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MUSC Bulletin | College of Medicine

College of Medicine | Academic Enhancement, Probation, and Professionalism Concerns

Individual student performance is closely monitored by the Dean’s Office. When a student’s performance does not meet designated levels of competency, either academically or professionally, a system of increasing surveillance is instituted as described below.

Academic Enhancement Plans
An academic enhancement plan is established for those students who demonstrate academic difficulties that if left unchecked could lead to more substantial academic problems.  A student will be required to meet with the Associate or Assistant Dean for Student Affairs: 1) if a student demonstrates substandard performance at any point in time in one or more themes, 2) if a student does not complete a clinical clerkship in its entirety (e.g. fails on OSCE or NBME exam on the first attempt , or 3) if the student does not successfully pass Step 1 or Step 2 of the USMLE on the first attempt.  At that time, the student will be required to develop an Academic Enhancement Plan.  The plans are designed to help prevent significant academic problems from developing or from progressing to probation. The College of Medicine Progress Committee expects each student to fully cooperate in creating and fulfilling the academic enhancement plan. While on an academic enhancement plan, students should minimize outside extracurricular activities (including any obligations with substantial time commitments) until the academic enhancement plan has demonstrated success.
 

Student Progress Committee

The Student Progress Committee conducts standing meetings at the end of each academic semester, as well as on an as needed basis. During these meetings, the Progress Committee reviews the academic and professional progress of all students with regard to established progression standards. Students in good academic standing are approved in aggregate for continuation of their studies at the meeting following the end of the academic semester. Students who do not meet required academic or professional standards or whose progress may be lagging as evidenced by academic and/or professional concerns are considered individually by the Progress Committee. When appropriate, additional Progress Committee meetings are called to consider students who are not demonstrating appropriate academic or professional progress. In all cases involving the possibility of an adverse action being recommended, the student will be invited to meet with the Progress committee, and no action will be recommended or taken until the student appears before the Progress Committee to discuss their particular circumstances. In addition, the student is afforded specific appeal rights in all cases involving a recommended adverse action. The appeal process will be conducted by a separate committee, namely the Student Progress Appeals Committee.

Reasonable efforts will be made to accommodate the student ‘s appearance before either the Student Progress Committee or the Student Progress Appeals Committee. A student may refuse to appear before a committee.  If a student does not report to the committee, a certified letter will be sent to the student to ensure that notification was received.  If student does not appear after certified notification, the Progress Committee may proceed with the recommendation, including potentially adverse actions. Student appeal rights also apply to this circumstance.              

Reasons for Referral to Progress Committee 
The Progress Committee may require students to appear before the committee for any of the circumstances listed. 

Preclinical Years
Academic Performance of less than 70% in any theme at the end of each block and/or at the end of each semester
Failure to remediate a theme at the end of a semester
Failure to complete the CPX 2 and Board Preparation Course at the end of year 2
Failure to take Step 1 by August after the second academic year
Failure to successfully complete Step 1 after three (3) attempts or failure to complete second attempt within 6 months of first attempt

Clinical Years
Failure to successfully complete Step 2 CK and Step 2 CS after three (3) attempts or failure to complete second attempt within 6 months of the first attempt
Failure of any clinical course or rotation
Failure of any clerkship OSCE or written exam
Failure of CPX3 exam and/or failure to remediate CPX 3 exam

All Academic Years
Failure to maintain satisfactory academic progress in meeting the degree completion requirements
Failure to take the USMLE Step exams by the specified time
Failure to meet professional expectations or requirements
All granted leave of absences or academic withdrawals
Failure to adhere to academic or professionalism advice by Student Affairs if the student is having either academic or professionalism difficulty
Failure to progress academically so that the requirements for graduation cannot be completed within 6 years.

Student Advocacy and Advisement
It is the role of the Office of Student Affairs to provide academic advisement to students from initial matriculation through successful graduation from medical school. Student Affairs monitors the academic and professional progress of all students. With regard to the Student Progress Committee, the Associate and/or Assistant Dean of Student Affairs meet with students prior to any appearance before the Student Progress Committee, Student Progress Appeals Committee, or Professionalism Subcommittee. At such meetings, the Associate or Assistant Dean for Student Affairs explains the process to the student and assists the student in preparing for the meeting (the written statement and verbal presentation). One or both Student Affairs Deans attend all Progress Committee meetings in an ex officio capacity to provide support and advocacy on behalf of the student. The student is also permitted to bring additional support person(s) or advocate(s) (not legal counsel) to any appearance before the Progress Committee.

Student Appeal Process
In cases where the Progress Committee recommends an adverse action (e.g., repeating school year, academic or professionalism probation, leave of absence, school withdrawal, dismissal), the student has the right to appeal this decision. Student appeals are heard by the separate Student Progress Appeals Committee. This committee consists of at least 5 members appointed for 3 year terms by the Senior Associate Dean for Medical Education (3 members constitutes a quorum). To avoid a potential conflict of interest, none of the members from the Student Progress Committee may serve on the Student Progress Appeals Committee. The ex officio members of the Student Progress committee include the Senior Associate Dean for Medical Education, the Associate and Assistant Deans for Student Affairs, and the Associate Deans for Curriculum - Basic and Clinical Sciences.

While the student is offered the opportunity to appeal all recommended adverse actions, the student can also choose at any point to waive their right to appeal. In addition, all appeals are completed in a timely manner with a target of no longer than 30 days following initial recommendation of an adverse action until the completion of all appeal procedures (sooner when possible). All appeals must be requested in writing to the Office of Student Affairs no later than 7 calendar days following initial recommendation of an adverse action. Unsuccessful appeals before the Student Progress Appeals Committee may be appealed directly to the Dean. All decisions rendered by the Dean are considered final.

Specific Circumstances

First Year

1.     A student who fails a theme or themes must remediate (if eligible) before the beginning of the next semester.

2.     If the student successfully remediates, then he/she must meet with the Associate or Assistant Dean for Student Affairs and is required to develop an academic enhancement plan.  Students are required to comply with all terms of the academic enhancement plan.

3.     If the student is ineligible for remediation or the remediation is unsuccessful, the student is eligible for dismissal and is referred to the Student Progress Committee.

Second Year

1.     A student who fails a theme or themes in the fall semester must remediate (if eligible) before the beginning of the spring semester. If a student fails a theme or themes in the spring semester he/she must remediate (if eligible) before taking Step 1 of the United States Medical Licensing Examination (USMLE).

2.     If the student successfully remediates the theme or themes, then he/she must meet with the Associate or Assistant Dean for Student Affairs and is required to develop an academic enhancement plan. Students are required to comply with all terms of the academic enhancement plan. 

3.     If the student is ineligible for remediation or the remediation is unsuccessful, the student is eligible for dismissal and will be referred to the Student Progress Committee.  

National Board Examinations

Students must adhere to USMLE regulations regarding the maximum number of attempts within one year (see www.usmle.org). Students are expected to review the Federation of State Medical Boards State-Specific Requirements for Initial Medical Licensure to understand the implications of failed  board examination attempts (http://www.fsmb.org/licensure/usmle-step-3/state_specific). 
 

National Board Examination, Step 1
All rising third year students must sit for Step 1 of the United States Medical Licensing Exam (USMLE) before beginning clinical rotations. 

If a student does not pass Step 1 on his/her first attempt:

·         He/she will be allowed to complete the rotation in progress and, if he/she is successful, both clinically and on any examinations, will receive course credit. 

·         He/she then will be registered for an Independent Study Course to prepare for Step 1 and must take a leave from 3rd year rotations

·         The student is required to meet with the Associate or Assistant Dean for Student Affairs and it is required that an academic enhancement plan be created. Students are required to comply with all terms of the academic enhancement plan. 

·         The student must complete a second attempt for Step 1 within 6 months of the first attempt.

If the student fails the examination on the second attempt:

·         He/she will be placed on academic probation and will remain on academic probation until he/she passes Step 1. 

·         He/she will be registered for the Independent Study Course until a passing score is achieved. 

Once a passing score is received, the student will be eligible to begin his/her next scheduled rotation. 

Students who do not pass Step 1 on their third attempt are eligible for dismissal and will be referred to the Student Progress Committee.

National Board Examination, Step 2 CK (Clinical Knowledge)
Successful completion of Step 1 of the USMLE is required before a student can take Step 2 CK. 

Students must take Step 2 CK before October 31 of their fourth year. This allows students to take the exam and, in the event that they do not pass, allows them enough time to take it again before graduation. 

If a student does not pass Step 2 CK on his/her first attempt:

·         He/she will be allowed to complete the rotation in progress and receive course credit if he/she is successful, both clinically and on any examinations. 

·         The student must arrange his/her schedule to prepare for the second attempt. The student is required to meet with the Associate or Assistant Dean for Student Affairs, and it is required that an academic enhancement plan be created. Students are required to comply with all terms of the academic enhancement plan.

·         The student must complete a second attempt for Step 2 CK within 6 months of the first attempt.

If a student does not pass Step 2 CK on his/her second attempt:

·         He/she will be placed on academic probation and will remain on academic probation until he/she passes Step 2 CK. 

A passing score on Step 2 CK is required for match certification. Failure to adhere to the established deadlines will lead to a referral to the Progress Committee and may result in an interruption of a student’s coursework, failure to graduate on time, and may result in the cancellation of his/her residency contract.  If a student matches for a residency position and has not successfully completed Step 2 CK, the student will not receive the Doctor of Medicine degree until the exam has been passed and the College of Medicine Dean’s Office will notify the residency program of the situation.

Students who do not pass Step 2 CK on their third attempt are eligible for dismissal and will be referred to the Student Progress Committee.

 

National Board Examination, Step 2 CS (Clinical Skills)

Students must take Step 2 Clinical Skills (CS) prior to November 30 of their fourth year.  Failure to take the exam by the deadline will result in a referral to the Progress Committee. Students must adhere to USMLE regulations regarding the Step 2 CS exam – see www.usmle.org for the full policy).  A passing score on Step 2 CS is required for graduation.

If a student matches into a residency position and has not successfully completed Step 2 CS, the student will not receive the Doctor of Medicine degree until the exam has been passed and the College of Medicine Dean’s Office will notify the residency program of the situation. 

If a student does not pass Step 2 CS on the second attempt he/she will be placed on academic probation. If a student does not pass Step 2 CS exam on the third attempt he/she is eligible for dismissal and will be referred to the progress committee.

Clinical Years
A student who receives a grade of IN for a clerkship will be required to meet with the College of Medicine Associate or Assistant Dean for Student Affairs and will be advised to participate in an academic enhancement plan developed by the student with assistance from a Student Affairs Dean. The student must remediate all third-year course work prior to August 1st of the fourth year unless extenuating circumstances exist (e.g., personal illness.)

1.     A student who receives a failing grade for a clerkship will be required to repeat the course and will be placed on academic probation. Probationary status is removed once the failed clerkship is successfully repeated. 

2.     Should a student receive a second IN before clearing the first, the student must immediately withdraw from course of study which he/she is presently taking and satisfactorily remove both IN grades before progressing. Exams and other failed components must be taken at the first offering in such instances.

3.     A student who has not remediated all 3rd year core clerkship course work will not be allowed to register for the USMLE Step 2 examination or participate in away rotations.

4.     A student who receives a failing grade for a clinical core course in the 4th year (e.g., the Senior Medicine Rotation or the Externship) will be placed on academic probation and must remove this deficiency by repeating and passing a core course at the first available opportunity. The student may be referred to the Progress Committee.

5.     A student who receives failing grades in two clinical core courses is eligible for dismissal and will be referred to the Student Progress Committee.

6.     A student who fails a selective or elective will receive a grade of Fail on their academic transcript. The student may be given the opportunity to repeat that selective/elective (at the discretion of the course director depending on the extent of the student’s deficits) or the student may be required to take a different selective/elective to demonstrate competency and ensure adequate remediation.

Clinical Practice Exam in Year 3 (CPX3)
The Clinical Practice Exam consists of standardized patient encounters and corresponding writing stations and is administered in May-June of year 3.  This examination is graded on an honors/pass/fail basis and will be included on students’ transcripts. In the event that a student fails the CPX3, a mentor will be assigned to him/her in order to remediate the problems that caused failure on the exam and the student must retake the exam.  Students must successfully pass or remediate the CPX3 prior to taking the USMLE Step 2 Clinical Skills exam.  Successful completion of the CPX3 is required for degree completion.   Remediation of the CPX3 will be reported on the MPSE. The Student Progress Committee reviews students’ CPX 3 performance. Students who fail the CPX 3 exam or who fail to remediate successfully are referred to the Progress Committee.

Academic Probation
Academic probation is established to identify those students who have had more significant academic problems. A student will be placed on academic probation for one or more of the following reasons: 1) if a student demonstrates failing performance in one or more themes, 2) if the student receives a failing grade for a clerkship, selective, or elective or 3) if the student does not successfully pass Step 1 or Step 2 of the USMLE on the second attempt.  Without demonstrable improvement during the probationary period, the student may be eligible for dismissal. The student will be informed of the probationary status in writing.  In the pre-clinical years, probationary status is removed at the discretion of the progress committee after a student has demonstrated a sustained and robust academic performance. In the clinical years, probationary status is removed once the failed clerkship is successfully repeated or the USMLE Step examination is successfully passed. Upon graduation with the M.D. degree, only information that is required to be disclosed will be shared with third parties.

Each student on academic probation is also required to meet with the Associate or Assistant Dean for Student Affairs to develop an Academic Monitoring Contract. Adherence to the contract is mandatory for continuation in medical school. Failure to do so may result in dismissal from medical school.  Students are required to play an active role in the development of the Academic Monitoring Contract.

While on probation a student must attend all required classes and activities unless precluded by a bona fide emergency or unless the absence is approved in advance by the course instructor or the Dean's Office.  A physician must document absence from a major exam due to illness. Except for the fourth year, no electives are permitted while a student is on academic probation; during the fourth year, no away rotations may be taken by a student on probation. During probation students may neither hold an elected office in student organizations nor represent the College at meetings. The student may not participate in activities that would entail absences from required courses.

Probation and/or any other adverse actions will be disclosed on the Medical Student Performance Evaluation (MSPE) at the time of application for residency (as required).

  
Last Published with Edits:August 15, 2016 10:08 AM
Last Comprehensive Review: August 2016
 
 
 
 

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