggestions Regarding Clinical Performance: Clinical Performance Comments Remaining Characters: 5000 Overall Professional Behavior 5) Professional Behavior (5=EX,4=VG,3=G,2=F,1=P) 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor Professional Behavior Comments and Suggestions 6) Comments and Suggestions Regarding Professional Behavior: Professional Behavior Comments Remaining Characters: 5000 https://rms1.newinnov.com/evaluationforms/evalu...st.aspx%3fcontrol%3devaluationquestionnairegrid (1 of 3) [11/16/2010 11:24:35 AM]

New Innovations RMS Evaluations Clinical Performance Attributes - Check any of the following clinical performance attributes that you consider a serious problem for this resident at this time. 7) Serious Problem 8) Serious Problem 9) Serious Problem 10) Serious Problem 11) Serious Problem 12) Serious Problem 13) Serious Problem 14) Serious Problem Data Collection Problem Identification Diagnostic Approach Management Knowledge Self-directed Learning Habits Technical/Procedural Skills Intra-operative Decision Making Professional Behavior Attributes - Check any of the following professional behavior attributes that you consider a serious problem for this resident at this time. 15) Serious Problem 16) Serious Problem 17) Serious Problem Communication Skills Relationship with patients and their families Relationship with other medical personnel https://rms1.newinnov.com/evaluationforms/evalu...st.aspx%3fcontrol%3devaluationquestionnairegrid (2 of 3) [11/16/2010 11:24:35 AM]

New Innovations RMS Evaluations 18) Serious Problem 19) Serious Problem 20) Serious Problem Reliability and Dependability Ability to assume responsibility within level of competence (Neither under or over confident) Equanimity ("the quality of remaining calm and undisturbed") Return to Questionnaire New Innovations, Inc. 1995-2010 https://rms1.newinnov.com/evaluationforms/evalu...st.aspx%3fcontrol%3devaluationquestionnairegrid (3 of 3) [11/16/2010 11:24:35 AM]

New Innovations RMS Evaluations Plastic Surgery Residency Program Paramedical Evaluation Form Evaluator: Subject: Status: Rotation: Program: Directions: Please complete this evaluation for all plastic surgery residents you have worked with during the past two to four months. Specific comments regarding strengths and weaknesses are of most value to help the residents progress in professional development. Thank you for participating in the resident evaluation process. Reuben Bueno, MD Residency Program Director Did the resident exhibit professional behavior? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Did the resident communicate well with the patient? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Did the resident communicate well with the family? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Did the resident communicate well with the nurses? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Did the resident communicate well with other residents and students? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Did the resident communicate well with the chief resident? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Was the resident's attire appropriate? 5 4 Excellent Very Good 3 Good 2 Fair 1 Poor N/A Did the resident respond in a timely fashion to pages? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A https://rms1.newinnov.com/evaluationforms/evalu...st.aspx%3fcontrol%3devaluationquestionnairegrid (1 of 3) [11/16/2010 11:31:07 AM]

New Innovations RMS Evaluations Did the resident respond to the patient's concerns? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Is the resident thorough in their evaluations? 5 4 Excellent Very Good 3 Good 2 Fair 1 Poor N/A Do patients and their families seem satisfied with the resident's treatment? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A In your opinion, is the resident cost conscious? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Is the resident a TEAM player? 5 4 Excellent Very Good 3 Good 2 Fair 1 Poor N/A Does the resident have an ethical approach? 5 4 Excellent Very Good 3 Good 2 Fair 1 Poor N/A Does the resident show empathy to the patient's conditions and concerns? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Does the resident perform medical procedures effectively? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Does the resident perform medical procedures promptly? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Does the resident counsel and educate the patient and their families? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A Do you read the resident's notes? Yes No N/A If Yes, are they thorough and understandable and are they legible? 5 Excellent 4 Very Good 3 Good 2 Fair 1 Poor N/A https://rms1.newinnov.com/evaluationforms/evalu...st.aspx%3fcontrol%3devaluationquestionnairegrid (2 of 3) [11/16/2010 11:31:07 AM]

New Innovations RMS Evaluations Was the resident respectful? 5 4 Excellent Very Good 3 Good 2 Fair 1 Poor N/A Was the resident compassionate? 5 4 Excellent Very Good 3 Good 2 Fair 1 Poor N/A Have you witnessed any aggressive or inappropriate behavior from the resident? Yes No N/A If Yes, please specify: Comments Remaining Characters: 5000 Overall Comments: Remaining Characters: 5000 Return to Questionnaire New Innovations, Inc. 1995-2010 https://rms1.newinnov.com/evaluationforms/evalu...st.aspx%3fcontrol%3devaluationquestionnairegrid (3 of 3) [11/16/2010 11:31:07 AM]

New Innovations RMS Evaluations Patient Satisfaction Survey Evaluator: Subject: Thank you for your time in completing this satisfaction survey. We wish to assess the overall professionalism of our residents and to insure your satisfaction through ongoing review such as these surveys. Your time in completing this survey is deeply appreciated. Should you have further comments or concerns, please do not hesitate to write down these at the end of the survey. Thank you again. Reuben Bueno, MD Residency Program Director 1) Did the resident introduce him or her self? Yes Somewhat No N/A 2) Did the resident maintain a courteous attitude? Yes Somewhat No N/A 3) Did the resident discuss the present medical issues with you? Yes Somewhat No N/A 4) Did the resident respond to your answers? Yes Somewhat No N/A 5) Did the resident listen to your concerns? Yes Somewhat No N/A 6) Did you notice good rapport with the nurses and attending physician? Yes Somewhat No N/A 7) Did you feel comfortable with the resident? Yes Somewhat No N/A 8) Did the resident maintain a professional disposition? Yes Somewhat No N/A 9) Was the resident respectful? Yes Somewhat No N/A 10) Was the resident compassionate? Yes Somewhat No N/A 11) Was the resident's behavior improper? Yes Somewhat No N/A https://rms1.newinnov.com/evaluationforms/evalu...st.aspx%3fcontrol%3devaluationquestionnairegrid (1 of 2) [11/16/2010 11:32:22 AM]

New Innovations RMS Evaluations 12) Did the resident seem rushed? Yes Somewhat No N/A 13) Would you want the resident to be your primary doctor? Yes Somewhat No N/A 14) Was the resident sensitive to age? Yes Somewhat No N/A 15) Was the resident sensitive to gender? Yes Somewhat No N/A 16) Was the resident sensitive to culture? Yes Somewhat No N/A 17) Did the resident demonstrate honesty? Yes Somewhat No N/A 18) Did the resident demonstrate commitment? Yes Somewhat No N/A 19) Did the resident demonstrate dependability? Yes Somewhat No N/A 20) Were you satisfied with the encounter with this resident? Yes Somewhat No N/A Overall Comments: Remaining Characters: 5000 Return to Questionnaire New Innovations, Inc. 1995-2010 https://rms1.newinnov.com/evaluationforms/evalu...st.aspx%3fcontrol%3devaluationquestionnairegrid (2 of 2) [11/16/2010 11:32:22 AM]

SIU RESIDENT POLICIES Resident Fact Sheet Institutional Policy for Resident Duty Hours Plastic Surgery Policy for Resident Duty Hours Late Start Policy Closure Reduction Policy Impairment Policy Licensing Examination Policy Selection & Promotional Policy Employment Authorization Policy (Visa Status Policy) Vacation & Other Leaves of Absence Policies Delinquent Medical Record Policy Academic Deficiency Policy Due Process & Resident Complaint Policy

2012-2013 RESIDENT FACT SHEET (for Springfield Programs) Stipends for 2011-2012 PGY I $47,348.00 PGY V $54,308.00 PGY II $48,793.00 PGY VI $56,408.00 PGY III $50,575.00 PGY VII $58,666.00 PGY IV $52,382.00 2012-2013 Stipends will be posted on SIU website by January 1, 2012. http://www.siumed.edu/resaffairs/residentinfo/policies.html Vacation/Sick/Bereavement/Education Leave All residents/fellows may be permitted up to 3 weeks of vacation 2 weeks of sick leave 1 week of educational leave 3 calendar days of bereavement leave Child Care Leave Residents and Fellows may be permitted to take up to twelve (12) weeks of leave without compensation in accordance with the Family and Medical Leave Act of 1993, after the birth of a child or the placement of a child with the resident/fellow for adoption or foster care. Duty Hours Each program will have duty hours optimal to the care of patients and in compliance with the general and special requirements of the ACGME. Parking/On Call Rooms/Meals All residents are provided with free parking. Secured sleeping rooms are furnished for all residents who are on in-house call. Meals are provided free of charge to all residents while on in-house call. Benefits Residents are employed by either Memorial Medical Center or St. John s Hospital, and are provided benefits through their employing hospital. Health insurance is provided at a minimal charge; an optional family plan can be purchased. Dental insurance is provided for the resident and family at a small fee. Life insurance is provided at no cost; additional coverage may be purchased. Disability insurance is provided at no cost. Additional disability insurance is available. Professional Liability Insurance Residents and fellows are provided professional liability coverage through their employing hospital. It will provide legal defense and protection against awards from claims reported or filed after the completion of the residency program if the alleged acts or omissions of the resident were within the scope of the residency program, in accordance with the affiliated hospitals self-insured trust and liability policy.

INSTITUTIONAL POLICY FOR RESIDENT DUTY HOURS The Graduate Medical Education Committee insures that individual training programs remain in compliance with their Residency Review Committee (RRC) Duty Hour Requirements through the following processes: 1. Residents must be provided with adequate opportunities to rest and sleep when on duty for 24 hours or more. On-call rooms to permit rest and privacy must be available for each resident on night duty in the hospital. 2. The educational goals and objectives of the program and the resident learning objectives must not be compromised by excessive reliance on residents to fulfill service obligations. Duty hours, however, must reflect the fact that responsibility for continuing patient care is not automatically discharged at specific times. Programs must ensure adequate backup support when patient care responsibilities are difficult or prolonged. 3. Resident duty hours and on-call periods must not be excessive. The structuring of duty hours and on-call schedules must focus on the needs of the patient, continuity of care, and the educational needs of the resident. Duty hours must be consistent with ACGME Requirements. The program director is responsible for monitoring resident activities to ensure that resident fatigue does not contribute to diminished learning or performance or detract from patient safety. 4. The individual contract for every resident will include the specific ACGME duty hour requirements. This makes compliance with the duty hour requirements a contractual obligation to every resident. 5. This policy shall apply to residents and fellows in both accredited and non-accredited training programs. 6. Compliance with this Duty Hour Policy will be monitored in the following ways: a. New Innovations Duty Hour Violation Reports can be generated at any time by each program to assist in monitoring resident and fellow duty hours. The Office of Residency Affairs will regularly generate reports for all residents and fellows for review by the GMEC. b. Residents may report concerns related to duty hours by completing and submitting a confidential duty hour complaint via the Residency Affairs web site, or by contacting the Designated Institutional Officer (DIO) or their delegate on the House Staff Board of Directors. c. Any reports of concerns related to duty hours or excessive institutional service obligations (scut work) will be promptly addressed with the program so that compliance can be assured at all times. d. Internal Reviews of the programs will always address work hour issues. e. End of year evaluation will address work hour issues. f. The DIO will report annually on compliance with ACGME duty hour requirements to the medical staff and governing body of each major participating JCAHO accredited hospital. Approved by the GMEC April 1, 2002 Amended and approved by GMEC on November 8, 2002 Amended and approved by the GMEC on March 21, 2003 Revised and Adopted by GMEC on November 16, 2007

Plastic Surgery Residency Program Duty Hours Policy Revised July 1, 2011 PLASTIC SURGERY Resident duty hours should be given to provide the resident with optimal opportunity for an excellent education experience while assuring the excellent continuity of patient care. The following guidelines are to be observed. (Home call) Residents are not required to stay in the hospital for their 24 hour of call. (1 in 7) Residents will take 1 day in 7 free of all educational and clinical responsibilities, averaged over a 4-week period. (1 in 3) A resident will be on call no more than every third night. (80 hours) Residents will be limited to 80 duty hours per week, averaged over a 4-week period. The duty hour time includes clinical and academic activities (conferences, lectures, faculty meetings). (Back-up) (PGY-1) A resident on call will always have a back-up resident so that patient care is not jeopardized during or following assigned periods of call. Residents must not exceed 16 hours in duration. Residents should have 10 hours, and must have eight (8) hours, free of duty between scheduled duty periods. Note: Duty hours do not include reading and preparation time spent away from the duty site. Resident duty hours will be monitored on a monthly basis by the Program Director. Faculty with post-call residents assigned to them for clinical or surgical duty, will be responsible for ensuring the resident's release from duty at the appropriate time. Faculty will monitor residents on a daily basis for signs and symptoms of fatigue and the negative effect of sleep-deprivation. Vacation and/or Sick days cannot be used as your 1 day free of all educational and clinic duties. If one week of vacation is taken, your average hours for the month are averaged over 3 and not 4 weeks

GUIDELINES FOR RESIDENTS WHO START LATE Incoming residents are contractually bound to start on time. If a resident is unable to start work by July 15th, the program director may, at his or her discretion, hold the position until September 1st. Any positions held beyond September 1st must have the approval of the DIO/Chair of the GMEC and the prospective employing hospital. If residents start before the 15 th day of the normal start date for their class and meet all other requirements, they may finish their first year on cycle with their class the following year. Residents starting more than 2 weeks late will not be allowed to make up missed time by forsaking their vacation and education leave. Such efforts to accelerate training and graduate on cycle are inappropriate and create inconsistencies within and between training programs. Residents who find themselves in a delayed start date are encouraged to attend and participate in the Orientation of New Residents. These guidelines will be followed by all programs. Exceptions will be brought before the GME Committee. Adopted by the GMEC 6/12/98 Amended and Approved by GMEC June 15, 2007

RESIDENCY PROGRAM CLOSURE/REDUCTION POLICY In the event that it becomes necessary for Southern Illinois University School of Medicine and its Affiliated Hospitals to reduce the size of a residency program or to close a residency program, the institution will inform its residents as soon as possible. Should such a reduction or closure become inevitable, the institution will make every effort to allow those residents in the program to complete their education at SIU School of Medicine and the Affiliated Hospitals. If any residents are displaced by the program or a reduction in the number of residents in a program, the institution will make every effort to assist the residents in identifying a program in which they can continue their education. Adopted by the GMEC on June 13, 1997 Reviewed and Approved by the GMEC on October 19, 2007

Impairment Policy Of SIU School of Medicine and Affiliated Hospitals For Residency and Fellowship Programs I. Introduction A definition of IMPAIRMENT for purposes of this policy: A physical or mental condition which causes a resident/fellow to be unable to practice medicine with reasonable care and safety commensurate with his/her level of training. Impairment of performance by resident/fellow physicians can put patients at risk. Impairment will be managed as a medical/behavioral illness. Implicit in this concept is the existence of criteria permitting diagnosis, opportunity for treatment, and, with successful progress toward recovery, the possibility of returning to work in an appropriate capacity. Impairment may result from depression or other behavioral problems, physical impairment, medical illness, and/or substance abuse and consequent chemical dependency. Untreated or relapsing impairment is not compatible with safe clinical performance. The goals of this policy are: 1. To prevent or minimize the occurrence of impairment, including substance abuse, among residents and fellows at SIU School of Medicine and Affiliated Hospitals. 2. To protect patients from risks associated with care given by an impaired resident/fellow physician. 3. To compassionately confront problems of impairment to effect diagnosis, relief from patient care responsibilities if necessary, treatment as indicated, and appropriate rehabilitation. In achieving these goals, several principles are involved: 1. The safety of the patients and the care for the impaired individual are of prime importance. 2. The privacy and dignity of the affected individual should be maintained to the fullest extent possible. 3. An Employee Assistance Program will help facilitate education, diagnosis and management. 1

II. Signs and Symptoms of Impairment Signs and symptoms of impairment may include, without limitation, the following: 1. Physical signs such as fatigue, deterioration in personal hygiene and appearance, multiple physical complaints, accidents, eating disorders. 2. Disturbance in family stability or evidence of personal or professional relationship difficulties with resulting isolation. 3. Social changes such as withdrawal from outside activities, isolation from peers, embarrassing or inappropriate behavior at parties, adverse interactions with police, driving while intoxicated or under the influence, undependability and unpredictability, aggressive behavior, argumentativeness, or unusual financial problems. 4. Professional behavior patterns such as unexplained absences, spending excessive time at the hospital, tardiness, decreasing quality or interest in work, inappropriate orders, behavioral changes, altered interaction with other staff, inadequate professional performance, or significant change in well-established work habits. 5. Behavioral signs such as mood changes, depression, slowness, lapses of attention, chronic exhaustion, risk taking behavior, excessive cheerfulness, flat affect. 6. Signs of drug use or alcohol abuse such as excessive agitation or edginess, dilated or pinpoint pupils, self-medication with psychotropic drugs, stereotypical behavior, alcohol on breath at work, uncontrolled drinking at social events, blackouts, binge drinking, changes in attire (e.g., wearing of long sleeve garments by parenteral drug users). Repeated evaluations documenting substandard academic performance or other grounds for consideration by the residency/fellowship program director of academic probation or remedial academic work, existing in conjunction with one or more sign(s) or symptom(s) of impairment, such as those listed above, may be considered in determining whether or not medical and/or psychiatric evaluation of the resident/fellow in accordance with Section III.D.4. or III.E.2. is warranted. III. Policy Implementation A. Education -- In an attempt to minimize the incidence of impairment, residents/ fellows are educated about physician impairment, including problems of substance abuse, its incidence and nature and risks both to the involved individuals and patients. Education includes knowledge concerning signs and symptoms of impairment, emphasizing detection of abnormal behavior associated with use of psychoactive drugs and alcohol abuse. 2

B. Counseling -- An assistance program will provide individual counseling both to supervisors and to individuals in need. In the latter case, reasonable efforts will be made to maintain confidentiality, subject to any reporting requirements imposed by law. C. Assessment -- Evaluation of impaired status: For both new residents/fellows with a history of impairment and current residents/fellows who experience impairment and/or for whom evidence of substance abuse exists, assessment of impairment will be performed under the auspices of an Employee Assistance Program of the employing hospital in consultation with the appropriate program director and the Designated Institutional Official to determine appropriate care and monitoring. D. Management: 1. Each program director, after consultation with appropriate resources and the employing hospital, is responsible for certifying the functional status of all residents/fellows and for judging whether functional impairment exists in an individual. When an individual with impairment is identified, the residency/fellowship program director will report this to the Designated Institutional Official. 2. Each resident/fellow, as a condition of employment, agrees to accept the decision of the program director and employing hospital. Should the program director and/or the employing hospital conclude, after consultation with the Employee Assistance Program or other appropriate individuals, that a resident/fellow is suffering from impairment, including substance abuse, he/she may immediately take appropriate action, which may include placing the impaired individual on a medical leave of absence with or without suspension from the training program. 3. If it is determined that the resident/fellow s impairment may adversely affect patient care, he/she may be suspended from the training program. 4. Appropriate action may also require medical and/or psychiatric evaluation. The sponsoring institution will use its best effort to select a physician and/or psychiatrist acceptable to the resident/fellow. 5. A written Return to Work Agreement with the resident/fellow, the School of Medicine and the employing hospital may be required. In this case, return from leave of absence for impairment shall be based upon written recommendations of an approved treatment program and agreement of the employing hospital and Program Director. E. Reporting Process -- All medical personnel have a duty, in part required by ethical concern for the well-being of patients and one s fellow professionals and in part as 3

mandated by state law, to report in confidence concerns about possible impairment both in themselves and in others to an appropriate supervisor. If a resident/fellow is observed to be impaired/disabled while engaged in the performance of his or her duties, the course of action shall be as follows: 1. The observer shall report his/her concern immediately to a responsible supervisor, ultimately the residency/fellowship program director. 2. When impairment is suspected, the program director shall seek assistance from the Designated Institutional Official. The Designated Institutional Official will ascertain the need for help, and facilitate an intervention leading to further professional evaluation and possible inpatient or outpatient treatment. Under such circumstances further professional evaluation may be required, including a medical and/or psychiatric evaluation. 3. The program director will notify the Designated Institutional Official, appropriate officials of the employing hospital and/or other appropriate persons. In consultation, a decision will be made regarding any leave of absence and, 1) information will be made available to the resident/fellow on the effects the leave of absence will have upon training and, 2) an evaluation will be made of the need to report such a leave of absence to the Illinois Department of Financial and Professional Regulation. 4. Appropriate and complete documentation of the actions taken under paragraphs E.1. through E.3. shall be performed and maintained. Such documentation shall be permanently retained and filed securely and separately from the records of the resident/fellow. 5. Should a resident/fellow about whom concern has been expressed, be determined by the sponsoring institution not to be impaired, the individual will be allowed to return to his/her residency/fellowship program without prejudice, provided that he/she is capable of performing his/her duties with reasonable care and safety commensurate with his/her level of training. 6. Should a resident/fellow dispute the findings made or actions taken under this Impairment Policy, he/she shall follow the Resident Grievance Procedure to resolve the disputed issues. IV. Policy Regarding the Use of Psychoactive Drugs by Residents/Fellows A. Use of controlled substances must be by prescription of a physician. Unprescribed use of controlled substances is illegal. Unprescribed use of non-controlled psychotropic drugs is inappropriate. Evidence of such use will result in evaluation for possible treatment and may be grounds for immediate suspension and ultimate termination. 4

B. For the purpose of this policy, use of alcohol during working hours, and particularly when one is engaged in patient care, is completely inappropriate. When one is on call, any use of alcohol that either produces or appears to produce (e.g. odor of alcohol on breath) evidence of behavioral impairment is also regarded as inappropriate. C. All residents/fellows, as employees of SIU affiliated teaching hospitals will be subject to the drug screening guidelines of these institutions. These guidelines are specifically articulated in the employment policies of each affiliated hospital. In general, the employing hospital reserves the right to perform drug screening if a resident/fellow s presence, behavior, or performance suggests intoxication or illegal drug use. Adopted by GMEC 6/13/97 Revised and adopted by GMEC 4/13/01 Revised and Adopted by GMEC on November 16, 2007 5

POLICY REGARDING LICENSING EXAMINATIONS RESIDENTS WITH MD DEGREE I. All MD applicants to residency programs at SIU School of Medicine are required to pass Parts I and II of the United States Medical Licensing Exam (USMLE) before beginning a PGY-1 position. II. During the PGY-II year, all MD residents in SIU School of Medicine training programs must pass Part III of the USMLE. Progression to the PGY-III year will not be allowed until the exam has been passed. RESIDENTS WITH DO DEGREE I. All DO applicants to residency programs at SIU School of Medicine are required to pass Parts I and II of the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX) before beginning a PGY-1 position. II. Before the end of the PGY-II year, all DO residents in SIU School of Medicine training programs must pass Part III of the COMLEX. Progression to the PGY-III year will not be allowed until the exam has been passed. TRANSFERRING RESIDENTS I. Residents transferring from another program to a residency or fellowship program at SIU School of Medicine at the PGY-III level or higher are required to have passed USMLE Part III or Part III of the COMLEX prior to starting their position. FELLOWS I. All applicants to fellowship programs at SIU School of Medicine are required to pass USMLE Part III or Part III of the COMLEX before beginning a fellowship position. The Designated Institutional Official (DIO) of SIU School of Medicine must approve exceptions to this policy in consultation with the resident s employing hospital. Approved by the GMEC September 13, 2002 Amended and approved by the GMEC April 18, 2003

SELECTION, EVALUATION, SUPERVISION, GRADED RESPONSIBILITY, PROMOTION/NON-PROMOTION AND DISMISSAL OF RESIDENTS POLICY SELECTION The selection of residents in each program shall be carried out by the Residency Program Director with the assistance of the teaching staff. Programs will select applicants who are eligible for appointment to accredited residency programs. (See Policy on Resident Eligibility and Employment Authorization) Programs will select applicants on the basis of their preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities such as motivation and integrity. Programs will not discriminate with regard to race, religion, national origin, citizenship, sex, age, handicap or other factors prohibited by law. The School of Medicine will participate in the National Resident Matching Program as an Institution. EVALUATION Each residency program must demonstrate that it has an effective plan for assessing resident performance throughout the program and for utilizing the results to improve resident performance. This plan should include 1. The use of methods that produce an accurate assessment of residents competence in patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. 2. Mechanisms for providing regular and timely performance feedback to residents that includes at least Written semiannual evaluation that is communicated to each resident in a timely manner The maintenance of a record of evaluation for each resident that is accessible to the resident. 3. A process involving use of assessment results to achieve progressive improvements in residents competence and performance. Appropriate sources of evaluation include faculty, patients, peers, self, and other professional staff. The program director must provide a final evaluation for each resident who completes the program. The evaluation must include a review of the resident s performance during the final period of education and should verify that the resident has demonstrated sufficient professional ability to practice competently without direct supervision. The final evaluation must be part of the resident s permanent record maintained by the institution. SUPERVISION Supervision of the residents shall be carried out by the designated teaching faculty under the direction of the Residency Program Director, and in accordance with the SIU Policy on Patient Care Activities and Supervision Responsibilities for GME Trainees and Attending Physicians. It shall be the Residency Program Director s responsibility to see that such supervision is adequate and appropriate to maintain both the optimal education environment and excellent quality of 1

patient care. Residents will be supervised by teaching faculty in a way that gives residents progressively increasing responsibility according to their level of education, ability and experience. Availability of the teaching staff will be structured in a way to ensure appropriate supervision. Determining the level of responsibility for each resident will be the responsibility of the Residency Program Director with input from the teaching staff. GRADED RESPONSIBILITY The responsibility given to residents in patient care should depend upon each resident s knowledge, problem-solving ability, manual skills, experience, and the severity and complexity of each patient s status. PROMOTION / NON-PROMOTION The criteria for advancement shall be based upon the following parameters, all of which need to be judged as competent for each level of advancement: A. Medical Knowledge B. Clinical Competence in Patient Care C. Interpersonal and Communication Skills D. Professionalism (includes absence of impairment) E. Attitudes F. Practice-Based Learning and Improvement G. Systems-Based Practice Specific criteria and requirements for advancement from one year to the next will be set by each individual program. In general, the following will be required for promotion from one training level to the next: PGY 1 to PGY 2: Acceptable progress in areas A through G Ability to supervise PGY1 s and students Ability to act with limited independence PGY 2 to PGY X: Acceptable progress in areas A through G Ability to supervise/teach Ability to act with increasing independence PGY X to Graduation: Competence in areas A through G Ability to act independently 2

Policies with respect to promotion/non-promotion to the subsequent year of training shall comply with the General and Special Essentials pertaining to that program. The decision for promotion or non-promotion shall be made by the Residency Program Director with consultation from the teaching faculty. A decision to withhold advancement or deny reappointment shall be taken only after documented counseling of the resident apprising him/her of the reason for such potential action, and documentation that the deficiencies have not been sufficiently corrected within a reasonable time. Notice to the resident that he/she will not be retained or promoted in the program for the upcoming contract year should occur four months prior to the expiration of the current contract whenever possible. If a resident believes that he/she has been dealt with unfairly in the above process, redress may be sought through the Resident Grievance Procedure. DISMISSAL Dismissal or non-promotion of a resident whose performance is unsatisfactory will be communicated in writing to the resident in accordance with GMEC policies on academic deficiencies and corrective action. Appeals of dismissal actions shall be handled through the Resident Grievance Procedure. Approved by GMEC on 10/16/98 Amended and approved by the GMEC on November 8, 2002 Amended and approved by the GMEC June 20, 2003 Amended and approved by the GMEC October 19, 2007 Amended and approved by the GMEMC October 16, 2009 3

POLICY ON RESIDENT ELIGIBILITY AND EMPLOYMENT AUTHORIZATION Southern Illinois University School of Medicine does not discriminate on the basis of race, religion, national origin, citizenship, sex, age, handicap or other factors prohibited by law in its Residency Programs. Eligible applicants must be graduates of medical schools accredited by the LCME, graduates of colleges of osteopathic medicine accredited by the AOA, or medical school graduates holding a valid certificate from the ECFMG or having completed a Fifth Pathway program provided by an LCME accredited medical school. Employment in an affiliated hospital is a required component of the residency program and, thus, all applicants accepted for admission into the Residency Programs will be required by law to provide verification of U.S. employment authorization in the United States at the commencement of employment as a resident with an affiliated hospital. The School of Medicine and its affiliated hospitals do not, as a matter of policy or practice, sponsor residents for H visas or benefits, except under extraordinary circumstances, as determined by the affiliated hospitals and the Office of Residency Affairs. Approved by the GMEC October 16, 2009

VACATION AND OTHER LEAVES OF ABSENCE POLICIES Provides the resident with vacation, educational leave, family and medical leave, parental leave, bereavement leave, sick leave and military leave as follows: VACATION* The resident may be permitted to take up to three (3) weeks per year of paid vacation.# A week of vacation will be defined as 5 weekdays (Monday Friday) and 2 weekend days (Saturday Sunday). Use of vacation leave shall be subject to approval in advance by the Program Director with the concurrence of the Affiliated Hospital. In determining whether to grant the resident s request for vacation, the Program Director may take into consideration patient care and the operational needs of the residency program. The resident shall be responsible for arranging appropriate coverage of patient care and other obligations as necessitated by the requested vacation; which arrangements shall be coordinated by the chief resident and the Program Director. Delinquent medical records, time records, logs and evaluations must be made current before the resident begins vacation. The resident shall not be entitled to accumulate unused vacation leave beyond the term of appointment. If the physician appointment is terminated in the middle of the year, the vacation the resident has available to him/her will be pro-rated by month. Residents who leave mid-contract will not have access to all 3 weeks of vacation. Residents who leave the country for vacation or other reasons and are then unable to return to the US may not have their position held beyond the approved vacation time granted by the Program Director, at the sole discretion of the Program Director and the Affiliated Hospital. EDUCATIONAL LEAVE The resident may be permitted to take up to one (1) week per year of paid educational leave at the discretion of the Program Director.# Use of educational leave shall be subject to approval in advance by the Program Director with the concurrence of the Affiliated Hospital. In determining whether to grant the resident s request for educational leave, the Program Director may take into consideration patient care, the operational needs of the residency program and the educational value to the resident of the requested educational leave. The resident shall be responsible for arranging appropriate coverage of patient care and other obligations as necessitated by requested educational leave, which arrangements shall be coordinated by the chief resident and the Program Director. Delinquent medical records, time records, logs and evaluations must be made current before the resident begins educational leave. The resident shall not be entitled to accumulate unused educational leave beyond the term of appointment. FAMILY AND MEDICAL LEAVE The resident may be permitted to take up to twelve (12) weeks per year of family and medical leave without compensation (other than paid vacation and/or sick leave used in accordance with 1

the policies of the Affiliated Hospital) during the term of appointment, in accordance with the Family and Medical Leave Act of 1993, state law, and the policies of the Affiliated Hospital. The resident shall make requests for family and medical leave in accordance with the existing policies of the Affiliated Hospital and should consult those policies for further information. BEREAVEMENT* The resident may be permitted to take up to three (3) calendar days per year of paid bereavement leave for a member of his/her immediate family, subject to approval in advance by the Program Director with the concurrence of the Affiliated Hospital. For these purposes, the immediate family is defined as spouse, child, parent, brother, sister, grandparent, grandchild, and corresponding in-laws. The policy of the Affiliated Hospital will be followed. The resident shall not be entitled to accumulate unused bereavement leave beyond the term of appointment. SICK LEAVE* The Resident may be permitted to take up to two (2) weeks per year of paid sick leave, to be used in accordance with the existing policies of the Affiliated Hospital. # If the resident is successful in being re-appointed to the residency program, sick leave may be accumulated and carried to successive appointment years. Sick days shall be documented by the program coordinator and an up-to-date report of the number of sick days used by the resident shall be available from the residency program and/or the Office of Residency Affairs. All paid sick leave not taken is forfeited and is not compensated upon termination of the resident s contract. PARENTAL LEAVE Maternity Leave Maternity leave will be granted upon request to all pregnant residents. The resident may be permitted to take up to a total of twelve (12) weeks of family and medical leave per year without compensation in accordance with the federal Family and Medical Leave Act of 1993, state law, and the policies of the Affiliated Hospitals. Maternity leave will be paid leave by initially using any available sick (up to 2 weeks) or vacation leave (up to 3 weeks). Once available vacation and sick leave is exhausted, any additional maternity leave will be family leave without pay. Maternity leave greater than twelve (12) weeks duration, except in cases of illness of mother or infant, will require approval by the Residency Program Director. Health insurance and other benefits will be provided while using vacation and sick leave. Health insurance and other benefits may be continued at the resident's expense while on family leave without pay. The pregnant resident should notify the Residency Program Director as soon as possible regarding her need for a maternity leave. The resident and program director should develop a plan regarding timing and duration of maternity leave. Leave which exceeds that period of time defined by the resident's specialty board as a leave of absence for which time need not be made up, must be made up at the end of the usual training interval. Upon return to work the resident will be reinstated without loss of training status, provided that her return is on the date previously approved by the program director. If leave is requested for more than twelve (12) weeks due to medical reasons, approval for return to the training program will be at the discretion of the Residency Program Director. For leave beyond twelve (12) weeks a doctor's certificate verifying the condition of the resident may be requested. In those cases where a resident must make up 2

time missed in order to fulfill board requirements, the resident will be paid for days worked and the institution will continue benefit coverage during the extension of training time. Schedule accommodations will meet the needs of the resident and the program (including other residents) so that special requirements of that discipline are met. Adoption The resident may be permitted to take up to twelve (12) weeks of family and medical leave per year without compensation in accordance with the federal Family and Medical Leave Act of 1993, state law, and the policies of the Affiliated Hospitals. The resident must discuss the impending adoption with the Residency Program Director in as much advance as possible, and leave should be granted to any mother or father during the first month after adoption of a child. Adoption leave will be paid by initially using any available vacation leave. Once available vacation time is exhausted, Family Leave will be unpaid and health insurance and other benefits may be continued at the resident's expense. If leave exceeds that period of time defined by the resident's specialty board as a leave of absence for which time not be made up, it will be made up at the end of the usual training interval. In those cases where a resident must make up time missed in order to fulfill board requirements, the resident will be paid for days worked and benefit coverage will continue during the extension of training time. Paternity Leave The resident may be permitted to take up to twelve (12) weeks of family and medical leave per year without compensation in accordance with the federal Family and Medical Leave Act of 1993, state law, and the policies of the Affiliated Hospitals. Such leave should be requested in as much advance as possible, and should be granted to any father during the first month after delivery or adoption of a child. Paternity leave will be paid by initially using any available vacation leave. Once available vacation time is exhausted, Family Leave will be unpaid and health insurance and other benefits may be continued at the resident's expense. If leave exceeds that period of time defined by the resident's specialty board as a leave of absence for which time need not be made up, it will be made up at the end of the usual training interval. In those cases where a resident must make up time missed in order to fulfill board requirements, the resident will be paid for days worked and the institution will continue benefit coverage during the extension of training time. ADDITIONAL TIME TO COMPLETE WORK If any specialty or sub-specialty Board requirements are more stringent than those outlined in this section, then the respective Board requirements shall govern and supersede these. In the event that the resident accumulates a total of more than the maximum allowable* days of absence from the Residency Program during a year (including vacation, educational, child care, bereavement and sick leave, suspension [with or without pay] or other absence), the resident shall be notified in writing by the Program Director as to whether such absence necessitates remedial work in order to fulfill the requirements of the Residency Program and Specialty Board. Such notification shall be provided to the resident prior to any planned leave (or at the earliest practicable time after any unplanned leave) which causes the resident to exceed this limit of absence from the Residency Program. 3

JOB SEARCH Successful career placement of the resident is a goal of the Residency Program. The Program Director may grant up to six (6) calendar days total during the last two years of training for this purpose, using prudent discretion. If approved by the RRC, this time may be counted as work days when tabulating days for RRC accreditation. ACCUMULATION OF LEAVE TIME Residency employment agreements are for a maximum of one year. The resident shall not be entitled to accumulate unused vacation, educational, job search, or bereavement leave from one period of appointment to the next. Nor shall the resident be entitled to any allowance or compensation for such leave not used during the contract period in which it is earned. MILITARY LEAVE All affiliated hospitals have current policies regarding military leave for their employees which preserve the employee s position and coordinate benefits, such as health insurance. In the event that it becomes necessary for a resident or fellow to be called into active duty, the policy of the employing hospital will become effective. It will be the responsibility of the resident to work with the appropriate employing hospital to ensure that the necessary paperwork is completed before the resident leaves for duty. # For duty hour/time reporting purposes, a number of days in a week of leave time will be determined by the respective residency program. For example, a week may be defined as 5 days (ambulatory rotation) or 6 days (inpatient rotation). * Maximum Allowable Absences Family Medicine Carbondale, Decatur, Quincy and Springfield = 31 days (Not including educational leave. 5 days educational leave allowed) Sports Medicine Carbondale and Quincy = 31 days (Not including educational leave. 5 days educational leave allowed) All other programs = 42 days Amended and Approved by GMEC April 20, 2007 Amended and Approved by GMEC December 19, 2008 Amended and Approved by GMEC March 19, 2010 to become effective June 26, 2010 4

Medical Records Completion Policy for Springfield Residents Accurate and timely completion of medical records is a core physician competency and demonstrates professionalsm. In an effort to keep medical records complete and current the Graduate Medical Education Committee at SIU School of Medicine has approved the following procedures. St. John s Hospital, Memorial Medical Center, and SIU HealthCare will work in conjunction in this effort, so that a resident with delinquent records at either hospital or any SIU Clinic will be managed in accordance with the same process, including notice of delinquent status, and, if necessary, clinical or disciplinary suspension. CLINICAL SUSPENSION Hospital Medical Records Every week St. John s Hospital and Memorial Medical Center will evaluate the completion status of medical records. Residents having incomplete medical records for 10 or more days will be identified. On the following day, day 1, an email will be sent directly to the resident from the records office. Residents also receive notification of medical records needing their attention via Saints Net or the MMC Physician Portal and they have access to these systems at all times. One week later, on day 8, delinquent residents will be paged by the medical records department (MRD) staff and advised that their medical records must be completed by 0800 3 days hence or they will be placed on DELINQUENT status. On approximately Day 10, the list of delinquent residents and medical records will be checked for completion by the MRD staff. That same day the MRD staff will either email or fax the NOTICE OF DELINQUENCY AND IMPENDING SUSPENSION to the SIU Office of Residency Affairs stating that the resident must complete his/her medical records within seven days or face SUSPENSION from clinical duties and training rotations. Such suspension will result in loss of privileges until the delinquent medical records are completed. The SIU Office of Residency Affairs (SIU ORA) will notify the Program Coordinator and Program Director of the delinquency and impending suspension. During the following seven day period, delinquent medical records will be monitored and SIU ORA will be notified when the resident has completed the medical record obligation. A resident s delinquent status will be lifted when the medical records are completed. Any resident who has not completed his/her medical records by noon of approximately day 18 will be suspended from hospital privileges, clinical duties and training rotations until the medical record obligation is met. If the determination is made at noon on Day 18 that suspension is necessary, SIU ORA will be immediately notified, and in turn notify the Program Coordinator and Program Director that SUSPENSION will start on the following day at 0800. SIU ORA will notify the HR department of the resident s employing hospital that the resident has been placed on Suspension with pay. The last moment that a resident can complete records and avoid suspension is noon on Day 18. If suspension is instituted it will take effect the following day, Day 19, and will remain in effect until

records are completed. The minimum duration of suspension is twenty-four hours. A resident cannot use vacation or leave time to make this time up. Once the medical records are completed, the MRD staff will notify the Program Coordinator and the SIU Office of Residency Affairs that the suspension has been lifted. The MRD staff will also clarify the number of days that the resident has been suspended for delinquent medical records. SIU HealthCare Clinic Medical Records Each clinical department and training program will develop appropriate internal standards for resident completion of medical records in SIU HealthCare clinics. Programs will ensure that the policies are consistent with the SIU HealthCare Medical Records Completion policy and outline expectations for resident medical records completion, methods of notification and consequences of delinquency up to and including clinical suspension. For SIU HealthCare clinic records, all medical record monitoring, notices of delinquency and decisions regarding clinical suspension are the responsibility of the program. As with St. John s Hospital and Memorial Medical Center, program suspension for SIU HealthCare clinical records delinquency will last a minimum of one day, will be with pay and will include suspension from hospital privileges, clinical duties and training rotations until the medical record obligation is met. The program coordinator will notify the Office of Residency Affairs by noon on the date of suspension. SIU ORA will notify the HR department of the resident s employing hospital that the resident has been placed on suspension with pay. Once clinic medical records are completed, the program coordinator will notify SIU ORA that the suspension has been lifted, and will report the exact dates of suspension that the program has on record. DISCIPLINARY SUSPENSION If a resident incurs either 3 instances of clinical suspension OR a cumulative number of days of clinical suspension that is equal to the number of years in their training program (i.e. 3 days for a 3 year program), he/she will then receive a 7- day disciplinary suspension with loss of clinical/hospital privileges, clinical credit and pay. This 7- day disciplinary suspension will be scheduled by the resident s Program Director at a time when it is least disruptive to the program and will in all likelihood result in a delayed graduation date. The SIU Office of Residency Affairs will notify the hospitals of the scheduled suspension without pay. If a resident incurs an initial 7-day disciplinary suspension, any subsequent instances of clinical suspension will result in an additional 7 day disciplinary suspension.

TIMELINE FOR HOSPITAL RECORDS The following diagram outlines the process for hospital medical records. The process and intervals for hospital medical records are the same at Memorial and St. John s, although the days of the week may vary between the two hospitals. Sample Calendar actual days and intervals may differ slightly between Memorial and St. John s Sunday Monday Tuesday Wednesday Thursday Friday Saturday Tentative list Validate and verify charts >10 days old Friday notification to residents/program Coordinators (Records 10 days) Day 1 (Records 11 days) Page residents to complete records by Monday Day 8 (Records 18 days) Delinquent Status: Notify SIU ORA. ORA will notify Coordinator & Director Day 11 (Records 21 days) Must complete records by noon. Day 18 (Records 28 days) SUSPENSION at 8a.m. Day 19 Amended and Approved by IRACC, January 18, 2011 Amended and approved by IRACC and GMEC September 2012

ACADEMIC DEFICIENCY POLICY Each program director is responsible for assessing and monitoring a resident s/fellow s academic and professional progress in the areas of: Medical Knowledge Clinical Competence in Patient Care Interpersonal and Communication Skills Professionalism (includes absence of impairment) Attitudes Practice-Based Learning and Improvement Systems-Based Practice Adherence to departmental, institutional and hospital policies and procedures Failure to perform adequately in any of these areas may result in corrective action, up to and including termination. If a resident/fellow is not progressing appropriately, the program has a responsibility to inform the resident/fellow of the deficiency and provide him/her with an opportunity to correct the deficiency. At times it is possible and appropriate for the program to provide extra assistance or educational experiences for the resident/fellow to aid in this. It is ultimately the resident s/fellow s responsibility to take the steps necessary to meet expectations. Notice of Deficiency Structured Feedback: All residents and fellows should be provided routine verbal and written feedback that is consistent with their educational program. Some examples of feedback techniques include verbal feedback (from supervising faculty and program director), rotation evaluations, semi-annual evaluations, summative evaluations, as well as input from patients, ancillary staff or the program s clinical competence committee. Feedback regarding serious deficiencies should be outlined for the resident/fellow, either in an evaluation form or a letter of concern. Letter of Deficiency: If a resident/fellow has been identified as having a deficiency, it is expected that he/she will receive routine structured feedback in order to identify and correct the issue. If the program director deems that routine structured feedback is not effecting the necessary improvement, or if the program director determines that the deficiency is significant enough to warrant something more than routine feedback or a letter of concern, the program director may elect to issue a Letter of Deficiency. This letter provides the resident/fellow with a) notice of the deficiency; and b) an opportunity to correct the deficiency. As much as possible, a Letter of Deficiency should describe the observed deficiency(ies), and the expected academic standard. The Letter of Deficiency should also include a timeline for reassessment or reevaluation.

A Letter of Deficiency must be cosigned by the program director and the DIO/chair of the GMEC. The program director will continue to provide the resident/fellow with feedback consistent with the Letter of Deficiency. If the resident/fellow satisfactorily resolves the deficiency(ies) noted in the Letter of Deficiency within the designated time frame, if specified, and continues to perform acceptably thereafter, the period of unacceptable academic performance does not affect the resident s/fellow s intended career development. Failure to Correct the Deficiency: If the program director determines that the resident/fellow has failed to satisfactorily correct the deficiency and/or improve his/her overall performance to an acceptable level, the program director, with input from the clinical competence committee, may elect to take further action which may include one or more of the following steps: Issuance of a new Letter of Deficiency Non-promotion to next PGY level Repeat of a rotation(s) that may extend the required period of training Extension of resident s/fellow s defined training period Denial of credit for previously completed rotations Non-renewal of resident s/fellow s contract Termination from the residency/fellowship program A decision not to promote a resident/fellow to the next PGY level, to extend a resident s/fellow s contract, to extend a resident s/fellow s defined period of training, to not renew a resident/fellow s contract, and/or to terminate the resident s/fellow s participation in a residency/fellowship program (Action(s)) would all be considered actions with potential impact on the trainee s career development. Actions may require disclosure to others upon request, including but not limited to privileging hospitals, licensure or specialty boards. If a resident/fellow is subject to an Action, he/she must be notified of this in writing. Such notification must be signed by the Program Director and the DIO/Chair of GMEC. Any resident/fellow who is not being promoted, or whose contract is not being renewed should be notified of this in writing at least four months prior to the end of the resident s/fellow s current contract, unless the primary reason(s) for such action occurs within four months prior to the end of the resident s/fellow s contract. Due Process and Request for Review: A resident/fellow who is subject to an Action may request a review of the decision as described in the Due Process and Resident Complaint Policy. A copy of the Due Process and Resident Complaint Policy should be given to any resident/fellow who is subject to an Action. Approved by GMEC February 19, 2010 to become effective June 26, 2010

DUE PROCESS AND RESIDENT COMPLAINT POLICY This policy will apply to all residents/fellows who participate in an SIU Graduate Medical Education (GME) training program. Due Process, as described within, applies to actions that are taken as a result of academic deficiencies and/or misconduct, and that may impact the intended career development of the resident/fellow. (See Academic Deficiency Policy and Professional Conduct and Misconduct Policy) Complaint refers to the review of resident/fellow complaints or issues related to the work environment or the program or faculty. Academic Matters: A decision not to promote a resident/fellow to the next PGY level, to extend a resident s/fellow s contract, to extend a resident s/fellow s defined period of training, to not renew a resident s/fellow s contract, and/or to terminate the resident s/fellow s participation in a residency/fellowship program (Action(s)) would all be considered actions with potential impact on the trainee s career development. A review of the program s decision to take an Action for academic matters may be requested by the resident/fellow. A written request for review must be submitted to the DIO/Chair of GMEC within fourteen (14) days of learning of the Action. Upon a request for review, the DIO/Chair of GMEC will first determine whether the matter is reviewable under this policy and if so, shall appoint a Review Committee. The Review Committee will be composed of two (2) full time faculty members and one (1) resident from a department or departments different than the requesting resident/fellow. The committee will make a determination whether the resident/fellow received appropriate notice of deficiency and an opportunity to correct it, and whether the decision to take the Action was reasonably made. The Review Committee will make a recommendation in this regard to the Dean of the School of Medicine and the CEO/COO of the resident s/fellow s employing hospital, who will jointly render a decision. This decision will be immediately effective, binding and final and not subject to further appeal. Prior to the Review Committee meeting, the Office of Residency Affairs (ORA) will be responsible for providing a copy of the resident s/fellow s file to the committee members. The resident/fellow and/or program director are at liberty to submit any additional relevant documentation to ORA for distribution to the committee members. Patient identifiers shall be removed from any documents. The committee will review the resident s/fellow s request for review, the resident s/fellow s file and any additional documentation provided (Materials). The review meeting will be scheduled in a timely manner. If the resident/fellow fails to attend without good cause, he/she will have been considered to have withdrawn the request for review. If the program director fails to attend without good cause, the meeting will proceed. The meeting will be attended by the three (3) committee members, the resident/fellow, program director and a representative of ORA. As this is an academic process, no attorneys or legal advisors shall be in attendance. The resident/fellow may have a faculty advisor or other support person present if he/she chooses. This support person will not be permitted to actively

participate unless requested by the chairperson of the Review Committee. The chairperson of the Review Committee will preside over the meeting, make introductions, and verify that all committee members have reviewed the Materials in advance. The resident/fellow will be given an opportunity to describe why he/she believes the Action was unwarranted and the basis for the request for review. The program director will then have an opportunity to respond to or clarify issues raised in the resident s/fellow s request for review. The committee members will then have an opportunity to ask questions of the resident/fellow and program director. The committee may interview others as they see appropriate to aid in the decision making process. If the committee identifies such individuals in advance, they will be invited to attend the meeting. Alternatively, the committee may identify individuals they need to interview after the meeting and before their deliberations. On conclusion of the committee meeting and after the committee members have had a chance to interview any other individuals they identify, the committee will deliberate without the program director and resident/fellow but with the attendance of an ORA representative. The committee will make a written report with their recommendations, along with a discussion of the rationale for the committee s decision. The ORA will be responsible for forwarding the written report along with a copy of the Materials to the Dean and the CEO/COO of the employing hospital. The Dean and CEO/COO will review the committee s written report and Materials and jointly render a decision. Misconduct Matters: A review of the decision to take an Action for misconduct matters may be requested by the resident/fellow. The review process will be the same as that for academic matters (outlined above) with the following exception: The Review Committee will make a determination whether the resident/fellow received appropriate notice and an opportunity to be heard regarding the matter at hand, and whether the decision to take the Action was reasonably made. The procedures as outlined above shall not preempt the Medical Staff By-laws or personnel codes of the hospitals and shall not preempt or limit any right of the hospitals under the Agreement With Physician (resident contract) to immediately suspend a resident/fellow. Complaint Matters: This refers to some cause of distress (such as an unsatisfactory working condition) that is felt by the resident/fellow to present a reason for complaint, but does not impact intended career development. Complaints must be dealt with in as confidential a manner as possible, and without fear of retaliation. A complaint or incident should be reported to the resident/fellow s Chief Resident or attending physician. If the Chief Resident or attending is unable to help the trainee effectively resolve the issue, the resident/fellow should take the problem to the Program Director for resolution. If satisfactory resolution is still not achieved after the Program Director has become involved, the resident/fellow may provide a written complaint report to the DIO/Chair of GMEC.

The DIO/Chair of GMEC will review the written complaint report and meet with the resident/fellow to ensure that steps as outlined above for Complaint Matters were followed. He/she may then convene other individuals deemed necessary to perform a reasonable inquiry and problem-solving process, including but not limited to the complainant s Program Director, hospital administrators, other residents/fellows or faculty, and/or human resources personnel. The DIO/Chair of GMEC and other appropriate participants will investigate all the issues associated with the complaint and will provide a final and binding decision to the resident/fellow, unless precluded by confidentiality (i.e. if a complaint culminates in a personnel action against a resident/fellow, faculty or staff member). Approved by GMEC February 19, 2010 to become effective June 26, 2010

SAMPLE DOCUMENTS AFFILIATED HOSPITAL BENEFIT PACKAGE AND AGREEMENT WITH PHYSICIAN

MEMORIAL MEDICAL CENTER Overview of Benefits for Residents Employed by MMC-2012 GROUP LIFE INSURANCE: Memorial provides 2 1/2 times annual salary of employee group term life insurance with matching accidental death & dismemberment. The maximum coverage amount is $300,000. Family Life insurance provided, coverage amount is $2500 for spouse, $1000 for each dependent child over the age of 6 months. No Cost to Employee GROUP LONG TERM DISABILITY INSURANCE: Memorial provides group coverage of 60% of salary up to a maximum of $5,000 (monthly benefit). The benefit covers disabilities that are non-work related. 90 day waiting period, must be disabled from own occupation for 2 years. No Cost to Employee GROUP MEDICAL INSURANCE: Quality PPO Plan - 100% coverage following various co-payments. Must utilize physicians from MHS Health Alliance physician listing. All hospital services must be provided by a Memorial Health System facility. PreTax Per Pay Cost = single $17.17 single+sp $40.65 single+ch(ren) $38.58 -family $50.10 ADD $13.85 TO THE ABOVE RATES IF A TOBACCO USER GROUP DENTAL INSURANCE: May enroll in group dental plan 50, 100% coverage for preventative services (e.g. teeth cleaning, oral exam, etc.), no deductible. 80 % coverage for primary services(e.g. x-rays, fillings, root canals, etc.). 50% coverage for major services (e.g. crowns, dentures, etc.). Annual deductible of $50.00 per person applied to primary and major services. $500 annual maximum per individual. PreTax Per Pay Cost = single $2.06 single+sp $4.83 single+ch(ren) $4.20 family $8.45 HEALTH/DEPENDENT CARE EXPENSE ACCOUNTS: May choose to set aside pretax dollars to reimburse self for uninsured medical expenses and day care expenses. Monthly Contributions: Health Care = $5000 annual max Dependent Care = $5000 annual max 403(b) Plan May choose between either ING or Prudential. The per pay deduction for the 403(b) is withheld before taxes and mailed to the company on behalf of the employee. CORPORATE MEMBERSHIP TO FITNESS CENTER: May join The FitClub or YMCA as a member with Memorial Medical Center and receive a discounted rate. 11/19/2012

SJH Medical Resident Summary of Benefits ST JOHN S HOSPITAL General Information MEDICAL RESIDENT BENEFIT SUMMARY Overview of Medical Resident Benefits Benefit Description Cost per Pay Period Single Family Health Insurance PersonalCare HMO $4.88 $32.07 Dental Insurance $50 deductible per person Plan pays $750 per year per person No orthodontics $0 $4.25 Long Term Disability 60% in-occupation coverage to age 65 $0 N/A Life Insurance $50,000 group term life insurance $0 N/A DENTAL PLAN COVERAGE PLAN CHARACTERISTICS Annual Deductibles Single Family Diagnostic and Preventive Services (Class I) General Restorative Services (Class II) Replacements and Other Major Services (Class III) COVERAGE $50 $150 No Deductible Plan Pays 100% After Deductible Plan Pays 85% After Deductible Plan Pays 50% Orthodontia Services (Class IV) No Coverage Yearly Maximum Benefit All Services $750

SJH Medical Resident Summary of Benefits GENERAL INFORMATION General Information Eligibility If you are a medical resident on contract with St. John's Hospital through affiliation with the SIU School of Medicine, you can elect to cover yourself, your spouse, and any unmarried dependent children ages 18 and younger. If you have unmarried dependent children ages 19 through 24 who are full-time students, they can be covered as well. At age 19, handicapped children who are currently enrolled in the health care and/or dental plan(s) may be covered beyond the standard age limits if evidence of incapacity is provided. Enrollment Enrollment in the Medical Resident Benefit Plan will occur upon your hire date. CHANGE IN OPTION Your Medical Resident Benefit Plan election made prior to the beginning of the Plan Year must remain in effect for the entire Plan Year, unless a life event occurs. The Internal Revenue Service requires strict adherence to this rule by all eligible participants. Once you have made your choice, you may not change from single to family coverage or family to single coverage; and you may not drop coverage or enroll. If you select no coverage for your dental election, you may not add dental coverage for two Plan Years. The Plan Year is defined as the calendar year (January 1 - December 31). Life Event You could experience a life event during the Plan Year which directly impacts your Benefit Plan choices for health care, dental and/or spending accounts. If your life event is a change in marital status (i.e. marriage, divorce, legal separation), loss or gain of a dependent (includes adoption) impacting plan status, loss or gain of your spouse s benefit coverage, a major continuing change in your scheduled hours or a transfer between Affiliates, you may make changes in the benefits impacted by the event. Contact your Human Resources Department within 30 days of the event for an explanation of the changes allowed by the Internal Revenue Service based on your particular situation. Paying For Benefits Before Taxes With Salary Reduction With salary reduction, (I.R.S. Code Section 125) you pay your share of your benefits program before Federal, State, and F.I.C.A. taxes are withheld from your paycheck. This actually increases your purchasing power and is a tax-efficient way to purchase your benefits coverage. So, you have a higher take-home pay than if you paid for your benefits with after-tax dollars. Insurance benefit premiums are paid with before-tax dollars. You should be aware that the use of salary reduction to purchase benefits may have a slight effect on the benefits you and your family will receive from Social Security at retirement or in the event of your disability or death. Social Security amounts are determined using a formula that takes your F.I.C.A. taxable income into account. When you convert a portion of your pay with salary reduction, you reduce your F.I.C.A. taxable income proportionately.

SJH Medical Resident General Information Summary of Benefits HEALTH CARE REIMBURSEMENT ACCOUNT Health Care Reimbursement Account Expenses Under our PLAN you may be reimbursed ONLY for health care expenses that are incurred during the PLAN YEAR and allowable deductions for Federal Income Tax. IRS Publication 502, Medical & Dental Expenses, includes a checklist of allowable and non-allowable expenses under our PLAN. YOU MAY CLAIM INCURRED EXPENSES FOR: YOURSELF and your SPOUSE Allowable DEPENDENTS you list and claim on your Federal Tax Return DEPENDENTS who could have been claimed had that person not received $2,000 or more of gross income OR had not filed a joint return. YOU CANNOT RECEIVE REIMBURSEMENT FOR: Expenses which have been reimbursed from insurance or other sources. Premiums for spouse or dependent s health insurance contribution, or life or income replacement insurances. The portion of your FICA Tax for hospital insurance. Illegal care, operations, drugs, or therapy. Travel your doctor told you to take for rest or change. Weight control programs, meals, diaper service, health club dues, household help, custodial care in an institution, marriage or family counseling or funeral expenses, nonprescription nicotine gum or patches. Due to ethical and philosophical reasons, abortions, sterilizations, and contraceptives will not be allowed as reimbursable expenses. Cosmetic surgery, electrolysis by a licensed technician, and hair transplants by a physician. Meals. Teeth bleaching and sonic toothbrush. QUALIFIED REIMBURSEMENT EXPENSE EXAMPLES: DIAGNOSIS AND THERAPY: Insulin treatments, laboratory tests, medical and dental exams, physical therapy, whirlpool treatments and X-ray. NON-PRESCRIPTION DRUGS*: Over-the-counter medications only with a physician s statement of medical necessity. HEALTH CARE AIDS: Braces & other orthodontic devices, contact lenses, crutches, dentures, glasses, guide dogs and their maintenance, hearing aids (including batteries), and wheelchairs. HEALTH CARE PROVIDER FEES: Acupuncturists, Chiropractors, Christian Science Practitioners, Dentists, Medical Doctors, Ophthalmologists, Optometrists, Osteopaths, Podiatrists, Psychiatrists, Psychoanalysts, Psychologists, Physical Therapists, and Radiologists. HOSPITAL CARE: Clinics, emergency care, inpatient care, laboratory, out patient care, therapies, and X-ray. INSURANCE: Co-Insurance, Co-Payments, and deductibles. MEDICATIONS: Drugs, medicine, vaccines, and vitamins your Doctor prescribed. NURSING SERVICES: Home health care, hospice, nursing care, visiting nurses. Note: If you pay someone to do both nursing and house work, you may only claim the expense for nursing. REQUIRED TRAVEL: Ambulance service, taxi service, and other travel costs to get medical care. If you use your own car, you may charge what you spent for gas and oil to go to and from the place you received care; or you can claim $.10 per mile. You may add parking and tolls to the amount you claim under either method. OTHER: Medical treatment for drug addiction, alcoholism, and smoking cessation programs (except as provided above). *Note: In order to receive reimbursement for non-prescription, over-the-counter drugs, your claim must include (1) a physician s written statement of medical necessity for the particular drug, and (2) a receipt which includes the date of purchase, the printed name of the drug, and its price. Receipts that are hand-written or that are for nonspecific general merchandise cannot be accepted.

SJH Medical Resident Summary of Benefits Health Care Reimbursement Account Generally, reimbursable expenses are those that are not otherwise paid by any group or individual health care insurance coverage, are incurred for the treatment of a specific medical problem and are prescribed by a licensed professional. A list of health or health care related expenses which are reimbursable through your Health Care Reimbursement Account is shown in the table. Any expenses you submit for reimbursement through your Health Care Reimbursement Account cannot be claimed again on your federal tax return. Filing a Claim General Information If you participate in the Plan, you must file a claim in order to be reimbursed for your health care or dependent care expenses. To do so, get a claim form from your Human Resources Department and submit it with receipts for your expenses. You may file claims for expenses incurred through the end of the Plan Year (December 31). If you terminate during the Plan Year, only those health care and dependent care expenses which were incurred prior to the termination date are eligible for reimbursement. You have up to 90 days after the end of the Plan Year to file claims which were incurred during the Plan Year. You may submit claims for payment at any time during the Plan Year and up to 90 days following the close of a Plan Year. You will also receive a detailed statement of your flexible spending account or accounts 90 days before the end of the Plan Year. In addition, each time you submit a claim you will receive detailed information regarding the status of your account. Reimbursement of eligible expenses will be made first from the resident s Health Care Reimbursement Account (HCRA) and then from the Supplemental Medical Reimbursement Plan only if the HCRA is exhausted. Reimbursement account checks are issued the Monday following your biweekly pay day, and they will be accompanied by an Explanation of Payment (EOP).

SJH Medical Resident General Information Summary of Benefits DEPENDENT CARE REIMBURSEMENT ACCOUNT Dependent Care Reimbursement Account (DCRA) Through this account, you can pay dependent care expenses necessary for you to work. If you re married, both you and your spouse must be working for dependent care expenses to be reimbursable. Other limitations on the use of the Dependent Care Reimbursement Account (DCRA) include: Expenses must be for a dependent you claim on your income tax return who is either under age 13 or physically or mentally incapable of caring for himself or herself (for example, an elderly parent). The dependent must spend at least eight hours a day in your home. (For this reason, nursing home care doesn t qualify). Your payments can t be made to a person you claim as a dependent, including your spouse or a child under age 19. Dependent care provided in a day care center or private home is covered. Day care centers that care for more than six people must be licensed in order for expenses to qualify. Dependent Care Tax Credit Under current law, you may take part of your dependent care expenses as a credit on your federal income tax return. For the care of one dependent, you can take a tax credit up to $1,050 for one child and $2,100 for two or more. The following table shows the current tax credit based on federal adjusted income. Any part of your expense that you apply to the federal tax credits is not eligible for reimbursement through the Dependent Care Reimbursement Account and vice versa. In most cases it will be to your advantage to use the DCRA to cover your day care expenses. However, because each person s tax situation is different you should consider whether this approach will benefit you or if you should claim these expenses when you file your tax return. DCRA Selection DEPENDENT CARE FEDERAL TAX CREDIT CHART Federal Adjusted Gross Income is: THEN Federal Tax Credit Percentage on Expense is: Maximum Amount of Tax Credit: 2 or more 1 child children Up to $15,000 35% $1,050 $2,100 15,001-17,000 34% 1,020 2,040 17,001-19,000 33% 990 1,980 19,001-21,000 32% 960 1,920 21,001-23,000 31% 930 1,860 23,001-25,000 30% 900 1,800 25,001-27,000 29% 870 1,740 27,001-29,000 28% 840 1,680 29,001-31,000 27% 810 1,620 31,001-33,000 26% 780 1,560 33,001-35,000 25% 750 1,500 35,001-37,000 24% 720 1,440 37,001-39,000 23% 690 1,380 39,001-41,000 22% 660 1,320 41,001-43,000 21% 630 1,260 43,001 & up 20% 600 1,200 Dependent care expenses are generally predictable and thus easy to budget. You usually know what your weekly or monthly cash outlay for dependent care will be. To estimate your qualified dependent care expenses, multiply the weekly charge by the weeks of care needed in the Plan Year, then divide by 26. This will be the biweekly amount you should deposit into a Dependent Care Reimbursement Account to cover your expenses.

SJH Medical Resident Summary of Benefits After you decide the amount you wish to deposit each pay period into the Dependent Care Reimbursement Account, write that amount on your enrollment form. Filing a Claim If you participate in the Plan, you must file a claim in order to be reimbursed for your health care or dependent care expenses. To do so, get a claim form from your Human Resources Department and submit it with receipts for your expenses. You may file claims for expenses incurred through the end of the Plan Year (December 31). If you terminate during the Plan Year, only those health care and dependent care expenses which were incurred prior to the termination date are eligible for reimbursement. You have up to 90 days after the end of the Plan Year to file claims which were incurred during the Plan Year. General Information You may submit claims for payment at any time during the Plan Year and up to 90 days following the close of a Plan Year. You will also receive a detailed statement of your flexible spending account or accounts 90 days before the end of the Plan Year. In addition, each time you submit a claim you will receive detailed information regarding the status of your account. Reimbursement account checks are issued the Monday following your biweekly pay day, and they will be accompanied by an Explanation of Payment (EOP).

SJH Medical Resident Summary of Benefits General Information LONG TERM DISABILITY PLAN SUMMARY Item Summary Elimination Period 180 days Benefit Level 60% Maximum Duration of Benefits See table below. ) Minimum Benefit Maximum Benefit The minimum benefits under all choices is the greater of 10% of your gross benefit offsets for other disability income you receive, or $100. $10,000 per mo. Maximum Duration of Benefits Age at Disability Less than age 60 Maximum Benefit Period To age 65 but not less than 60 months 60 60 months 61 48 months 62 42 months 63 36 months 64 30 months 65 24 months 66 21 months 67 18 months 68 15 months 69 & over 12 months

AGREEMENT WITH PHYSICIAN 2012-2013 THIS AGREEMENT, made and entered into this day of, 20 by the BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY, a body politic and corporate of the State of Illinois, located at Carbondale, Illinois, for and on behalf of Southern Illinois University School of Medicine, hereinafter referred to as the School of Medicine, and MEMORIAL MEDICAL CENTER, SPRINGFIELD, ILLINOIS, an Illinois not-for-profit corporation and an affiliate of Memorial Health System, hereinafter referred to as the Affiliated Hospital. The School of Medicine is also affiliated with St. John s Hospital, a not for profit corporation located in Springfield, Illinois. Both St. John s Hospital and Memorial Medical Center shall hereinafter be collectively referred to as Affiliated Hospitals and, a graduate of, class of, hereinafter referred to as the Physician. WITNESSETH THAT: The Physician hereby accepts the position of, in the Department of at the School of Medicine. The term of this agreement shall be for one (1) year commencing on, hereinafter referred to as the commencement date, and terminating on and shall renew automatically for additional periods, anticipated to end, at completion of the Physician s Residency or Fellowship Program, hereinafter referred to as the Residency Program, subject to adequate progression of the Physician through the Residency Program, as determined by the School of Medicine and Affiliated Hospital, or unless notice of non-renewal or termination of the Agreement is provided to the Physician. When appropriate, in the sole discretion of the Affiliated Hospital and School of Medicine, promotion of Physician will be evidenced by a renewal letter provided by the School of Medicine. This Agreement and any renewal hereof is contingent upon, without limitation, the following: proof acceptable to the School of Medicine and Affiliated Hospital that the Physician (i) has been issued a temporary or permanent license from the Illinois Department of Financial and Professional Regulation, (ii) can provide verification of U.S. employment authorization in the United States at the commencement of employment, (iii) satisfactorily completed prerequisites such as credentialing, a pre-employment health and drug and alcohol screen, criminal background check, and other routine employment processing as required by the Affiliated Hospital, and (iv) met the qualifications for resident eligibility as outlined in the School of Medicine Selection, Evaluation, Supervision, Graded Responsibility, Promotion/Non-Promotion And Dismissal Of Residents Policy, as amended from time to time, and as determined by the Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) (collectively the Requirements ). Anything to the contrary herein notwithstanding, in the event that such Requirements are not met or provided by the Physician to the Program Director by the commencement date of this Agreement or any renewal thereof, this Agreement and any renewal may be terminated without advance notice at the joint discretion of the Affiliated Hospital and the School of Medicine. In consideration of the Physician s acceptance of the aforesaid position, and of the covenants and agreements herein contained, the parties hereto do mutually agree as follows: A. THE AFFILIATED HOSPITAL SHALL: 1. Employ the Physician and pay him or her total annual compensation of ($ ) for the term of this Agreement, which compensation shall be prorated and paid on a bi-weekly basis. The amount of compensation to be paid to the Physician will be subject to adjustment on July 1 based on any standard changes in the rate of physician compensation authorized by the Affiliated Hospital during the term of this Agreement. 2. Provide the Physician with professional liability coverage under the insurance program of the Affiliated Hospital. Said professional liability coverage, whether by enrollment in a program of self-insurance, inclusion under a professional liability insurance policy or a combination Page 1

thereof, shall extend to the Physician while the Physician is performing professional duties and responsibilities as a part of the Physician s Residency Program, provided, however, that said professional liability coverage shall not apply to professional acts performed outside the scope of the Residency Program. Said professional liability coverage shall provide legal defense and protection against awards from claims reported or filed during or after the completion of the Residency Program, if the alleged acts or omissions of the Physician were within the scope of the Residency Program, in accordance with the Affiliated Hospital s self-insured trust and liability policy. 3. Provide health, dental, disability and life insurance benefits for the Physician under the employee insurance program of the Affiliated Hospital, as provided by the Affiliated Hospital s Plan Benefits, as amended from time to time. Health insurance benefits shall begin on the first recognized day of training. The Affiliated Hospital shall have the right to change such Plan Benefits during the term of this Agreement if said changes are consistent with changes made in the Plan Benefits of the Affiliated Hospital. The Physician shall have the option to include immediate family members under said insurance program at the Physician s own expense. 4. Provide designated sleeping quarters and meals for the Physicians during in-house call. 5. Provide the Physician with vacation (paid time off), educational leave, child care leave, bereavement leave, sick leave and job search leave according to the School of Medicine Vacation and Other Leaves of Absence Policy, as amended from time to time a. In the event that the Physician accumulates a total of more than calendar days of absence per year from the Residency Program during the term of this Agreement (including vacation [paid time off], educational, child care, bereavement and sick leave, suspension [with or without pay] or other absence), the Physician shall be notified in writing by the Program Director as to whether such absence necessitates remedial work in order to fulfill the requirements of the Residency Program. Such notification shall be provided to the Physician prior to any planned leave (or at the earliest practicable time after any unplanned leave) which causes the Physician to exceed this limit on absence from the Residency Program. 6. Provide the Physician with counseling, medical and psychological support services and measures to address physician impairment, including that due to substance abuse as described in the School of Medicine Impairment Policy, as amended from time to time. 7. Provide the Physician with such other benefits (including military leave), which are not inconsistent with the provisions of this Agreement, as are provided by the Affiliated Hospital through its existing policies, as applicable and amended from time to time. B. THE SCHOOL OF MEDICINE SHALL: 1. Establish and provide general supervision, guidance, and evaluation to the Physician as well as an educational program within each Department which complies with the education requirements as determined by the ACGME and/or AOA, as applicable. 2. Provide program direction and select faculty who determine resident proficiency to perform clinical duties and the degree of supervision necessary in the management and treatment of patients. 3. If approved by the School of Medicine, consult with and seek approval of the Affiliated Hospital prior to any change, expansion or extension of the Residency Program outside the facilities of the Affiliated Hospitals. 4. Adhere to duty hours which comply with the appropriate institutional and program ACGME/AOA requirements. 5. Adhere to the Residency Program Closure/Reduction Policy of the Graduate Medical Education Committee (GMEC). 6. Adhere to the ACGME/AOA or requirement to not require the Physician to sign a noncompetition guarantee. Page 2

C. THE PHYSICIAN SHALL: 1. Perform such duties as may be assigned to the Physician by the Program Director in accordance with the description of the Residency Program prepared by the Program Director and subject to the approval of the Affiliated Hospital, which duties shall be performed by the Physician conscientiously, to the best of the Physician s ability and under the highest personal bond of professional morals and ethics. As the position of the Physician involves a combination of supervised, progressively more complex and independent patient evaluation and management functions and formal educational activities, the competence of the Physician shall be evaluated by the Program Director on a regular basis with a record of the evaluation being held in the Physician s program file. Such evaluation will be part of the quality assurance program established for the purposes of reducing mortality and morbidity within the Affiliated Hospital. Under the supervision of approved credentialed attending teaching staff, the Physician shall: a. Provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health b. Demonstrate medical knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social behavioral) sciences and the application of this knowledge to patient care c. Participate in practice-based learning and improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care d. Practice interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and other health professionals e. Exhibit professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population f. Participate in systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system for health care and the ability to effectively call on system resources to provide care that is of optimal value g. Participate fully in the educational and scholarly activities of his /her program and, as required, assume responsibility for teaching and supervising other residents and students h. Participate in appropriate institutional committees and councils whose actions affect residents' education and/or patient care i. At least annually submit to the Chair of the GMEC (through the Office of Residency Affairs) a confidential written evaluation of the program faculty and of the educational experiences j. Regularly, or at a minimum of once a week, log on and review electronic mail on the Physician's School of Medicine electronic mail account 2. Abide by and at all times conform to the Corporate and Medical Staff Bylaws, Occupational Safety and Health Administration (OSHA), Health Insurance Portability and Accountability Act (HIPAA), the Illinois Department of Public Health (IDPH) infection control policies, and other rules, regulations, policies, ethical and religious directives of the Affiliated Hospitals and of the School of Medicine and all other general guidelines and moral codes, both stated and published, governing the practice of medicine; and the statutes, rules and regulations of the State of Illinois, including without limitation the Medical Practice Act and any and all other laws, rules and regulations relating to the licensing of physicians in training and the practice of medicine in the State of Illinois. Page 3

3. Accept no responsibilities for professional activities outside the scope of the Residency Program provided herein (including, but not limited to "moonlighting") unless approved in writing by the Affiliated Hospital and the Program Director, who shall have discretion as to whether or not such outside professional activities are permitted. With regard to those residency programs in which outside professional activities may be permitted, the Physician shall adhere to the policy on professional activities outside the scope of residency training as approved by the GMEC. D. Medical Specialty Board requirements applicable to the Residency Program specify that the Physician must perform months of actual service in a -month period. Anything in this Agreement to the contrary notwithstanding, it is understood and agreed by the Physician that if, because of approved leave or other absence, the Physician does not meet said Board requirements, it may be necessary for the Physician to extend the duration of the Residency Program until said Board requirements have been satisfied. E. The Physician agrees to abide by a risk management and quality control program which shall provide, without limitation, for the following: 1. The joint review of the Physician's credentials by the Affiliated Hospital and the School of Medicine. 2. The joint indoctrination of the Physician with respect to the Physician's responsibilities to the patient, the School of Medicine, and the Affiliated Hospital. 3. The suspension of the Physician for an indefinite period of time, for failure to comply with this Agreement or for reasonable cause, by the appropriate officials of the School of Medicine or the Affiliated Hospital. If such an event occurs, the Physician may be suspended from training and clinical duties without compensation as identified herein. 4. Compliance by the Physician with the School of Medicine s policy regarding licensing examinations. 5. Compliance by the Physician with regulations regarding completion of medical records at the Affiliated Hospitals and the School of Medicine. 6. Compliance by the Physician with regulations regarding completion of time records at the Affiliated Hospitals and the School of Medicine. 7. Compliance with all required education modules including on-line modules as proscribed by the Affiliated Hospitals and/or the School of Medicine. F. This Agreement may be terminated at any time by joint decision of the Affiliated Hospital and the School of Medicine, in which case the Physician's compensation specified herein will be prorated to the date of termination and the Physician will be paid for vacation (paid time off) earned but not used prior to the date of termination. In the event that a request for review is filed by the Physician under the Due Process and Resident Complaint Policy, as amended from time to time, pay and benefits may be continued at the discretion of the Affiliated Hospital. Decisions regarding advancement in the program will be made in accordance with the Selection, Evaluation, Supervision, Graded Responsibility, Promotion/Non-Promotion And Dismissal Of Residents Policy, as amended from time to time. G. The Physician shall be notified in writing by the Program Director, subject to the approval of the Affiliated Hospital, in the event the Physician's contract shall not be continued or if he or she will not be promoted to the next level of training for the following year. Said notice shall be provided at least four months prior to the expiration of the contract year or when a resident will not be promoted to the next level of training. As of the same date, the Physician shall notify the Program Director in writing of an intention not to return for the following year. However, if the primary reason(s) for the non-renewal or non-promotion occurs within the four months prior to the end of the agreement, the Program Director will provide the Physician with as much written notice of the intent not to renew as the circumstances Page 4

will reasonably allow, prior to the end of the agreement. H. In the sole discretion of the Affiliated Hospital and School of Medicine, if progression of the Physician through the Residency Program and extension of the Physician s time in the Residency Program is appropriate, an extension letter may be provided by the School of Medicine. I. It is the policy of the School of Medicine and the Affiliated Hospitals to maintain an environment which is free from all forms of harassment based on a person's legally protected status (including race, sex, national origin, religion, military status, age and disability) and sexual harassment (herein after referred to as harassment), improprieties and intimidation. The Physician is entitled to the protections afforded by these policies while serving as a resident hereunder. The Physician agrees to abide by the School of Medicine's and the Affiliated Hospitals respective policies regarding equal employment, sexual harassment and harassment on the basis of other protected status as set forth above. The Physician acknowledges that failure to abide by these policies may result in immediate termination of this Agreement. Allegations of discrimination and/or harassment will be addressed in accordance with the applicable policies of the School of Medicine or the Affiliated Hospital. J. The Physician agrees to abide by all standards outlined in the (225 ILCS 60/) Medical Practice Act of 1987. Any violations of that Act, including but not limited to Section 22, or other instances of ethical or moral turpitude is grounds for immediate termination and therefore cannot be requested for review under the Due Process and Resident Complaint Policy as amended from time to time. K. Unless otherwise mutually agreed by the Physician and the Program Director, at least thirty (30) days' advance notice of intent to resign from the Residency Program must be given, in writing, by the Physician to the Program Director. L. This Agreement constitutes the entire agreement and understanding between the parties with respect to the subject matter hereof; supersedes all prior agreements, written or oral, between the parties with respect to such subject matter and except for renewal, non-renewal, or extensions may be modified only by a written agreement signed by all of the parties. If any provision of this Agreement conflicts with any provision of any other document, agreement, policy, or guideline, the provisions in this Agreement shall prevail over any other conflicting provisions. M. The validity, interpretation and effect of this Agreement shall be governed by the laws of the State of Illinois. The parties hereby consent to the jurisdiction of the appropriate courts located in Illinois for the resolution of any dispute arising hereunder. N. In the event that one or more of the provisions of this Agreement is or are declared illegal, void or unenforceable, that shall not affect the validity of the remaining provisions of this Agreement. O. The Physician shall not have the right to request a review his/her failure to successfully pass the postoffer drug and alcohol test. P. The School of Medicine policies referenced in Witnesseth paragraph 3, Sections A.5, A.6., B.6., F, G, and J, each as amended from time to time, are available on the School of Medicine website at http://www.siumed.edu/resaffairs/residentresources/resresources.html. Page 5

IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed the day and year first written above. ACCEPTED: PHYSICIAN:,, Residency Program Director Printed Physician Name Illinois License No BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY MEMORIAL MEDICAL CENTER SPRINGFIELD, ILLINOIS J. Kevin Dorsey, MD, PhD Doug Rahn Dean and Provost for Chief Operating Officer Rita Cheng, Chancellor Southern Illinois University at Carbondale Amended and Approved by GMEC October 21, 2011 Page 6

AGREEMENT WITH PHYSICIAN 2012-2013 THIS AGREEMENT, made and entered into this day of, 20 by the BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY, a body politic and corporate of the State of Illinois, located at Carbondale, Illinois, for and on behalf of Southern Illinois University School of Medicine, hereinafter referred to as the School of Medicine, and ST. JOHN S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS, SPRINGFIELD, ILLINOIS, a not for profit corporation of the State of Illinois, located at Springfield, Illinois, hereinafter referred to as the Affiliated Hospital. The School of Medicine is also affiliated with Memorial Medical Center, an Illinois not-for-profit corporation and an affiliate of Memorial Health System. Both St. John s Hospital and Memorial Medical Center shall hereinafter be collectively referred to as Affiliated Hospitals and, a graduate of, class of, hereinafter referred to as the Physician. WITNESSETH THAT: The Physician hereby accepts the position of, in the Department of at the School of Medicine. The term of this agreement shall be for one (1) year commencing on, hereinafter referred to as the commencement date, and terminating on and shall renew automatically for additional periods, anticipated to end, at completion of the Physician s Residency or Fellowship Program, hereinafter referred to as the Residency Program, subject to adequate progression of the Physician through the Residency Program, as determined by the School of Medicine and Affiliated Hospital, or unless notice of non-renewal or termination of the Agreement is provided to the Physician. When appropriate, in the sole discretion of the Affiliated Hospital and School of Medicine, promotion of Physician will be evidenced by a renewal letter provided by the School of Medicine. This Agreement and any renewal hereof is contingent upon, without limitation, the following: proof acceptable to the School of Medicine and Affiliated Hospital that the Physician (i) has been issued a temporary or permanent license from the Illinois Department of Financial and Professional Regulation, (ii) can provide verification of U.S. employment authorization in the United States at the commencement of employment, (iii) satisfactorily completed prerequisites such as credentialing, a pre-employment health and drug and alcohol screen, criminal background check, and other routine employment processing as required by the Affiliated Hospital, and (iv) met the qualifications for resident eligibility as outlined in the School of Medicine Selection, Evaluation, Supervision, Graded Responsibility, Promotion/Non-Promotion And Dismissal Of Residents Policy, as amended from time to time, and as determined by the Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) (collectively the Requirements ). Anything to the contrary herein notwithstanding, in the event that such Requirements are not met or provided by the Physician to the Program Director by the commencement date of this Agreement or any renewal thereof, this Agreement and any renewal may be terminated without advance notice at the joint discretion of the Affiliated Hospital and the School of Medicine. In consideration of the Physician s acceptance of the aforesaid position, and of the covenants and agreements herein contained, the parties hereto do mutually agree as follows: A. THE AFFILIATED HOSPITAL SHALL: 1. Employ the Physician and pay him or her total annual compensation of ($ ) for the term of this Agreement, which compensation shall be prorated and paid on a bi-weekly basis. The amount of compensation to be paid to the Physician will be subject to adjustment on July 1 based on any standard changes in the rate of physician compensation authorized by the Affiliated Hospital during the term of this Agreement. Page 1

2. Provide the Physician with professional liability coverage under the insurance program of the Affiliated Hospital. Said professional liability coverage, whether by enrollment in a program of self-insurance, inclusion under a professional liability insurance policy or a combination thereof, shall extend to the Physician while the Physician is performing professional duties and responsibilities as a part of the Physician s Residency Program, provided, however, that said professional liability coverage shall not apply to professional acts performed outside the scope of the Residency Program. Said professional liability coverage shall provide legal defense and protection against awards from claims reported or filed during or after the completion of the Residency Program, if the alleged acts or omissions of the Physician were within the scope of the Residency Program, in accordance with the Affiliated Hospital s self-insured trust and liability policy. 3. Provide health, dental, disability and life insurance benefits for the Physician under the employee insurance program of the Affiliated Hospital, as provided by the Affiliated Hospital s Plan Benefits, as amended from time to time. Health insurance benefits shall begin on the first recognized day of training. The Affiliated Hospital shall have the right to change such Plan Benefits during the term of this Agreement if said changes are consistent with changes made in the Plan Benefits of the Affiliated Hospital. The Physician shall have the option to include immediate family members under said insurance program at the Physician s own expense. 4. Provide designated sleeping quarters and meals for the Physicians during in-house call. 5. Provide the Physician with vacation (paid time off), educational leave, child care leave, bereavement leave, sick leave and job search leave according to the School of Medicine Vacation and Other Leaves of Absence Policy, as amended from time to time a. In the event that the Physician accumulates a total of more than calendar days of absence per year from the Residency Program during the term of this Agreement (including vacation [paid time off], educational, child care, bereavement and sick leave, suspension [with or without pay] or other absence), the Physician shall be notified in writing by the Program Director as to whether such absence necessitates remedial work in order to fulfill the requirements of the Residency Program. Such notification shall be provided to the Physician prior to any planned leave (or at the earliest practicable time after any unplanned leave) which causes the Physician to exceed this limit on absence from the Residency Program. 6. Provide the Physician with counseling, medical and psychological support services and measures to address physician impairment, including that due to substance abuse as described in the School of Medicine Impairment Policy, as amended from time to time. 7. Provide the Physician with such other benefits (including military leave), which are not inconsistent with the provisions of this Agreement, as are provided by the Affiliated Hospital through its existing policies, as applicable and amended from time to time. B. THE SCHOOL OF MEDICINE SHALL: 1. Establish and provide general supervision, guidance, and evaluation to the Physician as well as an educational program within each Department which complies with the education requirements as determined by the ACGME and/or AOA, as applicable. 2. Provide program direction and select faculty who determine resident proficiency to perform clinical duties and the degree of supervision necessary in the management and treatment of patients. 3. If approved by the School of Medicine, consult with and seek approval of the Affiliated Hospital prior to any change, expansion or extension of the Residency Program outside the facilities of the Affiliated Hospitals. 4. Adhere to duty hours which comply with the appropriate institutional and program ACGME/AOA requirements. 5. Adhere to the Residency Program Closure/Reduction Policy of the Graduate Medical Education Committee (GMEC). Page 2

6. Adhere to the ACGME/AOA or requirement to not require the Physician to sign a noncompetition guarantee. C. THE PHYSICIAN SHALL: 1. Perform such duties as may be assigned to the Physician by the Program Director in accordance with the description of the Residency Program prepared by the Program Director and subject to the approval of the Affiliated Hospital, which duties shall be performed by the Physician conscientiously, to the best of the Physician s ability and under the highest personal bond of professional morals and ethics. As the position of the Physician involves a combination of supervised, progressively more complex and independent patient evaluation and management functions and formal educational activities, the competence of the Physician shall be evaluated by the Program Director on a regular basis with a record of the evaluation being held in the Physician s program file. Such evaluation will be part of the quality assurance program established for the purposes of reducing mortality and morbidity within the Affiliated Hospital. Under the supervision of approved credentialed attending teaching staff, the Physician shall: a. Provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health b. Demonstrate medical knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social behavioral) sciences and the application of this knowledge to patient care c. Participate in practice-based learning and improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care d. Practice interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and other health professionals e. Exhibit professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population f. Participate in systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system for health care and the ability to effectively call on system resources to provide care that is of optimal value g. Participate fully in the educational and scholarly activities of his /her program and, as required, assume responsibility for teaching and supervising other residents and students h. Participate in appropriate institutional committees and councils whose actions affect residents' education and/or patient care i. At least annually submit to the Chair of the GMEC (through the Office of Residency Affairs) a confidential written evaluation of the program faculty and of the educational experiences j. Regularly, or at a minimum of once a week, log on and review electronic mail on the Physician's School of Medicine electronic mail account 2. Abide by and at all times conform to the Corporate and Medical Staff Bylaws, Occupational Safety and Health Administration (OSHA), Health Insurance Portability and Accountability Act (HIPAA), the Illinois Department of Public Health (IDPH) infection control policies, and other rules, regulations, policies, ethical and religious directives of the Affiliated Hospitals and of the School of Medicine and all other general guidelines and moral codes, both stated and published, governing the practice of medicine; and the statutes, rules and regulations of the State of Illinois, including without limitation the Medical Practice Act and any and all other Page 3

laws, rules and regulations relating to the licensing of physicians in training and the practice of medicine in the State of Illinois. 3. Accept no responsibilities for professional activities outside the scope of the Residency Program provided herein (including, but not limited to "moonlighting") unless approved in writing by the Affiliated Hospital and the Program Director, who shall have discretion as to whether or not such outside professional activities are permitted. With regard to those residency programs in which outside professional activities may be permitted, the Physician shall adhere to the policy on professional activities outside the scope of residency training as approved by the GMEC. 4. Ethical and Religious Directives. Physician, the School of Medicine and Affiliated Hospitals acknowledge that Affiliated Hospital is operated in accordance with the Ethical and Religious Directives for Catholic Healthcare Services as promulgated, from time to time, by the United States Conference of Catholic Bishops, Washington, D.C., of the Roman Catholic Church ("Ethical and Religious Directives"), and that the principles and beliefs of the Roman Catholic Church are a matter of conscience to Affiliated Hospital. It is the intent and agreement of the parties that neither this Agreement nor any part hereof shall be construed to require Affiliated Hospital to violate said Ethical and Religious Directives in its operation and all parts of this Agreement must be interpreted in a manner that is consistent with said Ethical and Religious Directives. D. Medical Specialty Board requirements applicable to the Residency Program specify that the Physician must perform months of actual service in a -month period. Anything in this Agreement to the contrary notwithstanding, it is understood and agreed by the Physician that if, because of approved leave or other absence, the Physician does not meet said Board requirements, it may be necessary for the Physician to extend the duration of the Residency Program until said Board requirements have been satisfied. E. The Physician agrees to abide by a risk management and quality control program which shall provide, without limitation, for the following: 1. The joint review of the Physician's credentials by the Affiliated Hospital and the School of Medicine. 2. The joint indoctrination of the Physician with respect to the Physician's responsibilities to the patient, the School of Medicine, and the Affiliated Hospital. 3. The suspension of the Physician for an indefinite period of time, for failure to comply with this Agreement or for reasonable cause, by the appropriate officials of the School of Medicine or the Affiliated Hospital. If such an event occurs, the Physician may be suspended from training and clinical duties without compensation as identified herein. 4. Compliance by the Physician with the School of Medicine s policy regarding licensing examinations. 5. Compliance by the Physician with regulations regarding completion of medical records at the Affiliated Hospitals and the School of Medicine. 6. Compliance by the Physician with regulations regarding completion of time records at the Affiliated Hospitals and the School of Medicine. 7. Compliance with all required education modules including on-line modules as proscribed by the Affiliated Hospitals and/or the School of Medicine. F. This Agreement may be terminated at any time by joint decision of the Affiliated Hospital and the School of Medicine, in which case the Physician's compensation specified herein will be prorated to the date of termination and the Physician will be paid for vacation (paid time off) earned but not used prior Page 4

to the date of termination. In the event that a request for review is filed by the Physician under the Due Process and Resident Complaint Policy, as amended from time to time, pay and benefits may be continued at the discretion of the Affiliated Hospital. Decisions regarding advancement in the program will be made in accordance with the Selection, Evaluation, Supervision, Graded Responsibility, Promotion/Non-Promotion And Dismissal Of Residents Policy, as amended from time to time. G. The Physician shall be notified in writing by the Program Director, subject to the approval of the Affiliated Hospital, in the event the Physician's contract shall not be continued or if he or she will not be promoted to the next level of training for the following year. Said notice shall be provided at least four months prior to the expiration of the contract year or when a resident will not be promoted to the next level of training. As of the same date, the Physician shall notify the Program Director in writing of an intention not to return for the following year. However, if the primary reason(s) for the non-renewal or non-promotion occurs within the four months prior to the end of the agreement, the Program Director will provide the Physician with as much written notice of the intent not to renew as the circumstances will reasonably allow, prior to the end of the agreement. H. In the sole discretion of the Affiliated Hospital and School of Medicine, if progression of the Physician through the Residency Program and extension of the Physician s time in the Residency Program is appropriate, an extension letter may be provided by the School of Medicine. I. It is the policy of the School of Medicine and the Affiliated Hospitals to maintain an environment which is free from all forms of harassment based on a person's legally protected status (including race, sex, national origin, religion, military status, age and disability) and sexual harassment (herein after referred to as harassment), improprieties and intimidation. The Physician is entitled to the protections afforded by these policies while serving as a resident hereunder. The Physician agrees to abide by the School of Medicine's and the Affiliated Hospitals respective policies regarding equal employment, sexual harassment and harassment on the basis of other protected status as set forth above. The Physician acknowledges that failure to abide by these policies may result in immediate termination of this Agreement. Allegations of discrimination and/or harassment will be addressed in accordance with the applicable policies of the School of Medicine or the Affiliated Hospital. J. The Physician agrees to abide by all standards outlined in the (225 ILCS 60/) Medical Practice Act of 1987. Any violations of that Act, including but not limited to Section 22, or other instances of ethical or moral turpitude is grounds for immediate termination and therefore cannot be requested for review under the Due Process and Resident Complaint Policy as amended from time to time. K. Unless otherwise mutually agreed by the Physician and the Program Director, at least thirty (30) days' advance notice of intent to resign from the Residency Program must be given, in writing, by the Physician to the Program Director. L. This Agreement constitutes the entire agreement and understanding between the parties with respect to the subject matter hereof; supersedes all prior agreements, written or oral, between the parties with respect to such subject matter and except for renewal, non-renewal, or extensions may be modified only by a written agreement signed by all of the parties. If any provision of this Agreement conflicts with any provision of any other document, agreement, policy, or guideline, the provisions in this Agreement shall prevail over any other conflicting provisions. Page 5

M. The validity, interpretation and effect of this Agreement shall be governed by the laws of the State of Illinois. The parties hereby consent to the jurisdiction of the appropriate courts located in Illinois for the resolution of any dispute arising hereunder. N. In the event that one or more of the provisions of this Agreement is or are declared illegal, void or unenforceable, that shall not affect the validity of the remaining provisions of this Agreement. O. The Physician shall not have the right to request a review his/her failure to successfully pass the postoffer drug and alcohol test. P. The School of Medicine policies referenced in Witnesseth paragraph 3, Sections A.5, A.6., B.6., F, G, and J, each as amended from time to time, are available on the School of Medicine website at http://www.siumed.edu/resaffairs/residentresources/resresources.html. IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed the day and year first written above. ACCEPTED: PHYSICIAN:,, Residency Program Director Printed Physician Name Illinois License No BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY ST. JOHN S HOSPITAL SPRINGFIELD, ILLINOIS J. Kevin Dorsey, MD, PhD Robert Ritz Dean and Provost for President and Chief Executive Officer Rita Cheng, Chancellor Southern Illinois University at Carbondale Amended and Approved by GMEC October 21, 2011 Page 6