The Senior Associate Dean meets with the residents of each individual residency program. This is done without the Department Chair, the Program Director, any faculty, fellows, medical students or others. The door is closed and the "ground rules" are clearly defined as follows: all discussion is confidential unless the residents by consensus decide that they want the GME Dean to follow-up a particular issue with the Program Director and/or Department Chair. The goal of the program are the following:

1. To provide the residents to meet the Senior Associate Dean and to recognize her primary responsibility as their advocate.
2. To allow the residents the opportunity to safely address issues related to their educational experience and/or their work environment without fear of intimidation or retaliation.

This program provides remarkable and highly valuable insight into the residency programs for the Senior Associate Dean. During the prior year, the Associate Director of GME has accompanied her and has been a valuable resource both to the Senior Associate Dean and to the residents regarding follow-up of numerous issues. For example, occasionally a simple administrative challenge is brought to the Dean's Office attention through these sessions such as a resident sharing problems with the on-call room. This occurred in one program and was quickly addressed through communication then follow-up with the UCSF Medical Center with correction via the Associate Director of GME and the Chief Operations Officer of Moffit-Long who conducted an inventory of all call rooms and resolved many issues (i.e. new mattresses, phones, furniture, etc). Occasionally, the issue is more complex and/or sensitive. For example, one set of residents brought forward questions of billing compliance. This was addressed through direct communication with the Department Chair and the Compliance Office with both clarification of billing rules/regulations in joint faculty/resident teaching sessions and several changes in practices. Oversight and sensitivity to potential intimidation and/or retaliation allowed for a clear avoidance of such. Follow-up "Lunch" sessions provided both short-term and long-term oversight of proper billing practices and faculty/resident relationships. Another issue brought forward by the residents with a request to address with the faculty and departmental leadership (Chair and Program Director) involved a sense of sub optimal clinical supervision and teaching. Meetings with the Department Chair and Program Director resulted in a complete re-organization of both the didactic and the clinical teaching curriculum and practices. Follow-up "Lunch" sessions confirmed a sustained improvement and markedly increased satisfaction of the residents as well as an absence of intimidation and/or retaliation. Hence, this program has been proven to be of remarkable valuable and an effective means of providing a environment in which residents may raise and resolve issues without fear of intimidation or retaliation.