In the event of unsatisfactory performance (depending upon the nature and/or extent of the
unsatisfactory performance) or if at the end of the timeline specified in the written counseling
improvement plan, the clinical trainee/research fellows performance has not improved to the extent
and within the period of time considered acceptable by the program, the clinical trainee/research
fellow may be issued a performance warning. The program invokes performance warning status by
written notification to the clinical trainee/research fellow that advises that his/her performance is
not satisfactory and that includes a clear statement that the clinical trainee/research fellow is on
performance warning. This notice to the clinical trainee/research fellow shall include a detailed
description of the unsatisfactory performance, the expectations for performance improvement and
time parameters in which performance is to improve. As a result of a performance warning, clinical
trainee/research fellows clinical duties and other activities may be restricted or otherwise curtailed
by the Program Director.
In the event a clinical trainee/research fellow is placed on performance warning, a copy of the
performance warning notice shall be forwarded to the Director of Graduate Medical Education for
inclusion in the clinical trainee/research fellow’s academic file. The Director of Graduate Medical
Education or the Chairman of the Education Institute will discuss the performance warning with the
Performance warning status may be issued for a predetermined period of time (for example, three
months) or for an indefinite period, as determined by the program. The program also has the
discretion to extend any period of performance warning status. A clinical trainee/research fellow
who has been placed on performance warning shall have this status and his/her progress towards
performance improvement reviewed by the Program Director or designee on a regular basis.
The Program shall inform the trainee in writing when the performance warning has been lifted and
that the program is now satisfied with the improvement and current status of their performance.
Performance warnings may be appealed to the GME Department (See Procedure for
Clinical Trainee/Research Fellow Appeal Process) by the clinical trainee/research fellow.
Dismissal from Training and Administrative Leaves of Absence
If upon the expiration of the performance warning status or in the event of an indefinite period of
performance warning after at least the first periodic review by the Program Director or designee, the
clinical trainee/research fellows performance has not improved to the extent considered acceptable
by the Program and the Director of Graduate Medical Education or Chairman of the Institute of
Education, the clinical trainee/research fellow may be immediately dismissed from the program.
In addition and not withstanding, any of the foregoing to the contrary, a clinical trainee/research
fellow may be dismissed from Cleveland Clinic “for cause” or otherwise dismissed from the
program or placed on an administrative leave of absence without prior counseling and/or
performance warning status for: 1) apparent serious violations of ethical, legal or medical practice
standards of conduct 2) patient safety
concerns or 3) investigation of adverse incidents/issues
involving a clinical trainee/research fellow. In the event a clinical trainee/research fellow is
dismissed from the program under any circumstance or placed on administrative leave of absence,
the clinical trainee/research fellows Program Director and the Director of Graduate Medical
Education or Chairman of the Institute of Education, shall advise the clinical trainee/research fellow
in writing of the dismissal or the administrative leave of absence and the general nature of the
grounds therefore. Dismissal from training may be appealed by the clinical trainee/research fellow
unless, the reason for dismissal falls under the single significant events noted below*.