Florida Residency & Fellowship Programs — Due Process and Non-Renewal

Written by Zachary Gaynor, attorney · The Florida Bar, admitted 2016 · court admissions. Reviewed 3 September 2026.

Who are the largest residency sponsors in Florida?

HCA Florida is the largest GME enterprise in the state — and it is six separate ACGME sponsoring institutions, not one. Together they run 151 accredited programmes and 2,388 residents and fellows, more than double the next largest. University of Miami/Jackson Health System is the largest single sponsor at 101 programmes and 1,109 trainees, followed by UF Gainesville (84 / 940) and USF Morsani (73 / 750).

Why “which sponsor” is the first question in a resident’s case

A residency dispute is governed by the sponsoring institution’s GME policy manual and your agreement of appointment — not by the hospital you happen to work in, and not by the medical school whose name is on the building. The six HCA Florida sponsors each have their own Graduate Medical Education Committee, and HCA’s system-wide manual is expressly labelled a model policy, with each local committee “responsible for reviewing, approving, and adopting all policies.”

So a resident at an HCA programme cannot assume the system manual is the operative text. Ask which GMEC adopted which version, and when. That single question resolves a surprising number of Florida residency disputes.

Ranked by size, academic year 2024-2025

Programmes and residents/fellows, from ACGME’s public reporting:

University of Miami / Jackson Health System — 101 / 1,109
University of Florida College of Medicine (Gainesville) — 84 / 940
USF Morsani College of Medicine — 73 / 750
HCA Florida Healthcare (Margate) — 36 / 627
UCF / HCA Florida Healthcare (Orlando) — 43 / 614
HCA Florida / USF Morsani GME Tampa South — 28 / 467
HCA Florida / USF Morsani GME Tampa North — 26 / 435
UF College of Medicine Jacksonville — 36 / 390
AdventHealth Florida — 33 / 338
Orlando Health — 27 / 318
Larkin Community Hospital — 18 / 254
Memorial Healthcare System — 14 / 249
Florida State University College of Medicine — 14 / 214
Mount Sinai Medical Center of Florida — 13 / 205
Florida Atlantic University Schmidt College of Medicine — 11 / 167

Three corrections to names that appear on most lists. Mayo Clinic Florida is not a Florida ACGME sponsor — its Jacksonville programmes sit under Mayo Clinic College of Medicine and Science in Rochester, Minnesota. Cleveland Clinic Florida likewise sits under the Cleveland Clinic Foundation in Ohio. Tampa General Hospital is not a sponsor at all; it is USF Morsani’s primary teaching hospital, and USF is the sponsor of record. If you are a resident at any of those, the policy that governs you is held by an institution in another state.

No Florida GME sponsor is on ACGME probationary status. Twenty-one programmes or institutions nationally were on probation as of 2 September 2026; none is in Florida.

Which sponsors actually publish their due-process policy

ACGME Institutional Requirement I.B.5 obliges every sponsoring institution to have a policy covering resident grievances and due process. It does not oblige them to publish it. Most Florida sponsors do not.

Sponsors that publish one:

Memorial Healthcare System — the most complete public set in the state: separate Due Process, Grievance, Disputes and Complaints, Discipline, Renewal and Promotion, and Special Review policies, plus the full agreement of appointment.
UCF / HCA Florida — roughly 27 individual policy documents, including a grievance policy, a performance/renewal/promotion/discipline policy, and a sample resident contract.
University of Florida — GME-303, grievance, suspension, non-renewal or dismissal.
UF Jacksonville — a due process policy inside the resident manual.
USF Morsani — GME-218, corrective action, discipline and due process.
HCA Healthcare — a system core manual containing due process, grievance and corrective action policies, subject to the local-adoption caveat above.
Florida State University and Florida Atlantic University — full GME policy manuals.

Sponsors that do not publish one: University of Miami / Jackson Health System · Orlando Health · AdventHealth Florida (which posts only a 2019 manual and two isolated policies) · Mount Sinai Medical Center of Florida · Nicklaus Children’s Hospital · Lakeland Regional Health · BayCare Health System · Johns Hopkins All Children’s Hospital · Nemours Children’s Hospital.

That the state’s largest single sponsor — UM/Jackson, with 101 programmes and roughly 1,100 trainees — publishes salary and onboarding information but no due-process, grievance or non-renewal appeal policy is the most consequential fact on this page. A resident there facing non-renewal cannot read the procedure that governs them without asking for it. Ask in writing, to the DIO, and keep the request and the response.

What makes a residency dispute different

A resident is simultaneously a trainee and an employee, and that dual status shapes everything:

Non-renewal is not dismissal, and the notice rules differ. ACGME requires written notice of intent not to renew, ordinarily no later than four months before the end of the agreement — but where the cause arises within those four months, the institution must give as much notice as circumstances reasonably allow. Which of those two routes the programme used is worth establishing immediately.
The academic decision and the employment decision travel together. A remediation plan, a probation, and a non-renewal are educational judgements with contractual consequences, which is why the agreement of appointment matters as much as the policy manual.
Reporting obligations follow you. What the programme reports to a future employer, to a state licensing board, and on credentialing verifications is often more consequential than the training year itself. The wording of any summary or verification letter is worth addressing at the time.
Board eligibility can turn on completed months and documented competencies, so the precise end date and the credit given for time served are rarely trivial details.
Fair-hearing rights under a hospital’s medical-staff bylaws sometimes run in parallel with the GME policy, particularly for fellows with independent privileges.

Practical first steps for a resident or fellow

Request, in writing and by name: the GME policy manual version in force on the date of the action; your signed agreement of appointment; the programme’s promotion and remediation policy; every evaluation and milestone assessment in your file; and the minutes or written outcome of any Clinical Competency Committee or GMEC review concerning you. Note the date of each request. Those documents are the case, and they are far easier to obtain before a decision is final than afterwards.

Common questions

My programme will not give me its due-process policy. What now?

Ask the Designated Institutional Official in writing. Every ACGME sponsor is required to have one. Many Florida sponsors, including the largest, simply do not publish it — which means asking is the only way to get it, and the request itself becomes part of the record.

Is non-renewal the same as being fired?

No, and the distinction matters. Non-renewal means the agreement is not extended; dismissal ends it early. They carry different notice requirements, different appeal routes under most policies, and they read differently to a future employer.

How much notice must I get of non-renewal?

Ordinarily no later than four months before the agreement ends. Where the ground arises within that four-month window, the institution must give as much notice as the circumstances reasonably allow — which is a standard capable of being tested.

I am at an HCA programme. Which policy applies to me?

The one your local Graduate Medical Education Committee adopted. HCA’s system manual is a model policy and each of the six Florida sponsors adopts its own version, so ask which text and which revision date governs your programme.

Does a residency dispute affect my medical licence?

It can, through reporting and credentialing rather than directly. Licensing boards and future employers ask about non-renewals, probations and early terminations, so how the outcome is characterised in writing is often the most important thing to get right.