FEAR: Faculty Evaluation and Retaliation—A Survey of Family Medicine Program Directors

BACKGROUND AND OBJECTIVES: Evaluating resident physicians is essential for resident development and patient safety. Fear of retaliation from residents may be a barrier to faculty completing resident physician evaluations. This study examined family medicine program directors' perceptions on fear of retaliation from resident physicians as a barrier to faculty completing honest, high-quality evaluations. METHODS: The study was conducted as part of the 2024 Council of Academic Family Medicine Educational Research Alliance study of family medicine residency program directors. The 10-item survey assessed program directors' perceptions of faculty fear of retaliation, the impact of this fear, and rates of retaliation occurring in their programs in the last 3 years. RESULTS: The response rate was 45.39% (320/705). More than half (56.4%, 172/305) perceived that faculty in their programs are reluctant to give critical feedback on evaluations; nearly half (48.9%, 150/305) believed that fear of retaliation is a barrier. Fear of a reciprocal negative evaluation (34.5%, 106/305) and fear of formal complaints (38.9%, 119/305) were prevalent. Lack of adequate documentation was attributed to a failure to remediate and dismiss a resident in 19.8% (61/307) and 11.7% (36/306) of programs, respectively. Formal complaints against an evaluator or program occurred in 18.6% (57/307) of programs, and civil lawsuits were filed in 5.2% (16/306) in the preceding 3 years. CONCLUSIONS: Family medicine program directors perceive fear of retaliation from residents as a barrier to faculty completing honest, high-quality evaluations. Formal complaints and even civil lawsuits against evaluators or programs are not uncommon.