Decisions regarding resident advancement and dismissal.

An orthopaedic resident had been counseled repeatedly regarding his unprofessional behavior. He had indicated, on multiple occasions, that patient-care tasks had been completed when, in fact, they had not. He had shifted his responsibilities to other residents both with and without their knowledge. Despite acceptable technical skills, he had often been poorly prepared for surgical cases. After repeated guidance sessions, warnings, and admonishments, he was dismissed from his training program.