Student Academic Progress

Student Progress Committee

The Dean of the School of Medicine has delegated to the Student Progress Committee responsibility for issues related to the progress of students while enrolled in medical school. This includes, but is not limited to, decisions on promotion, remediation, probation, leaves of absence, expanded curricular programs, suspension, dismissal and graduation.

The Student Progress Committee is composed of nine to twelve faculty members from the UW School of Medicine. The Associate Dean of Student Affairs serves as the committee's chair. Faculty members are selected based on their knowledge and understanding of the medical school program and their interest in committing time to serve on the committee. The committee membership also represents a balance between the basic science and clinical disciplines.

The Student Progress Committee expects that students will perform at an unqualified passing or above level in all coursework, and will satisfactorily meet all graduation requirements. The student usually receives feedback on his/her performance through course examinations or other assessments and may also discuss performance with the Associate Dean of Student Affairs or with the Student Progress Committee when necessary. A student who has received two fail grades during the academic year will automatically be placed on academic probation. The committee may also place a student on probation based on overall marginal performance to provide a warning of poor performance.

The committee reviews students' records on a routine basis to ensure satisfactory progress in all areas included in the requirements for graduation. These include performance in coursework, III, USMLE Steps 1, 2-CK, and 2-CS, professional attitudes and behavior that demonstrate fitness for medicine, and high standards of conduct within the medical school and community. Recognizing that students progress at varying rates, there are opportunities given for additional study and reexamination to learn the material and for expansion of the curriculum beyond the four years if this is considered to be the appropriate approach given the identified deficiency. A pattern of documented concerns (two or more) about a student's performance may indicate an unsatisfactory performance when the record is viewed as a whole, even though passing grades have been assigned in each course or clerkship. Dismissal from the School may occur, regardless of whether the student has been on probation, if the student fails to maintain an acceptable academic record, fails to follow academic directives provided by the School's committees, or fails to develop professional attitudes and behavioral patterns appropriate to a career in medicine. The Faculty Council on Academic Affairs reviews the Student Progress Committee's actions, and the Dean of the School of Medicine has final approval of the committee's and council's recommendations for dismissal.

The review mechanism available to the student will, in general, include:

(1) notification of inadequacies when they occur and where appropriate,
(2) careful and deliberate decision-making
(3) an opportunity for the student to meet informally with the Student Progress Committee

The student may be accompanied by a medical school faculty advocate. The presence or appearance of a student's legal counsel is not permitted because a formal hearing and appeals are not part of the academic review process. The committee's decision is based on the professional judgment of faculty after reviewing the student's entire academic record including the student's academic performance in both cognitive and non-cognitive areas.

As part of the Student Progress Committee’s operating guidelines, the committee has approved a process for providing advance information to course chairs and/or clerkship directors on students who have had significant difficulty in coursework or in areas of professional and personal conduct. The following guidelines are used when providing information in advance of the student beginning the course or clerkship:

The Student Progress Committee approves the use of the advance information process when the student has had significant difficulty in prior coursework. This difficulty may be in any area(s) of evaluation, (i.e. cognitive and/or non-cognitive). The two major objectives for using the advance information process are: (1) to provide the student with additional support and help in the area(s) of deficiency as appropriate and (2) to ensure that there is adequate feedback to the student and evaluation of the area(s) of concern.

Having the information prior to the beginning of the course or clerkship, the course chair or clerkship director can use discretion in making small group or tutor assignments (predominantly for basic science courses) or for selecting the team or hospital site to which the student is assigned (predominantly for clinical clerkships or electives). The advance information also allows the course chair or clerkship director to directly handle situations that may arise during the course or clerkship should the faculty, teaching assistants or residents identify a problem early.

To reduce the possibility of negative bias, the information on the student’s record is sent only to the course chair or clerkship director and not to the individual faculty member and teaching assistant or attending and resident team to which the student is assigned. It is anticipated that the course chair or clerkship coordinator will check discreetly with the appropriate individuals at an appropriate interval after the course has begun to see whether any problems have arisen. As needed, the course chair or clerkship coordinator will speak to the chair of the Student Progress Committee about the student’s progress.

The student is advised when the advance information process is being used, and receives a copy of the information sent by the chair of the Student Progress committee to the course chair or clerkship director describing the process and the area(s) of deficiency or concern. The student is also advised to contact the course chair or clerkship director prior to the beginning of the course in order to establish a contact with whom to discuss issues of concern and to agree upon a mechanism for dealing with problems should they arise.

The Student Progress Committee has also authorized the chair of the committee to use discretion in providing information to course chairs or clerkship directors at a lower threshold of difficulty to provide earlier intervention to assist the student. The College mentor may also serve as a helpful resource to the course chair or clerkship director should issues arise in communications at the mentor–clerkship director level. Clerkship directors who are aware of a student having difficulty in their clerkship may, with the student’s permission, provide advance information to the clerkship director of the next clerkship to which the student is assigned. The intent of this extended use of advance information is to permit earlier intervention and assistance for students having difficulty and/or to allow for better decisions on small group or clinical site or team assignments that may provide a better learning environment for the student.

Guidelines for advance information on student academic progress

The following are general guidelines, which have been established by the committee, on what is expected of all students. When a student does not meet these general expectations, the committee will set specific guidelines for performance that are relevant to the issue being considered.

All required basic science courses and clinical clerkships must be completed within the University of Washington School of Medicine's own program. Under rare circumstances, and with the approval of the course chair, Student Progress Committee and the appropriate curriculum committee, a student may be permitted to complete a required course at another approved medical school.

A student is expected to complete successfully the first year of the Foundations Phase curriculum in order to be promoted to the second year, and is expected to complete successfully the second-year Foundations Phase prior to being promoted to the clinical curriculum. If the Student Progress Committee recommends dismissal while the student is in the basic science curriculum, the committee will determine the appropriateness of the student's continuing in coursework. If the student is permitted to continue in coursework or in fulfilling other graduation requirements such as Independent Investigative Inquiry or USMLE during the dismissal review process, the committee will make a decision, on a quarterly basis, whether to permit the student to schedule additional coursework. In most cases, the student will not be able to complete more than one quarter's work while in the dismissal review process.

The USMLE Step 1 examination must be taken following successful completion of the Foundations Phase curriculum and prior to entering the clinical curriculum. The student must be enrolled and in good academic standing to be approved to take the USMLE examination. If the student does not pass this examination, he/she may not be permitted to continue in the clinical curriculum.

In the clinical curriculum, students are expected to complete the required third-year clinical clerkships without interruption, unless there is a personal or family emergency or academic issue for which permission is given to reschedule a clerkship. Permission is required to delay a required third-year clerkship into the fourth year. Should a fail grade be received in a clinical clerkship and if the student is permitted to continue in school, the Student Progress Committee, in consultation with the department, will arrange the remediation as soon as possible. In most cases, the student will be expected to repeat the clerkship at the next available opening. At times, the deficiency in a clerkship may be sufficiently serious that no additional clerkships may be taken until the level of the student's competence can be determined through a mechanism agreed upon by the Student Progress Committee in consultation with the department that submitted the fail grade. Similarly, if the fail grade results in a dismissal recommendation, no additional coursework can be taken without the approval of the Student Progress Committee. Should an issue of personal and/or professional behavior be raised as a concern, the appropriate administrative official and/or the Student Progress Committee will make a decision on whether the student may continue in the clinical curriculum. Examples of issues that will prohibit continuance in the clinical setting are concerns related to patient care or potential for compromising necessary compatibility for effective functioning of the healthcare team, as well as concerns related to professionalism.

Both components of the USMLE Step 2 examination must be passed prior to graduation. USMLE Step 2-Clinical Knowledge and Step 2-Clinical Skills must be taken in the July-to-September time frame of the fourth year. The status of compliance of taking on time and/or completion of the USMLE examinations is noted in the dean's Medical Student Performance Evaluation (MSPE). If either component of Step 2 is not passed, this and the timing of the retake will be noted in the dean's MSPE. The residencies to which students applied or matched are informed of the student's status if unsuccessful on either component of Step 2.

Satisfactory progress on the Independent Investigative Inquiry (III) project is monitored. The III requirement must be completed in a timely manner based on the student's progress in the curriculum. Deadlines for III selective choice and final requirements are managed by the Curriculum Office. Failure to meet specified deadlines will result in an interruption of the student's progress in the clinical curriculum and may initiate a dismissal recommendation.

Throughout the medical school training, the student is expected to develop and demonstrate professional qualities, attitudes and behavioral patterns appropriate to a career in medicine and consistent with the oath taken at the time of graduation. The student is expected to maintain high standards of personal and professional behavior in interactions with patients, peers, members of the healthcare team and members of the faculty and staff, and to follow hospital policies and procedures. Integrity is considered an essential personal quality for successful completion of the M.D. program. Students are expected to abide by university, local, state, and federal regulations and laws. Should concerns arise in any of these areas, the appropriate administrative official and/or the Student Progress Committee may make a decision on whether the student may continue in the curriculum.

Guidelines for personal/professional conduct

The UW School of Medicine is committed to maintaining the highest standards of academic performance, professional behavior, personal integrity and respect for each other as individuals among our students, residents, fellows, faculty and staff. Integrity is considered an essential personal quality for successful completion of the M.D. degree, and thus breaches of integrity are considered grounds for suspension or dismissal. Medical students enter a world of self-regulation where they will be responsible for the professional behavior of their colleagues within the medical profession, as well as their own. It is expected that students will be on their honor to maintain these high standards of professional behavior in all aspects of their medical school training, both in the academic setting and also in the community.

Students are expected to abide by university, local, state and federal regulations and laws. Infractions of these standards may result in a sanction, up to and including dismissal, being imposed by the Student Progress Committee apart from whether there is any action that may be taken in civil or criminal court. For any infractions related to personal/professional behavior and conduct, the Student Progress Committee's review process will be followed. Where applicable, students may be referred to the University Disciplinary Committee.

Below are broad categories of personal/professional behavior and conduct that fall under the purview of the Student Progress Committee as part of the overall academic standards expected of students who are continued in the medical school program and/or recommended for graduation. This is not intended as an exhaustive list, but rather as general guidelines for students.

Cheating

  • Any examinations, including concurrent, no-fault, midterm or final
  • Copying work of others or intentionally allowing others to copy your work

Plagiarism

  • Careless attribution of sources
  • Intentional misrepresentation

Inappropriate interaction with patient

  • Taking action regarding patient care outside of the care team hierarchy
  • Arguing about diagnosis or treatment in front of patient
  • Describing patient in inappropriate terms
  • Inappropriate personal relationship with patient or member of patient's family

Inappropriate behavior in clinical setting

Non-compliance with HIPAA and/or Security Agreement

  • Taking patient's record from the hospital
  • Inappropriate access to patient's electronic record

Talking about patient in public setting

Acting beyond level of responsibility without direction from the patient care team

Fabricating clinical data (i.e., when asked about patient status or when recording information on the patient)

Inappropriate personal attire/hygiene; non-compliance with required immunizations

Ignoring proper universal precautions

  • Not following protocols for infection or disease spread precautions, such as for hepatitis B positive or HIV positive status

Inappropriate interaction with peers, staff, faculty

Argumentative behavior beyond what is reasonable for issue or setting

Harassment or abusive behavior

Assault

Inappropriate behavior outside coursework

Conviction of a misdemeanor or felony

Harassment or abusive behavior

Crimes against property

Guidelines for academic probation

Placement on probation

A student may be placed on academic probation if, in the judgment of the Student Progress Committee, his or her progress is unsatisfactory in any area that falls under the committee's purview related to graduation criteria.

If a student has two or more concurrent fail grades, he/she will be automatically placed on probation, or may be dismissed. Receipt of additional fail grades while on probation or failure to convert such grades to pass in accordance with the committee's specified timetable may result in dismissal from the UW School of Medicine.

Status while on probation

Probationary status is noted on the internal medical school transcript, but is not recorded on the official university transcript. Probation is essentially a warning to the student that she/he must show improvement if he or she is to remain in the School. The student is expected to maintain an unqualified passing or above level of performance in subsequent coursework for retention in the School and will be advised of any other criteria for performance or personal and professional behavior. This means that a marginal performance is unacceptable.

While enrolled in basic science courses, a student on probation must receive permission from the Dean of Student Affairs to take electives and should not plan to participate in major medical school or outside activities or work. While enrolled in the clinical curriculum, the Student Progress Committee will oversee the student’s scheduling of electives. If there are significant reasons to be considered for additional elective courses, activities or work, the student may request approval for changes from the Dean of Student Affairs, and any modification will be reported to the Student Progress Committee. The student should not expect to be approved for such programs as the International Health Opportunities Program (IHOP) or Integrating the Healthcare Enterprise (IHE), approved for coursework at other institutions, or to be recommended for entry into other major programs, fellowships or degrees while on probation.

Removal from probation

A student is eligible for consideration for removal from probation when the following condition(s) related to being placed on probation has/have been met:

(1) satisfactory remediation of all failed coursework,
(2) satisfactory completion of two quarters of full-time coursework, and
(3) absence of any other issues of concern being considered by the Student Progress Committee.

Depending on the student’s academic record, a student may be retained on probation until successful completion of the USMLE examination that is related to the area of the curriculum in which the student has had difficulty. Students are removed from probation once they have met the criteria specified.

Guidelines for due process

Within the academic review process, there are opportunities for the student to request a review meeting with the Student Progress Committee if he or she believes that all information was not taken into account in the committee's deliberation process or if the student wishes to request a different course of action than recommended by the committee.

The disciplinary review process follows University of Washington guidelines within the context of the UW School of Medicine’s review process. When an incident has been reported, the student is asked to meet with the vice dean for academic, rural and regional affairs and the Associate Dean of Student Affairs. If neither are available to deal with the incident in a timely way, another appropriate administrative official is requested to participate in this review process. If, after the facts are disclosed, there is evidence that the incident does not involve a breach of the standards of personal and professional conduct of a physician-in-training, the vice dean for academic, rural and regional affairs determines the appropriate resolution. If, after the facts of the incidents are disclosed, the student acknowledges guilt, the case is referred to the Student Progress Committee and is managed under the academic review process. If the student assumes an acceptable level of responsibility related to the issues of concern, but takes a different position on the incident presented, the vice dean for academic, rural and regional affairs presents both views to the Student Progress Committee for consideration. If the student does not acknowledge guilt surrounding a serious issue with supporting documentation, the vice dean for academic, rural and regional affairs may initiate a disciplinary referral to the University of Washington Disciplinary Committee. Once a conclusion is reached based on the disciplinary review, the case is referred to the Student Progress Committee and is managed under the academic review process.

For issues related to remediation, reprimand, probation, leaves of absence, suspension and expanded curricular programs, the student may request a review meeting with the Student Progress Committee to request reconsideration of the committee's recommended remediation plan. The decision of the Student Progress Committee following such a review meeting is final, and the course of action will then be implemented. The Dean of Student Affairs works with the student and the Associate Dean of Curriculum to schedule the plan directed by the Student Progress Committee.

For issues involving a recommendation for dismissal from medical school, the student is informed by the Student Progress Committee of the deficiencies on which the dismissal recommendation is based. In most cases, there has been at least one previous letter informing the student of deficiencies and the expected level of performance if the student is to continue in the UW School of Medicine. When the student is informed of a dismissal recommendation, he or she has two main options. One is to submit a letter of withdrawal from medical school to the Dean of Student Affairs. The second is to request a dismissal review meeting with the Student Progress Committee. This meeting should occur as soon as possible but not later than the next routinely scheduled meeting unless a delay is approved by the committee. The format of the dismissal review meeting has three components:

• During the first segment, the committee members review the student's entire medical school record and any additional information requested by one of the deans or the committee or submitted by the student about his or her performance or extenuating circumstances interfering with performance. In addition, the student may request to have individuals write letters of support for his/her continuance in medical school.

• The second segment of the meeting is the interview with the student. At this time, the student can make a presentation to provide the committee with his or her perspective on his or her performance, and there is an opportunity for questions and answers between the student and the committee members. In addition, the student is permitted to have present a member of the medical school faculty as an advocate; however, legal council is not permitted in the academic review process. The faculty advocate can present information to the committee and/or participate as needed during the question-and-answer period. The level of participation of the medical faculty advocate is a decision the student makes in consultation with his or her advocate. Once all the information that the student wants to share with the committee is presented and there are no more questions, the student and the medical faculty advocate are asked to leave the meeting room.

• During the third segment of the meeting, the committee meets in executive session without the student and advocate present and makes a decision on the dismissal recommendation. The student is invited to wait in the Academic Affairs Office area so that he or she can be informed by the chair of the committee of the decision immediately. The committee's decision is also sent to the student in writing.

It is important that the student understands that the academic review process is different from a disciplinary or courtroom scenario in which there are multiple levels of appeal. There are three components to the academic review process. These include the student being informed of the academic and/or professional standard deficiency, having an informal (i.e., an attorney is not permitted) meeting with the Student Progress Committee, and there being a careful and deliberate committee decision-making process. Thus, it is also important to understand that the review meeting with the Student Progress Committee is the only meeting at which the student has an opportunity to provide relevant information that he/she believes the committee needs to know before making a final decision. When the student is in the dismissal review process, the committee will determine the appropriateness of the student’s continuing in coursework.

If the Student Progress Committee sustains the recommendation for dismissal from medical school and the student does not withdraw from the School, the committee's recommendation is forwarded to the Faculty Council on Academic Affairs for a review of process. This does not include a review of the student’s performance to reconfirm the committee’s recommendation nor an interview with the student. If the Faculty Council determines that the School's process has been followed, the decisions of both the Student Progress Committee and the Faculty Council on Academic Affairs are forwarded to the Dean. While the student may request a meeting with the Dean, the granting of such a meeting is at the Dean’s discretion.

After reviewing the information on which the decisions were based, the committee's and council's recommendations, and, if granted, information from an interview with the student, the Dean will make the final decision and there is no further review within the UW School of Medicine. The student is informed by the Dean of the final decision in writing. During the academic review process, the student has the right to withdraw from the School at any time up to the point when the Dean makes the final decision. If in the future the student requests a recommendation letter from an administrative official of the School, the academic performance and dismissal recommendation may be included in the letter.

If the outcome of the dismissal review meeting is that the Student Progress Committee overturns its dismissal recommendation, the committee will determine the academic plan that must be followed to allow the student to continue in school. The committee will also specify criteria for the student’s subsequent performance in order for him/her to be considered to be making satisfactory progress