Professional Impairment

For the purpose of this document, professional impairment is defined broadly as an interference in professional functioning which is reflected in one or more of the following ways: a) an inability and/or unwillingness to acquire and integrate professional standards into one's repertoire of professional/clinical behavior; b) an inability to acquire sufficient clinical skills to reach an acceptable level of competency; and/or c) an inability to control personal stress, psychological disorder and/or strong emotional reactions which interfere with professional functioning.

Such inabilities can be distinguished from "problems" in that problems refer to a trainee's behaviors, attitudes or characteristics that, though of concern and requiring remediation, are perceived to be expected and/or not excessive at this level of training. Problems become "impairments" when they include one or more of the following characteristics: a) the trainee does not acknowledge, understand or address the problem when it is identified, b) the problem is not merely a reflection of a skill deficit that can be rectified by academic or didactic training, c) the quality of services delivered by the trainee is severely negatively affected, d) the problem is not restricted to one area of professional functioning, e) a disproportionate amount of attention by training personnel is required, and/or f) the trainee's behavior does not change as a function of feedback, remediation efforts and/or time.