Academic & Professional Advancement Policy

Policy

Objective

The purpose of this policy is to promote student academic achievement, maintain academic and professional standards (knowledge, skills, attitudes and behaviors) and achieve fairness and consistency in decisions regarding students with academic or professional deficiencies. It is the policy of the School of Medicine to give every qualified and committed student the opportunity to graduate; however, the School reserves the right, in its sole and absolute discretion, to make judgments about who has or has not demonstrated the necessary qualifications to earn the M.D. degree and to practice medicine competently.

Outline of Policy

All academic deficiencies, patterns of unprofessional behavior and egregious violations of professionalism will be presented to the Academic Standards and Achievement Committee (ASAC) that acts on behalf of the faculty of the School of Medicine. This policy specifies how the ASAC will deal with student academic deficiencies in courses, clerkships, electives, the Clinical Performance Examination (CPX) and with failures on the United States Medical Licensing Examination (USMLE) Step 1 and Step 2 examinations, including compliance with the Standards for Academic Standing (see end of this document).

Definition of Academic Failure

The courses in the Phase 1 pre-clerkship, the three-week Intersession course in Phase 2 clerkships, and the courses and electives in the Phase 3 post-clerkship of the Cells to Society Curriculum are graded as pass/fail (P/F); any F constitutes a failure. The Phase 2 clerkships are graded with letter grades (A+, A, B, C or F). With the exception of the Patient-Student Partnership Course, a cumulative score of 70% or higher is required for successful completion of each course and clerkship. Earning a cumulative score of less than 70%, failing any individual clerkship component, or not completing any of the required course or clerkship assignments (EPAs, RCEs, IPEs, etc) constitutes a failure and is documented on the official transcript and the Medical Student Performance Evaluation (MSPE). The Patient-Student Partnership Course requires a score of 80% or higher to pass. Failure to achieve an 80% in this course constitutes a failure and would likewise be documented on the official transcript and the MSPE.

Professionalism

Professional attitudes and behaviors are components of the 12 Competencies Required of the Contemporary Physician that enable the independent performance of the responsibilities of a physician and therefore are a requirement for the successful award of the degree of Doctor of Medicine. The School of Medicine’s Professionalism Expectations (https://med.virginia.edu/md-program/ume-md-curriculum/ ) establish general standards applicable to all students in the School of Medicine. However, it is the responsibility of the faculty and the ASAC, as appropriate, to interpret and apply the general Professionalism Expectations to specific situations when concerns are raised about student performance or behaviors.

Evaluation of professional attitudes and behaviors is an integral part of a student’s assessment and generally is accomplished through observation and feedback to students through course/clerkship assessments of student performance. Praise/Concern Cards and written narratives are assessment tools used to describe behaviors in areas of altruism; honesty and integrity; caring, compassion and communication; respect for others; respect for differences; responsibility and accountability; excellence and scholarship; leadership and knowledge and other skills related to professionalism. These professional attitudes and behaviors are monitored and recorded throughout undergraduate medical education.

Any breach of professionalism resulting in a recorded observation, e.g., Professionalism Concern Card, letter, written report, etc., must be addressed with the student by their college dean and documentation of the discussion must be recorded. If a student receives three or more written observations of concern or is reported for two breaches of the Health Insurance Portability and Accountability Act (HIPAA), or is cited for a single violation of the Digital Learning Environment and Educational Materials Policy (https://med.virginia.edu/policies/digital-learning-environment-and-educational-materials/) or a single egregious breach of professionalism, notice will be sent to the ASAC for review. Egregious behaviors, such as but not limited to assault on or threat to a patient, patient’s family member, student, GME trainee or faculty member, conduct that may constitute a felony, etc., regardless of whether criminal prosecutions are initiated or pursued, will be referred immediately to the ASAC, irrespective of whether previous observations of concern exist, with the recommendation for dismissal from school. A student identified as having a pattern of unprofessional behavior may be directed to further counseling and/or to supportive remediation and/or placed on academic warning or academic probation (as defined below), or if the professional violations are severe, a student may be dismissed from school even if they have passing grades in all courses. The ASAC will assess the severity of the problem, the management, and the consequences, including possibly reporting the behaviors in the student’s Medical Student Performance Evaluation (MSPE).

Medical Scientist Training Program Students

Decisions regarding academic deficiencies of MSTP students during their MD coursework are governed by the ASAC. Final decisions regarding academic deficiencies of MSTP students during their doctoral coursework are determined by the ASAC, but the decision is weighted heavily upon the recommendation of the BIMS Academic Progress and Achievement Committee (BAPAC), which acts as a subcommittee to the ASAC with respect to MSTP students. The BAPAC serves as an institutional oversight committee with representation from all Biomedical Sciences (BIMS)-affiliated degree-granting programs to ensure that individual programs have followed their processes regarding remediation and dismissal for academic deficiencies, ensuring due process for students. The BAPAC assesses whether the policies have been followed and assures fairness and consistency across the interdisciplinary programs comprising BIMS. See individual BIMS-affiliated PhD program standards and “BAPAC Operating Procedures” at https://med.virginia.edu/bims/forms-and-committees/committees/bims-academic-progress-and-achievement-committee/.

Reports of an MSTP student’s unprofessional, unethical, or illegal activities or behaviors are reviewed and acted upon by the ASAC.

MD/Public Health Sciences Combined Degree Students

Decisions regarding academic deficiencies of PHS graduate students during their MD coursework are governed by the ASAC. Final decisions regarding academic deficiencies of PHS graduate students during their PHS coursework are determined by the ASAC, but the decision is weighted heavily upon the recommendation of the PHS Academic Promotion and Achievement Committee (PHS APAC), which acts as a subcommittee to the ASAC with respect to PHS graduate students. See SOM Bylaws, Section 8, Standing Committees, PHS Academic Promotion and Achievement Committee, (https://med.virginia.edu/policies/by-laws/ ).

Reports of a MD/PHS graduate student’s unprofessional, unethical, or illegal activities or behaviors are reviewed and acted upon by the ASAC.

Grading during Phase 1 (Pre-clerkship)

The pre-clerkship phase of the Cells to Society Curriculum comprises the first three semesters of the educational program. This phase consists of ten graded courses, each assigned a pass/fail grade at the end of the course:

Integrated Systems I (first semester)
Integrated Systems II (second semester)
Integrated Systems III (third semester)
Foundations of Clinical Medicine 1-A (FCM 1-A)
Foundations of Clinical Medicine 1-B (FCM 1-B)
Foundations of Clinical Medicine 1-C (FCM 1-C)
Patient Student Partnership 1-A (PSP 1-A)
Patient Student Partnership 1-B (PSP 1-B)
Patient Student Partnership 1-C (PSP 1-C)
Social Issues in Medicine (SIM) (either semester one or two during the first year).

Integrated Systems I consists of the following course components or “systems”: Cells to Society, Foundations of Medicine (FoM), Microbes & the Immune System (MIS), and Cells, Blood and Cancer (CBC). Integrated Systems II consists of the following course components: Musculoskeletal Integument System (MSI), Gastrointestinal System (GI) and Mind, Brain and Behavior (MBB). Integrated Systems III consists of the following course components: Cardiovascular System (CV), Pulmonary System (Pulm), Renal System, Endocrine-Reproductive System (Endo-Repro) and Classroom to Clinics (C2C). In order to receive a passing grade for an integrated system course, a student must have an average score for all systems of 70% or above.

Patient Student Partnership 1 (three courses) runs in tandem with Foundations of Clinical Medicine 1 and introduces students to a longitudinal patient experience. Performance is assessed in at each semester by a P/F grade. Students must achieve an 80% or greater on the requirements for this course in order to pass.

In order to progress to the third semester of the curriculum, a student must have achieved an average score of 70% or higher on Integrated Systems I and Integrated Systems II and have received a P for FCM-1A and 1B, PSP-1A and 1B, as well as Social Issues in Medicine. Failure to meet any one of these criteria will result in a referral to the ASAC for review and action. Any requirement for remediation must be completed prior to the beginning of the third semester.

Successful completion of the third semester requires an average score of 70% or higher in the Integrated Systems III course, and a grade of P in FCM-1C and PSP-1C. Failure to meet any one of these criteria will result in a referral to the ASAC for review and action.

Interim Assessments:

Interim assessments are any quiz, TBL, or assignment that count for less than or equal to 8% of the overall system or course component. Anything 8% or less of the system or course component total score will not be remediated.

Summative Examinations

A passing score on a summative examination within a course is 70%. Students achieving less than 70% on a summative assessment will be referred to the ASAC with the recommendation from the respective system leader for remediation. If the student is in good standing professionally, and has no other academic deficiencies, the ASAC generally will allow the student to take a reexamination. The reexamination score will be the average of the two exams, not to exceed 75%. If the summative examination is failed the second time with a score lower than 70%, the ASAC will review the student’s performance again and decide either to allow the student to make a third attempt at a reexamination or repeat the course. The final decision regarding reexamination rests with the ASAC. Failure to pass a summative on the third attempt constitutes a failure of the system and therefore failure of the course. Any approved summative reexaminations must be taken according to the approved make-up schedule for the current academic year at the next available examination time as determined by the ASAC. Students can retake only one summative exam on a scheduled re-examination day. A student failing 5 total summative examinations in the pre-clerkship phase of the curriculum will be referred to the ASAC and will be considered for dismissal. A student who does not take an examination and who does not have an excused absence, will receive a professionalism concern card and a referral to the ASAC.

Given extenuating circumstances and with approval by their college dean, a student may delay the taking of a summative examination. The exam may not be taken prior to the scheduled date and time and a student forfeits the right to challenge examination items to avoid delaying the post exam review process.

All summative exams for a given semester (Integrated Systems I, II, or III) must be remediated and passed before progression to the next semester or Phase of the curriculum.

Regarding anatomy practical examinations, a score of 70% or higher is passing. Individual anatomy practical exam scores factor into the respective organ system grades, e.g., an anatomy practical examination score in MSI factors into the MSI grade and an MBB anatomy practical exam score factors into the MBB grade. Anatomy practical examinations also are graded as a thread across the Integrated System in which they occur, i.e., Integrated Systems II or III. A cumulative score of 70% or higher across the anatomy thread in Integrated Systems II and III is required to progress to the clerkship phase of the curriculum. Students achieving a cumulative anatomy score of less than 70% for Integrated Systems II (consisting of anatomy practical examinations from MSI, GI and MBB) or Integrated System III (consisting of anatomy practical examinations from CV, Pulmonary, Renal and Endo-Repro) will be referred to the ASAC and require remediation. Any remediation required by the ASAC will include all anatomy from the semester failed, and the format for reexamination will be at the discretion of the anatomy director. Reexamination must occur by the end of the semester break immediately following the course in which the failure occurred. With approval of the anatomy director, remediation may occur during spring break, early summer break or fall break.

One component of assessment in FCM-1 is OSCEs. Students must achieve a passing grade on the OSCEs in FCM to pass the FCM course. A passing grade on the FCM-1B OSCE is required to pass FCM-1B and to progress to the third semester. A passing grade on the FCM-1C OSCE is required to pass FCM-1C and begin Phase 2. A failure on the FCM 1 B or 1C OSCE is referred to the ASAC for review and action. Typically, the ASAC allows a student in good standing to remediate and retest. A second failure of the FCM OSCEs results in an F in the corresponding course and the student will be referred to the ASAC for review and action. The FCM-1B OSCE must be passed prior to starting the third semester and the FCM-1C OSCE must be passed prior to starting Phase 2. Students who have failed an OSCE examination are required to participate in OSCE remediation sessions as a condition of their reexamination.

Phase 2 and Phase 3

Promotion to Phase 2 (Clerkships)

Students who achieve a passing grade in Integrated Systems I, Integrated Systems II, Integrated Systems III, FCM-1A-B-C, PSP-1A-B-C, and SIM, may progress to Phase 2. Students must pass the Clerkship Readiness Course prior to progressing further in Phase 2.

Remediation of Academic Deficiencies in Phase 2:

To pass a clerkship, a student must achieve a final overall score of 70%, they must pass all individual grading components (e.g. shelf examinations, clinical performance evaluations, etc.), and complete all requirements of the clerkship (e.g. RCEs, EPAs, IPEs, etc.). The final percentage achieved correlates to an assigned letter grade of A+, A, B, C, or F. Failure of a shelf exam, clinical skills assessment or the clinical performance evaluation requires referral to ASAC. Final decision on remediation lies with ASAC and may include repetition of a single graded component of clerkship or its entirety. Failure to pass other required components, like topic presentations, etc. require remediation but not ASAC referral. Initial scores for all components will be used to calculate the final clerkship grade.

The Surgery, Anesthesia, Gynecology and Obstetrics clerkship (SAGO) is a combined 12-week course compromising 6-weeks of Surgery and 6 weeks of Anesthesia/Gynecology/Obstetrics. A student must pass each of the separate 6-week portions of this clerkship to pass the overall clerkship. If a student fails one of the 6-week portions but passes the other, only the failed portion must be remediated.

If a student is required to repeat a clerkship, it will be noted in the MSPE. The student’s transcript will show two enrollments in the same course with two independently determined and reported grades.

Intersession

Intersession is a required three-week course graded as P/F at the completion of the final week of the course. Students must achieve a 70% on assignments to pass the course. Earning a cumulative score of less than 70% constitutes a failure and an automatic referral to the ASAC. Remediation of a failure in this course is required and would be arranged with the course directors and occur after completion of the Phase 2 curriculum.

USMLE Subject Examinations in Phase 2 and Phase 3

A passing score on each subject (shelf) examination will be set by the annual recommended passing score determined by the National Board of Medical Examiners. This passing score can be modified by recommendation of the Assessment Committee with review and approval by the Curriculum Committee. Not achieving this score constitutes a failure of the examination and therefore a deficiency for the course or clerkship. The student will be assigned an Incomplete on their transcript until the deficiency is removed when the examination is passed. Students who do not achieve a passing score on a shelf examination will be referred to the ASAC with the recommendation from the course or clerkship director for appropriate remediation. Generally, if the student performed well clinically and is in good standing professionally, the student would be able to take a reexamination. A reexamination grade, if passing, will remove the deficiency from the course or clerkship; however, the initial score is the only one that will be factored into the final course or clerkship grade. The final grade then will replace the Incomplete on the transcript. If the initial subject examination score is so low that it mathematically prevents achieving a 70% in the course or clerkship, then the ASAC may consider having the student repeat the course or clerkship and all its graded components. A second failure of the shelf exam will be referred to the ASAC for review and action. Should the ASAC permit the student to take the shelf examination a third time and the student passes, the course or clerkship deficiency will be satisfied; however, the first score is the only one calculated into the course or clerkship grade. Failure to pass a shelf examination on the third attempt constitutes a failure of the course or clerkship and will be referred to the ASAC for review and action. If approved, shelf reexaminations in Phase 2 will occur at the completion of Phase 2. By special arrangement with the clerkship director, a shelf re-examination may be scheduled during breaks between clerkship blocks. A student with an outstanding deficiency in a single clerkship may be allowed to continue into the Phase 3 portion of the curriculum but will not be allowed to take an elective in the discipline of the clerkship deficiency until the deficiency has been remediated. If a student fails the Emergency Medicine shelf in Phase 3, reexamination will be by special arrangement with the course director. If a student fails shelf examinations in three different course or clerkships, the student will be referred to the ASAC for review and will be considered for dismissal from the SOM.

Numerical or Narrative Grading Challenge in Phase 2

If a student wishes to challenge the numerical calculation of their grade or the contents of their performance summary narrative in a course or a clerkship, the request must be made to the course director or clerkship director within 4 weeks of the assignment of that grade. The student must meet with the course or clerkship director to discuss their concerns. If this does not resolve the issue, the student has the right to appeal in writing to the Associate Dean for Curriculum. This appeal must occur within 2 weeks of the clerkship director decision. The joint decision of the Associate Dean for Curriculum and Associate Dean for Assessment and Evaluation and Scholarship will be final.

Foundations of Clinical Medicine-2

Foundations of Clinical Medicine-2 is an extension of the FCM curriculum. It runs in tandem with the Phase 2 and is a Pass/Fail course. A requirement of this course is successful passing of the Clinical Performance Examination (CPX) to be taken at the completion of Phase 2. Students failing the CPX are referred to the ASAC and should review their performance and address their deficiencies prior to retaking the examination. Students who have failed the CPX are required to participate in CPX remediation sessions as a condition of their reexamination.

Remediation of Academic Deficiencies in Required Courses of Phase 3:

There are 6 required courses in the Phase 3 Curriculum: Bedside to Community (B2C); an Advanced Clinical Elective (ACE); the Emergency Medicine Course (EM), the Intensive Critical Care Medicine Course (ICCM), the Internship Readiness Course and Foundations of Clinical Medicine-3 (FCM-3). The ACE, the EM Course, and the ICCM Course are 4-week required experiences that are graded Pass/Fail. B2C and the Internship Readiness Course are required 2- week courses that are graded Pass/Fail. FCM-3 runs throughout Phase 3 and is a Pass/Fail course. Students must achieve a passing grade in all 6 of these courses to receive credit. Remediation of a deficiency in these courses is required.

Remediation of a deficiency in an elective is not required, however the student will not receive credit toward the MD degree for that elective. A student must meet the elective credit requirements in order to fulfill graduation requirements. Failures in the Phase 3 curriculum will be referred to the ASAC to determine the plan for remediation.

Narrative or P/F Grade Challenge in Phase 3

If a student wishes to challenge their grade or the contents of their performance summary narrative in a Phase 3 course, the request must be made to the course director within 4 weeks of the assignment of that grade. The student must meet with the course director to discuss their concerns. If this does not resolve the issue, the student has the right to appeal in writing to the Associate Dean for Curriculum and Associate Dean for Assessment, Evaluation and Scholarship. This appeal must occur within 2 weeks of the course director’s decision. The joint decision of the Associate Dean for Curriculum and the Associate Dean for Assessment, Evaluation and Scholarship will be final.

Entrustable Professional Activities (EPAs)

The UVA Entrustable Professional Activity (EPA) Program is a longitudinal, integrated component of the curriculum in which learners are assessed through direct observation during authentic patient encounters. EPAs are clinical tasks outlined by the Core Entrustable Professional Activities for Entering Residency (https://www.aamc.org/media/20211/download). Additional information about the program can be found at (https://med.virginia.edu/md-program/ume-md-curriculum/longitudinal-curriculum/) or in the VMED system under EPA Program Resources in the Quick Links Section).

Although the data from EPA assessments do not contribute to course/clerkship/elective grades, EPA assessments are required components of the curriculum. The specific requirements (number of EPA assessments) for each course/clerkship/elective are reviewed and approved by the Curriculum Committee. If a student fails to complete the required assessments, the EPA Leadership team will review the issue to consider submission of a Professionalism Concern card. The Entrustment Committee aggregates data from EPA assessments to make a summative decision about students’ readiness to perform EPA tasks with specified levels of supervision at each of these stages. If at any stage the Entrustment Committee has concerns about a student’s abilities to meet clinical performance expectations, they can refer the student to the Clinical Skills Enrichment Program for additional small group or individualized coaching. If at the end of the Phase 2 clerkship phase, the Entrustment Committee has concerns about a student’s readiness to perform EPA tasks with indirect supervision, the Committee will make a recommendation to the Academic Standards and Achievement Committee (ASAC) that the student should engage in an enrichment elective, the Clinical Mastery Elective, prior to enrolling in an Advanced Clinical Elective. The ASAC determines if a student is required to complete the elective.

Incompletes and University Withdrawals

An Incomplete may be assigned for a course or clerkship on a student’s transcript should an emergent situation, e.g., death of immediate family member, illness or accident, etc., arise after the student successfully has completed the majority of the requirements. An Incomplete cannot be assigned as a grade when the student is failing the course or clerkship. When the requirements have been completed, the Incomplete will be removed and replaced by the course or clerkship grade. An Incomplete grade will become an F one year after it is issued if not remediated. Grades that become an F after one year will not be changed after remediation.

Should a student need extended time off from medical school, interrupting a course or clerkship, the student must request a leave of absence or withdrawal per School of Medicine Leave of Absence, Withdrawal, Readmission Policy (https://med.virginia.edu/policies/leave-of-absence-withdrawal-and-readmission-policies/ ).

Graduation

In order to receive the recommendation from the ASAC for graduation and conferral of the MD degree, a student must satisfy all academic and professionalism requirements with no outstanding deficiencies. In addition, passing scores on the CPX, USMLE Step 1 and USMLE Step 2 are required for graduation.

Steps 1 and 2 of United States Medical Licensing Examination (USMLE):

Passing USMLE Step 1 and USMLE Step 2 is required for graduation. Students are allowed a total of three attempts to pass Step 1 and a total of three attempts to pass Step 2. Failure to pass either exam on the third attempt will result in the student’s dismissal from the School of Medicine, without recourse to the appeals process. For May graduation, passing both exams must be documented by May 1.

Overall Time Limits

All requirements for graduation, including passing USMLE Step 1 and Step 2 , must be completed within six years from the date the student matriculated in the School of Medicine. For students in the MD/PhD combined degree program, graduation requirements must be completed within nine years; students in the MD/JD program must complete graduation requirements within eight years; for students in other combined degree programs graduation requirements must be completed within seven years. Exceptions to this policy are rare and must be approved by the ASAC.

Testing Accommodations

When testing accommodations have been granted to a student by the SOM, a student must share their intention to utilize that accommodation with the respective course or clerkship director at least two weeks prior to a formative/summative assessment in Phase 1and at the time of orientation for each clerkship during Phase 2.

Procedure for Handling a Deficiency or Failure

The Course, System or Clerkship Director notifies both the student and the School of Medicine Registrar/College Dean of deficiency or failure.
The student is withdrawn from clinical responsibilities (if applicable).
The student is required to meet with their College Dean. At this meeting, the Policy on Academic and Professional Advancement is discussed, and the student is notified of the next the ASAC meeting. The ASAC meetings usually occur monthly. In Phase 1 of the curriculum, a student who scores less than 70% on a summative assessment shall meet with the system leader and/or the Director of Academic Enhancement to discuss learning strategies to improve performance.
The student shall be reviewed by the ASAC.
Students may submit a written statement, results of a drug test, results of a Counseling and Psychological Services (CAPS) screening or any other relevant data to the ASAC and/or request to meet in person with the ASAC.
All students subject to dismissal, suspension, or who may be required to repeat an academic period will be offered the opportunity to meet with the ASAC, whether at an ASAC meeting and/or a special meeting. An academic period is defined as any course or clerkship for which a student receives an independent grade.
The ASAC reviews each student’s medical school file, considers any other relevant information or data and recommendations from a Course or Clerkship Director, and determines remediation or other action based upon the Policy on Academic and Professional Advancement. If the ASAC determines that dismissal, suspension, or repetition of an academic period may be an appropriate action, the decision will be deferred, and the student will be invited to return before the committee at a special meeting subject to the process below. If it is known in advance that dismissal, suspension, or repetition of an academic period will be considered, the matter may be referred directly to a special meeting.
The Chair of the ASAC notifies the student in writing of the Committee’s decision.
If applicable and approved, the Office of Student Affairs schedules the remediation required by the ASAC in collaboration with Course or Clerkship Directors considering the make-up schedule for that academic year.
In cases in which the ASAC determines that dismissal, suspension, or repetition of an academic period may be an appropriate action, the student will be notified that a special meeting will be scheduled as soon as possible, but with the allowance of adequate time for the student to prepare. The purpose of the special meeting is to afford the student a full and fair opportunity to present any evidence they would like the ASAC to have before deciding on action. The following rules shall govern the special meeting:
- In preparation for the special meeting, the student is permitted upon request to inspect their entire medical school file.
- At the special meeting, the ASAC chair (or their designee) will present information regarding the academic and/or professionalism concern(s), which may include documentation and/or witnesses. The student also will have the opportunity to present evidence to explain or mitigate the academic and/or professionalism concern(s), which may be in the form of their own testimony, witness testimony, or documentation.
- Legal counsel representing the student may attend the special meeting, but counsel’s role is limited to providing advice to the student. Legal counsel will not be permitted to participate actively in the presentation of testimony, questioning of witnesses or presenting argument.
- In advance of the special meeting, the student and the ASAC chair will exchange exhibit and witness lists on a date to be determined by the ASAC chair. Thereafter, both parties may designate rebuttal exhibits and/or witnesses on a date to be determined by the ASAC chair. Absent unusual circumstances, no additional evidence will be permitted to be presented at the special meeting.
- The student may present evidence at the special meeting in the form of testimony (including their own) and documentary exhibits.
  - Affidavits may be produced in lieu of live testimony, with the understanding that such affidavits may receive less weight than live witnesses, because there will be no opportunity to ask additional questions of the individual.
  - The ASAC will take reasonable efforts to ensure that any SOM faculty and staff that the student requests to provide testimony at the special meeting are able to attend in person. However, this may result in scheduling delays.
- At the special meeting, the ASAC chair (or their designee) will present the academic and/or professionalism concern(s) regarding the student, followed by any additional evidence they wish to present to the ASAC for consideration. Thereafter, the student will present any evidence and/or testimony on their behalf. Following testimony of a witness or the student, the student and members of the ASAC will have an opportunity to ask questions.
  - Witnesses must be treated with respect at all times. The ASAC chair may cease or limit questioning of a witness for failure to do so.
- The special meeting will be recorded by the ASAC. No other recording or photography of the special meeting is permitted. Upon request, the student will be provided with a copy of the recording within a reasonable time following the hearing.
- The ASAC chair retains the right to put reasonable limits on the number of witnesses to be presented and the total length of the special meeting based on the circumstances of the particular situation.
- Following the special meeting, the ASAC will meet to decide on the appropriate remedy. The ASAC will hold a formal vote to confirm any decision. The student will be informed of the ASAC’s decision in writing as soon as possible following the vote.

If the ASAC votes to suspend or dismiss a student, the student can appeal the decision of the ASAC following the Appeals Process described below. However, decisions regarding graduation due to failure to pass USMLE Steps 1 or 2 cannot be appealed.

The SOM registrar shall communicate with student, College Dean and the ASAC to confirm when deficiencies or examination failures have been remediated.

Academic Appeals Process

If the ASAC requires a suspension or dismissal from the School of Medicine, the notification to the student will provide the option of an appeal and a description of the appeals process, except that students failing to pass Steps 1 or Step 2 of the USMLE within three attempts for each exam will not be permitted an appeal. The student must notice their appeal to the Associate Dean for Student Affairs no later than 14 days from receipt of notification or lose the right to appeal.
Upon written notification from an eligible student to the Associate Dean for Student Affairs indicating the student’s decision to appeal, the Associate Dean for Student Affairs shall notify the Appeals Committee, who will review the decision of the ASAC. The three-person Appeals Committee is a standing committee appointed by the Dean, comprised of three clinical department chairs, as well as two alternate clinical department chairs in case of conflict of interest or scheduling issues. The Assistant Dean for Compliance and Accreditation serves as staff liaison to the Appeals Committee, ex officio, and without vote.
The student is permitted to inspect their entire medical school file, including any material upon which the decision of the ASAC was based. The Appeals Committee will be provided with all materials submitted at the special meeting of the ASAC, to include a transcript of the special meeting, and a copy of all exhibits and other documents used or referenced at the special meeting. The student and the ASAC chair (or their designee) also will be provided with all of these materials not already in their possession.
The student is permitted to have counsel, but legal counsel’s role at the Appeals Committee hearing is to provide advice to the student. Legal counsel may not participate actively in the proceeding.
The Appeals Committee is to conduct an appeal hearing within a reasonable period of time as the schedules of the involved parties permit. In preparation for the appeal hearing, the Appeals Committee will review the special meeting record and evidence.
Appeals Committee hearings will provide both the student and the medical school representative presenting the case equal time to argue why the ASAC decision should be upheld or rejected. The Appeals Committee may limit the time provided for the hearing, which shall be binding upon the hearing participants. Absent unusual circumstances (to be determined by the Appeals Committee chair), no new evidence or witnesses may be produced at the appeal hearing. Instead, the appeal hearing is an opportunity for the student to highlight the important pieces of information and evidence presented to the ASAC, and advocate for a different outcome.
The Appeals Committee will uphold, modify, or reject the decision(s) of the ASAC. In its deliberations, the Appeals Committee must accord deference to the decision of ASAC. The Appeals Committee’s review shall be limited to: (a) compliance with the Policy on Academic and Professional Advancement and other applicable UME policies and procedures, and (b) whether there is sufficient evidence to support the decision of ASAC. The Appeals Committee may uphold, modify or reject the adverse action. However, before modifying or rejecting the adverse action, the Appeals Committee must conclude that: (a) there was a failure to follow the Policy on Academic and Professional Advancement and/or other applicable UME policies and procedures and that failure negatively affected ASAC’s decision, and/or (b) that there is not substantial evidence to support the decision.
The appeal hearing will be recorded by the Appeals Committee. No other recording or photography of the hearing is permitted. Upon request, the student will be provided with a copy of the recording within a reasonable time following the hearing.
Following argument by the student and the ASAC chair (or their designee), the Appeals Committee will adjourn the hearing and reach a decision.
The Appeals Committee’s decision must be submitted to the student, the chair of the ASAC, and to the Dean and/or the Dean’s designated chief academic officer within ten (10) calendar days of the close of the hearing and copied to the Office of Educational Affairs and the registrar.
The decision of the Appeals Committee will be final, except that a student may submit a procedural challenge for failure to comply with the academic appeals process to the Dean of the School of Medicine. Should the Dean and/or the Dean’s designated chief academic officer determine that there was a failure to follow procedure, the Dean and/or the chief academic officer will remand to the Appeals Committee for remediation of the compliance issue and reconsideration.

General Operational Procedures

The ASAC will schedule monthly meetings and will also meet on an as-needed basis (within 10 days of a report, e.g., egregious behavior) to address immediate issues. The ASAC may be superseded by University policy or legal action.

Definitions of Academic Status

A student may be placed on academic warning by the ASAC during a specified period in which the student’s academic and/or professional deficiencies must be remediated or they will risk progression to academic probation. An academic warning is not reflected on the MSPE.

A student may be placed on academic probation by the ASAC during a specified period in which the student’s academic progress and/or professional behaviors are monitored closely with periodic required reviews by the ASAC. The student remains enrolled during this time. The committee may appoint specific faculty to implement remediation and evaluate the student’s progress. If deficiencies or failures are not rectified according to the remediation plan set by the ASAC within the specified period of time, the student is subject to dismissal from the University. Academic probation is reflected on the MSPE.

Definitions of Academic Standing

A student is in good academic standing if the student makes satisfactory progress, defined as progressing at a pace of completion allowing the student to meet academic requirements to achieve the Doctor of Medicine degree within a six-year limit (150% of the program length) set from matriculation.

A student is not in good academic standing if making inadequate academic progress that threatens their ability to achieve the Doctor of Medicine degree within a six-year limit set from matriculation as determined by the Academic Standards and Achievement Committee.

The following are standards for each phase of the curriculum to determine whether or not students are maintaining Satisfactory Academic Progress (SAP).

Phase 1, Pre-clerkship:

A student is declared not in good academic standing if they have failures in any course or system that are not successfully remediated at the time of the first day of class, second and third semester.

A student is declared not in good academic standing if they have greater than 2 course Incompletes and/or Withdrawals and if the Incompletes or Withdrawals are not remedied at the time of the first day of class, second and third semester.

A student is declared not in good academic standing if they have failures in any course that are not successfully remediated at the time of the first day of clerkships.

Phase 2, Clerkships:

A student is declared not in good academic standing if they have greater than 2 failures, Incompletes, and or Withdrawals in any clerkships or the intersession course which have not been remediated prior to the beginning of the Phase 3 Curriculum.

Phase 3, Post-Clerkship:

The student is declared not in good academic standing if not making adequate progress to achieve the Doctor of Medicine degree within the time limit set from matriculation.

The student is declared not in good academic standing if they fail two or more elective rotations or required Phase 3 courses.

Oversight

The Curriculum Committee has oversight and approval for this policy.

Related Policies

History

Revised and reaffirmed May 2024
Revised August 2023
Reviewed and reaffirmed May 2023
Revised June 2022
Revised June 2021
Revised July 2020
Revised June 2019
Revised July 2018
Revised June 2017
Revised July 2016
Revised November 2015
Revised July 2015
Revised August 2014
Revised August 2013
Original effective date April 1, 2012