Policies Governing Medical Students' Academic Progress and Conduct


POLICIES GOVERNING MEDICAL STUDENTS’
ACADEMIC PROGRESS AND CONDUCT
Perelman School of Medicine
University of Pennsylvania
Effective January 1, 2020

 

I.     OVERVIEW
II.    ACADEMIC PERFORMANCE and PROGRESSION
          A. Graduation Requirements

          B. Competency Requirements
          C. Transcript Designations
          D. Remediation Requirements
          E. Grade Appeals
III.   STANDARDS of PROFESSIONALISM and STUDENT CONDUCT
IV.   LEAVES of ABSENCE
V.    THE STUDENT STANDARDS COMMITTEE
          A. Purpose
          B. Composition
          C. Function
VI.   PROCEDURES for PROBATION, SUSPENSION, and DISMISSAL
VII.  APPEALS PROCESS for DECISIONS of the STUDENT STANDARDS COMMITTEE
VIII. MANDATORY REPORTING
IX.   BEHAVIORAL HEALTH and STUDENT HEALTH PROGRAM ACCESS

I.   OVERVIEW
The Perelman School of Medicine (PSOM) has established principles and methods for the evaluation of student achievement and professional conduct. These principles guide the decisions related to academic progression, promotion, and graduation, as well as any disciplinary processes. Students admitted to PSOM are expected to maintain high standards of academic performance, and personal and professional conduct. They must demonstrate that they have attained a mastery of knowledge, skills, attitudes, and behaviors necessary for the practice of medicine.

To earn the MD degree, each student must: 

  1. Achieve the educational goals and specific requirements of the curriculum at a passing level within the timeframe established by PSOM; the standard timeframe for the MD degree is 4 years with a maximum of 6 years (not including scholarly time for approved research, dual degrees or leaves of absence).
  2. Demonstrate the intellectual, interpersonal, and technical skills required of a physician.
  3. Attain a level of clinical judgment which warrants entrustment by the Faculty as ready for residency.
  4. Comply with PSOM and University of Pennsylvania standards of conduct, professionalism, patient care, and academic integrity.
  5. Complete all requirements toward the MD degree, including curricular, administrative, and internal and external examinations.
  6. For students earning a PhD degree in addition to the MD degree, comply with the standards set forth in Expectations and Monitoring of MD/PhD students and with the standards of the second-degree program.

Students must earn a minimum of two credits in every four-month period of time to maintain full-time status.

The Doctor of Medicine degree provides access to patients, which is a special privilege and responsibility. The Student Standards Committee assumes responsibility for determining the overall competence of each student with respect to academic progress and professionalism. A student is awarded the MD degree after approval by a consensus vote of the Student Standards Committee and with referral to the Standing Committee of Department Chairs and the Dean of PSOM.

The Undergraduate Medical Education Committee sets the educational objectives and standards of achievement for students to demonstrate that they have mastered the requisite knowledge and skills of a subject area. The course director(s) apply these standards in determining whether a student has successfully met the course requirements or if corrective action is needed (see Section V). The Advisory Deans and Student Standards Committee reviews the academic progress and professional conduct of each student, and monitors those students who encounter academic difficulties or demonstrate conduct which is deemed to be unprofessional.

 

II.   ACADEMIC PERFORMANCE and PROGRESSION
There are many curriculum paths which a student can take during their medical education. The major ones are:

  • MD degree only
  • MD/PhD degrees
  • MD and Master’s degrees
  • MD and Certificate(s)
  • MD and an extra educational year

A. Graduation Requirements
The MD degree requires successful completion of all the following: 

  • Modules 1 and 2 – The Science of Medicine
  • Module 3 – Technology and Practice of Medicine
  • Module 4 – The Core Clinical Clerkships
  • Clinical Skills Inventory (CSI) Exam
  • Module 5 – Clinical Electives, Frontiers Courses in Medical Science, SubI, and Scholarly Pursuit
  • Module 6 – Humanism and Professionalism
  • USMLE Steps 1 and 2 Clinical Knowledge (CK) and Clinical Skills (CS)*
  • Advanced Cardiovascular Life Support (ACLS)

* The entering class of 2015 and those beyond must take and pass Steps 1, 2CK, and 2CS to fulfill graduation requirements. Prior to 2015, taking the exams fulfilled graduation requirements, with a passing score not required.

Completion of the MD degree also requires meeting all professionalism requirements, including administrative modules and other administrative compliance requirements.

A student on leave or away from the program to pursue a PhD or other scholarly work must adhere to, and is subject to, any grading policies in place at the time of return.

As of January 2018, Modules are graded as follows:
(P-pass, F-fail, W-withdrawal, I-incomplete, U-unsatisfactory, H-honors, HP-high pass)

Module

Transcript Grades

Temporary Grades

 

1/2/3/6

P/F/W

I/U

 

4/5

H/HP/P/F/W

I/U

P/F/I/U for one- and two-week courses

Prior to January 2018, modules were graded as follows:

Module

Transcript Grades

Temporary Grades

 

1/3/6

P/F/W

I/U

 

2

H/P/F/W

I/U

 

4/5

H/HP/P/F/W

I/U

P/F/I/U for one- and two-week courses

B. Competency Requirements
Students must achieve competence in all of the eight categories listed below to satisfy the graduation requirements outlined in Section A above:

  1. Patient Care
    Students must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
  2. Medical Knowledge
    Students must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences, and the application of this knowledge to patient care.
  3. Practice-Based Learning and Improvement
    Students must be able to investigate the practice of medicine by appraising and assimilating scientific evidence.
  4. Interpersonal and Communication Skills
    Students must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients’ families, and professional associates.
  5. Professionalism
    Students must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
  6. Systems-Based Practice
    Students must demonstrate an awareness of and responsiveness to the larger context and system of health care, and the ability to effectively call on system resources to provide care that is of optimal value.
  7. Interprofessional Collaboration
    Students must demonstrate values and ethics for interprofessional practice, identify their roles and responsibilities, demonstrate effective interprofessional communication, and the value of teams and teamwork.
  8. Personal and Professional Development
    Students must commit to exploration and discovery of professional interests, commit to personal wellness and seek support when necessary. Students must actively seek out mentors.

C. Transcript Designations
Pass is issued when a student’s performance meets the requirements for a course.

High Pass and Honors may be issued in certain courses when the student’s performance exceeds the requirements.

Unsatisfactory is issued when an exam is not passed. Unsatisfactory is replaced by a passing grade when a remedial exam is satisfactorily completed. For the first Unsatisfactory grade, the course director will meet with the student to develop an academic plan, and will specify what the additional remedial assessment will be (e.g. course or shelf exam, written assignments, etc.). The maximum grade permitted after receipt of an Unsatisfactory grade for a clerkship/clinical course is High Pass.

All Unsatisfactory grades are reported to the Student Standards Committee (SSC) and tracked (see Section V for more information on SSC). Students who have received 2 Unsatisfactory grades are automatically placed by SSC to the internal designation: Academic Watch (see Section V, C, 4 – Ad Hoc Committees). For a single course, if the remedial exam assessment is not satisfactory and a third attempt is needed, the student’s record and academic plan will be presented to SSC for review of the student’s academic status. The course director will again meet with the student to develop a new study plan and will specify what the additional remedial work will be (e.g., shelf exam untimed, oral exam, written assignments, etc.). If the additional assessment attempt is successfully completed, the maximum possible course grade will be Pass. After three unsuccessful attempts the course grade will be converted to a Fail. In such a case, the student must appear before SSC for an academic plan. If the student receives a second Unsatisfactory grade in a different course, the internal designation of Academic Watch will be applied and the situation reviewed by SSC. Any student with a single Fail or Unsatisfactory (not due to an exam failure alone) in a clerkship or Module 5 course will be reported to and reviewed by SCC. Unsatisfactory or failing performance in a clinical rotation is a rare occurrence and must be reviewed immediately in order to rectify any specific competencies prior to the student continuing on with other courses/clerkships. Students who fail CSI will be placed on Academic Watch, will be presented to SSC, and remediation will be monitored.

In general, an Unsatisfactory grade is a temporary grade. However, if the Unsatisfactory remains for an extended period of time, it will stay on the transcript as a permanent grade, with the final grade reflected in the academic year when the course is taken and passed.

Fail designates inadequate knowledge, lack of clinical skills, and/or serious breach of professional behavior. A Fail is issued when:

  • Performance is not at the passing level after three exam attempts
  • Professionalism is not at the passing level
  • Clinical performance is not at the passing level

Students who receive a grade of Fail for a required sub-I will usually be required to retake the sub-I in the same discipline. However, a student may petition SSC to request permission to fulfill the requirement in another discipline.

SSC will be notified of all non-passing grades requiring remediation (Unsatisfactory and Fail). SSC may request more information about the record of a student brought to its attention. Students with multiple failures in exams (but without a failure in a course) may be reviewed in more detail by SSC. Students with two or more Unsatisfactory grades in exams and/or courses, with concerns of and/or documented issues of professionalism (not limited to, but including, arrests, criminal activity, inappropriate patient care, HIPAA violations, etc.) may be reviewed and/or asked to appear before SSC. When a student receives a Fail grade, their entire academic record will be reviewed by SSC, and the student will have the option to appear before SSC. SSC will determine the student's academic status and review their academic plan. If SSC grants the student the opportunity to retake a course, a passing grade must be achieved within the time frame set by SSC. For each repeated course, two entries will appear on the student's transcript. When a course is repeated, all grading options, including Honors, are available. Fail grades and repeated courses are mentioned in the Medical Student Performance Evaluation (MSPE).

Incomplete is issued when the student’s academic performance is satisfactory but they are unable to complete the course by the course end date. Except for students on a leave of absence, all outstanding course requirements of an incomplete course must be fulfilled within the academic year in which the Incomplete was issued or within six months of its posting, whichever is longer. All grading options are available when the course is completed. If the course requirements are not met within the specified timeframe, the Incomplete will be converted to a Withdrawal. If it is a required course, the student will need to re-register for the course at a later time.

Withdrawal – A student may withdraw from a course if they are not able to complete the course due to extenuating circumstances (including, but not limited to, personal illness or family emergency) or due to the start of a leave of absence. A permanent transcript grade of Withdrawal is issued after the first 20% of a course has been completed. All grading options are available when the entire course is re-attempted.

D. Remediation Requirements
Remedial exams/assignments need to be carefully scheduled due to courses running continuously. To not impact performance in other courses, when remediation is approved, an enrolled student (i.e., not on a leave of absence) will complete make-up work according to the schedule listed below.

Unsatisfactory grades in Year 1 must be remediated prior to pursuing summer experiences. All remediation must be completed by August 1. Students may request permission to remediate prior to the summer only with joint permission of the Associate Deans. Under appropriate circumstances, students may be allowed to remediate Module 1 examinations over the winter break.

All Unsatisfactory grades in courses pursued during fall of Year 2 must be remediated before a student can progress to Module 4. A student must receive joint permission from the Associate Deans to remediate an examination prior to completion of Module 2.

For MD/PhD students, in order to begin graduate course work in the fall of Year 3, all Unsatisfactory grades in courses during the first six months of Module 4 must be successfully remediated before the start of their graduate school orientation, typically occurring in late August. Further, all Unsatisfactory grades during Module 4 must be successfully remediated in order to progress into Module 5.

Clerkship exam or shelf failures: Students must receive joint permission from the Associate Deans to remediate any examination prior to completion of Module 4. In addition, all exams must be successfully passed before attempting Step 1 or Step 2CK.  MD/PhD students must take Step 1 prior to entering the PhD phase, unless they receive written permission from SSC. If a student fails one shelf or departmental examination, the student may request a schedule revision from the appropriate Associate Dean to address the exam failure. Failure of two or more shelf or departmental examinations will require remediation of both examinations prior to continuing with clinical rotations.

E. Grade Appeals
Failing Grade or Narrative

If a student is dissatisfied with a failing grade or narrative assigned by a course/clerkship director, the student may contact the course/clerkship director to discuss the grade within two weeks of the grade posting. The course/clerkship director must review the decision within two weeks of the date of first contact; otherwise, the student may proceed with the next step of the appeal. The course/clerkship director will review the student’s performance in the course, decide if a grade or narrative revision is warranted, and notify the student of their determination. It should be noted that the narrative will be what is included in the MSPE, and this is the opportunity for narrative changes related to the clinical paragraph. If the grade or narrative is not changed and the student wishes to pursue the issue further, the student may follow the process outlined below. A student may also consult with the Associate Dean for Student Affairs regarding the process.

Pass to High Pass or High Pass to Honors
Student appeals for changing the grade (not the narrative) of clinical rotations from Pass to High Pass or changing High Pass to Honors will be addressed two times per year (after discussion with the course/clerkship director). The student will be invited to attend a grade appeal meeting or may submit a written statement for the appeal hearing to the Associate Dean for Student Success and Professional Development.

  • The request for the appeal must be submitted to the Associate Dean for Student Success and Professional Development only after discussion with the clerkship director. 
  • The discussion must take place within two-weeks’ time of the date the grade is officially posted.
  • The clerkship director must respond within two weeks of the student’s request for discussion.
  • If there is no response the student may proceed with the next step of the appeal.
  • If the grade is not changed and the student wishes to pursue the issue further, the student must follow the appeal process identified below.
  • The Associate Dean for Student Affairs is available for consultation.

No grade appeals will be considered outside of the prescribed timeframe.

For Module 4 or 5 courses, students are not permitted to contact the faculty and housestaff for evaluation feedback outside of the standard mechanisms already in place to receive their evaluation and assessment feedback. A student found to have done so will forfeit the right to pursue the appeal process.

The appeal process will not be available to students who fail to attempt to discuss the grade or narrative of concern with the course/clerkship director.
 

Details Related to Proceeding Further with the Grade Appeal Committee

  1. Within four weeks of the grade posting, submit a written request to appeal the grade to the Associate Dean for Student Success and Professional Development, with a copy sent to the Associate Dean for Student Affairs and the appropriate Associate Dean for Curriculum. Requests may be sent by email but the substance of the email must be limited to the appeal. A request for appeal must clearly state what the appeal is about and provide relevant supporting information.
  2. Must meet with the Associate Dean for Student Affairs who will review the appeals protocol with the student and provide guidance during the process. It would be ideal to meet in advance of submitting the appeal, but if timing does not permit, after submission will be acceptable.
  3. The Associate Dean for Student Affairs will alert the course/clerkship director that the student wishes to pursue a formal appeal, and confirm that due diligence was done to review the situation prior to proceeding with the appeal.
  4. A Grade Appeal Committee (GAC) will be convened and will consist of five standing faculty members, with three as a quorum (with no conflicts of interest, i.e. not involved in the course or department). The standing faculty members will be appointed by the Senior Vice Dean for Medical Education. The GAC will independently review information submitted by the student and the course director. If the GAC so deems appropriate, the student and/or course director may appear before the GAC and the GAC may interview others with relevant information. The GAC’s decision on the matter will be final.

NOTE: As per the policy on appeals, the GAC will convene as needed for failing grades or Medical Student Performance Evaluation narrative changes within the time frame noted. Grade changes from Pass to High Pass or High Pass to Honors (with no narrative changes) will be considered twice a year but within the timelines as indicated in the policy.

 

III.  STANDARDS of PROFESSIONALISM and STUDENT CONDUCT

Medical students must behave with paramount concern for patients' welfare and show respect for the rights of patients. In addition, they must adhere to the highest standards of intellectual integrity and honesty in their interactions with patients, colleagues, faculty and administrators. Students are expected to adhere to all standards of the University of Pennsylvania and PSOM including, but not limited to, the PSOM Code of Student of Conduct; Code of Academic Integrity; Code of Professional Conduct; and Academic Honor Code, which describes the rights and responsibilities of students; and the R.I.S.E Code of Conduct, which is an initiative of Penn Medicine.

University of Pennsylvania Code of Student Conduct https://catalog.upenn.edu/pennbook/code-of-student-conduct/

University of Pennsylvania Code of Academic Integrity https://catalog.upenn.edu/pennbook/code-of-academic-integrity/

The Student Standards Committee has developed policies and procedures which address professional conduct. Professional conduct includes, but is not limited to:

  • Adherence to appropriate standards of behavior (demeanor, use of language, appearance and timely response) with patients, students, faculty, colleagues, staff, and all individuals encountered during a student’s tenure at the University of Pennsylvania Perelman School of Medicine.
  • Adherence to appropriate standards of confidentiality with respect to information about patients, and adherence to HIPAA guidelines.
  • Treatment of patients and their families with dignity and respect, both in their presence and in discussions with other members of the healthcare team.
  • Appropriate introduction of medical student role when interacting with patients and their families.
  • Honesty in interactions with clinical and research colleagues, and in recordkeeping.
  • Respect for the limits of responsibility and activity set forth by supervisors.
  • Adherence to all hospital policies related to drug and alcohol use and abuse.

Concerns about the professionalism of a student may be presented to SSC for their review, after discussion at the Advisory Deans Committee (as described in Section V), with consensus for referral. SSC may delegate investigation of any matter to a subcommittee, who may make recommendations to SSC, prior to review of the matter.
 

Academic Honor Code for the Perelman School of Medicine at the University of Pennsylvania

All students who matriculate in the Perelman School of Medicine are required to sign and abide by the following Honor Code.

I will conduct myself in accordance with the highest standards of honesty and integrity in all academic activities (including clinical work and research).  This includes adherence to the pledges below:

I will neither give nor receive aid in examinations or assignments unless expressly permitted by the instructor.

I will report accurately all data regarding history and physical findings, laboratory results, and other information relevant to patient care. 

Any research I conduct will be done in an unbiased manner, with results reported truthfully and with credit given for ideas developed and work done by others.

I will not engage in any form of plagiarism in any manuscript, presentation, or course paper as outline in the University of Pennsylvania’s Code of Academic Integrity. I understand that plagiarism includes: using the exact language of someone else without the use of quotation marks and without giving proper credit to the author; presenting the sequence of ideas or arranging the material of someone else, even though such is expressed in my own words, without giving appropriate acknowledgement; or submitting a document written by someone else but representing it as my own. 

I agree to comply with the University’s Code of Academic Integrity.

I understand that I may be brought before the Student Standards Committee if I violate this honor code. 

 

IV.  LEAVES of ABSENCE

Voluntary Leave of Absence
Students may request a leave of absence for up to one year from the appropriate Associate Dean. Students may take time away from their studies for various reasons, including but not limited to: family obligations or other personal circumstances, health issues, military service, and pursuit of other degrees or career-related opportunities.

A leave is a period of non-enrollment marked by loss of student status. Students on a voluntary leave may be eligible to work in PSOM as long as student status is not required, with approval by the Associate Dean for Student Affairs, and with the understanding that the activity will not fulfill any MD requirements. However, students on leave may not participate in any PSOM-sponsored patient care activities in the inpatient setting, outpatient setting, or in the community. Students may not take Step 1, Step 2CK, or Step 2CS while on a leave of absence, and students may not participate in any remediation activities while on leave. A leave of absence will be noted on the student’s transcript and in the Medical Student Performance Evaluation without giving specific reasons.

The student must submit a written request to the Associate Dean for Student Affairs outlining the reason for the leave, and they must also meet with the Associate Dean for Student Affairs to discuss their situation. When the leave is for medical reasons, the student will be expected to provide supporting documentation from a healthcare provider within the Penn Medicine system. The Associate Dean for Student Affairs will decide on the leave request. If the student is enrolled in the MD/PhD program, the Associate Dean for Physician Scientist Training must also participate in the decision on the request. Any student with academic (including professionalism) deficiencies at the time of a non-medical leave must also have the approval of SSC prior to the start of the leave. SSC will consider the request and may require stipulations during the leave and in order for the student to return. In addition, all students with extant academic/professionalism deficiencies at the time of a leave must have SSC approval upon their return, including a plan for remediation, and may be required to appear before SSC. Any student on medical leave must provide a written, fit for duty certification (by CAPS/Student Health and/or a Penn Medicine medical provider) in order to return.

SSC must be consulted about all leave requests involving any of the following circumstances: The request is for a leave of absence for more than one year; the request is to add additional time to an existing leave; the student returned from a previous leave and is requesting a new leave; or academic or professionalism difficulties as described above on requesting the leave. The student’s overall academic progress will be considered when deciding if additional leave is granted. Students who do not return to full-time status at the end of the leave, without having been granted an extension, may be administratively withdrawn from the Perelman School of Medicine and dropped from the enrollment. The student will need to reapply for admission if they wish to return at a future date.

The Associate Dean for Student Affairs or their delegate will present a quarterly report to SSC on all students on leave.

Once the leave has been approved, the student will receive information in a letter from the Office of Student Affairs regarding the following:

  • Participation in student organizations or PSOM committees
  • Possession of HUP and Penn ID cards and access keys
  • Use of Penn email account
  • Inclusion on PSOM-sanctioned email distribution lists
  • Financial obligations
  • Impact on transcript and Medical Student Performance Evaluation
  • Insurance obligations and options
  • Implications of the leave on loan repayment grace periods

Short-term Breaks
A short-term break may be requested when a student needs to miss two to eight weeks of Modules 1, 2, 3, 4, or 6. Requests for schedule adjustments that exceed eight weeks will be treated as requests for a leave of absence. A request for a short-term break must be approved by the Associate Dean for Student Affairs. The student must communicate with the Associate Dean for Student Affairs at the beginning of the short-term break and again when they would like to resume coursework. If a short-term break is requested for medical reasons, the student must provide documentation from a Penn Medicine physician to support the request, and also provide documentation from a Penn Medicine physician to support their readiness to return when they want to resume coursework. A single short-term break will not be noted in the MSPE, and will be considered as “borrowing” from vacation time; however, multiple breaks from the curriculum may be noted on the Medical Student Performance Evaluation, at the discretion of SSC. In order to qualify for a short-term break, it must not extend the student’s “time in school”.

University of Pennsylvania Involuntary Leave of Absence
Under the following circumstances, the University may place a student on an involuntary leave of absence, or require conditions for continued attendance, when the student exhibits behavior resulting from a psychological, psychiatric, or other medical condition that:

  • threatens, harms, or has the potential to harm the health or safety of the student or others
  • causes or threatens to cause significant property damage
  • significantly disrupts the educational and/or other activities of the University community

The process is initiated by a request sent from the Senior Vice Dean for Medical Education to the Office of the Vice Provost for University Life. To review the University’s Involuntary Leave of Absence Policy, please refer to the PennBook: https://catalog.upenn.edu/pennbook/involuntary-leave-of-absence/.

 

V.  THE STUDENT STANDARDS COMMITTEE       

A. Purpose
The Student Standards Committee (SSC) is appointed by the Senior Vice Dean for Medical Education, who represents the Dean in providing oversight for the educational activities of PSOM. SSC advocates for the future patients of the student and is not an advocate for the student. Among its many roles, SSC:

  1. Reviews academic (including professionalism) competencies, milestones, assessments, and evaluations of PSOM students.
  2. Adjudicates and monitors students needing corrective actions, including assigning disciplinary actions and/or Medical Student Performance Evaluation notations.
  3. Reviews requests for leaves of absence beyond one year.
  4. Reviews students for promotion and graduation.
  5. Considers advanced standing requests.
  6. Performs other functions as outlined in this document, and as deemed appropriate by the Senior Vice Dean for Education.

In conducting its work, SSC has access to all admissions and academic materials related to students.


B. Composition

Faculty, Student, and Administrative Membership

SSC is composed of 16 full-time faculty members, 13 or more of whom must be full-time standing faculty (tenure or clinician-educator track), and may include up to three academic-clinician track faculty. SSC members are appointed for a three-year term, renewable for one more term, with some flexibility for staggered membership. SSC also includes four students, and administrative ex-officio non-voting members. See below for voting standards. The ex-officio members include but are not limited to the Senior Vice Dean for Medical Education, the Associate Dean for Admissions, the Associate Dean(s) for Curriculum, the Associate Dean for Student Affairs, the Associate Dean for Student Success and Professional Development, the Director of Student Affairs, and senior staff from the office of the Senior Vice Dean for Medical Education. The Associate Dean and the Director for Physician Scientist Training are invited as guests when a MD/PhD student’s record is reviewed. The Chair of SSC and the Senior Vice Dean for Medical Education may include senior staff as required to the meeting.

The Chair of SSC is a full-time standing faculty member (tenure or clinician-educator track) appointed by the Senior Vice Dean for Medical Education for a three-year term, with priority given to a faculty member with experience on SSC. The Chair may be appointed for one additional term by the Senior Vice Dean for Medical Education. An Associate Chair, also a current standing faculty member of SSC, may be appointed by the Senior Vice Dean for Medical Education. A former Chair may continue to serve on SSC as a voting faculty member for one additional three-year term.

The students eligible for membership are identified through a process coordinated by the Office for Student Affairs with the Medical Student Government. The Associate Dean for Student Affairs provides the final approval and appointment of student members. The student members must be at the second-year medical student level or above, and be in good standing in PSOM. Their appointments are for two-year terms and may be renewed for one additional year at a time. Should a student come under the purview of SSC for academic issues or professionalism issues during their membership tenure, they must resign, and another student will be appointed in their place.

Meetings may be in person, virtual, or by other electronic means.
 

C. Function

Student Record Reviews and Student Status

Students’ records are reviewed bi-weekly at meetings conducted by the UME Leadership Team and with Advisory Deans. The Office of Student Affairs and/or the Associate Dean for Student Success and Professional Development will oversee the aforementioned meetings, to track students with non-passing grades requiring remediation or professionalism concerns. Academic and professionalism issues related to dual degree students in OMFS and MD/PhD programs will also be reported to a student’s other program. Non-passing grades in exams and courses will be reported to SSC. Student profiles may be presented to SSC after referral by the Advisory Deans Committee. Such referrals may be prompted by more than one exam or course failure, failure of an Objective Structured Clinical Examination (OSCE) or of a clinical component, or can be made at the discretion of the Advisory Deans Committee. Professionalism issues of concern may be reviewed in detail by SSC.

The student will be notified by the Office of Student Affairs prior to the student’s profile/record being presented before SSC and, depending on the nature of the concern, given the option to appear at the meetingIf the student accepts the opportunity to make a presentation to SSC, they are encouraged to be accompanied by a faculty advisor as an advocate who is a member of PSOM full-time faculty (regardless of track). At no time will a student be permitted to bring more than one advisor. The advisor may not speak during the presentation but may confer with the student before and during the meeting; and, after all presentations, may be allowed to address SSC with prior permission of the Chair. The student may never bring a legal advisor to SSC, which serves as an academic committee, noting that PSOM considers professionalism an academic competency. Family members and legal advisors may not serve as a presenting advisor, but may remain outside the room during the meeting. A student will be informed of SSC’s recommendations and decisions about their academic progress or professional conduct.

When a student’s profile/record is presented, SSC’s options include, but are not limited to, the following actions:

  1. No action but request updates on future performance (tracking).
  2. Recommend an appropriate evaluation. 
  3. Recommend a leave of absence.
  4. Recommend to the Senior Vice Dean for Medical Education to initiate the process for an involuntary leave of absence, if the student does not accept a leave recommendation.
  5. Place or remove student on Academic Watch (see below). 
  6. Place or remove student on Academic Warning (see below).
  7. Review remediation plan with option to recommend modifications.
  8. Indicate a disciplinary action which can include a reprimand (permanent notation in the Medical Student Performance Evaluation and documented in a letter sent to a student indicating a disciplinary action), suspension (required time out of school; unable to participate in any curricular or extracurricular school activities or events), probation, and/or dismissal. Probation indicates that a student is not in good standing with serious academic (including professionalism) deficiencies.
  9. SSC may also require that a disciplinary and/or academic notation or accolade be placed in the Medical Student Performance Evaluation. 

SSC will be given periodic updates on students who are on Academic Watch, Academic Warning, and/or Probation. The designations of Academic Watch, Warning, and Probation are not progressive, or regressive.

The Senior Vice Dean for Medical Education and/or the Associate Dean for Student Affairs, acting either on behalf of a faculty committee or PSOM, may request an administrative evaluation of a student by a consulting psychiatrist or other mental health or health professional chosen by PSOM. This evaluation serves not as a clinical encounter but rather to address academic, personal, and/or behavioral concerns that may have been brought to the attention of the Dean’s Office. A failure to comply with a request for an administrative evaluation may affect the ability of SSC to make an appropriate recommendation for the student. The content of the evaluation would be private and available to the student. The recommendations are shared by the evaluator with administrative leadership and discussed with the student. Summary information may be shared with SSC only on a need-to-know basis in order to best support a student plan.

Academic Watch (without disciplinary action)

  • is a status indicating mild to moderate academic/professional deficiencies
  • is a designation which is not considered a disciplinary action, and the student remains in good standing
  • is not mentioned in the student’s Medical Student Performance Evaluation letter
  • is not mentioned in outside requests for documentation (e.g., visiting student elective applications, other degree program applications, license requests)
  • is noted in the internal Registrar’s record
  • indicates that there will be close follow up by the student’s Advisory Dean and the Office of Student Affairs

Academic Warning (without disciplinary action)

  • is a status indicating moderate to severe academic/professional deficiencies
  • is a designation which is not considered a disciplinary action, though the student is not in good standing
  • may or may not be mentioned in the student’s Medical Student Performance Evaluation letter (a decision of SSC based on whether there is an institutional responsibility to inform external parties)
  • is not mentioned in outside requests for documentation (e.g., visiting student elective applications, other degree program applications, license requests)
  • is noted in the internal Registrar’s record
  • indicates that there will be close follow up by the student’s Advisory Dean and the Office of Student Affairs
  • course directors may be notified of this status and interim evaluations may be sought
  • clinical course directors have the right to determine the student’s site assignments

Probation (disciplinary action)

  • is a status indicating severe academic/professional deficiencies
  • is a designation which is considered a disciplinary action
  • is mentioned in the student’s Medical Student Performance Evaluation letter
  • is mentioned in outside requests for documentation (e.g., visiting student elective applications, other degree program applications, license requests)
  • precludes participation in rotations outside of Penn or in extra educational activities, such as a year of research
  • may preclude a student from enrolling in a graduate program (i.e. a second degree at Penn or at another institution)
  • course directors may be notified of this status and interim evaluations will be sought
  • clinical course directors have the right to determine the student’s site assignments
  • See Section VI for probation procedures

Dismissal
If a student is unable to remediate the performance deficiencies which led to Watch, Warning, or Probation, dismissal may be considered by SSC as outlined in the procedures below in Section VI.

1. Quorum
All voting requires a quorum and no votes may be conducted in the absence of a quorum. A quorum for issues other than probation or dismissal consists of at least nine voting members (including the Chair), at least seven of whom must be standing faculty. A simple majority of those present carries a motion.

For probation and dismissal, a quorum requires a minimum of nine voting standing faculty members (tenure or clinician-educator tracks) to be present, and a simple majority of those present carries a motion. Abstentions may prevent a motion from carrying and, in effect, delay an action from being taken for decisions. 

Student Voting
No more than two students may vote at any meeting. In the case that more than two students are present, they must decide prior to the start of the meeting which two votes will count. Students may attend and participate in discussions that might lead to the decision of a probation or dismissal but they may not vote on such decisions.  

2. Ex-officio members
Ex-officio members participate in all SSC business and do not vote. The Senior Vice Dean for Medical Education, along with administrative faculty and staff, may present recommendations to SSC for any remedial actions or other options for the students. The staff in the Academic Programs Office and staff in the Office for Student Affairs will share administrative responsibilities. Minutes may be taken by any staff member. The files of SSC will be maintained in a secure shared electronic file. All letters from SSC will come from the Academic Programs Office on behalf of the SSC Chair. The Associate Dean for Student Affairs will prioritize the advocacy role for students whenever possible, recognizing that all administrative leaders have institutional responsibilities.

3. Recusal
Members of SSC are listed here and should recuse themselves from reviewing a matter if they believe, in good faith, that their capacity for making an objective determination is or may reasonably appear to be impaired. Students who are scheduled to appear before SSC may request the recusal of student or faculty members due to a conflict of interest. The request must be directed to the Chair, via the Associate Dean for Student Affairs, at least one week in advance of the scheduled appearance date. The student, as well as committee faculty/students who are the subject of the request, will be notified of the Chair’s determination. Recused individuals will not be permitted to view case materials, participate in discussion, or vote on the matter(s) in question.

If the Chair declines the request it must be done so within 48 hours of submission, and the student may petition SSC by writing an email message to the Senior Vice Dean for Medical Education to request a vote on the question of whether or not the committee member(s) should be recused from the proceeding. This vote would be led by the Senior Vice Dean for Medical Education. The Chair and subject(s) of the recusal would be ineligible to vote.

4. Ad Hoc Committee
To facilitate the management of students who are not making satisfactory progress or require remediation plans, the Chair may convene an Ad Hoc Committee to gather information and develop recommendations for the appropriate course of action to address academic concerns. An Ad Hoc Committee may decide, by a majority vote, non-disciplinary issues that may or may not be time-sensitive, and such decisions must be reported to SSC at the next full committee meeting. Such issues may include students who have received 2 Unsatisfactory grades, which indicates automatic placement on Academic Watch; and students who have successfully remediated and are under consideration to be removed from Academic Watch. The Ad Hoc Committee members must include at least three voting committee members, two of which must be standing faculty. Other faculty (non-voting) may be invited as content experts. There should be at least one Dean present with appropriate administrative support provided to the Ad Hoc Committee.

Other Committees:
Other committees may be convened by the Chair with approval of the Senior Vice Dean for Medical Education. Upon approval, a subcommittee of SSC will be charged with reviewing Professionalism issues, reporting back to SSC.

5. Conduct of Committee
The following describe some, but not all, principles which should be adhered to during all SSC meetings:

  • Robert’s Rules of Order shall govern SSC’s activities.
  • Confidentiality must be strictly maintained for all discussions and written materials. The written materials cannot be removed from the meeting location.
  • Students appear before SSC so relevant information can be acquired in a respectful way. Direct advice should not be offered, and recommendations should not be made while the student is in the room with the Committee. Discussion among Committee members should only take place once the student leaves the room.
  • There is absolutely no recording by phone or other device by students or Committee members during the meetings.

6. Information Available to The Committee
This Committee is the only body in PSOM who has access to the entire student record. The following are some examples of typical sources of information that can be made available to SSC, if requested, when reviewing the performance or behavior of a given student.

  1. Student’s PSOM file (performance evaluations and all appeals information)
  2. Student admissions file
  3. Course performance or performance on any assessment including Clinical Skills
  4. Fitness for duty evaluation and any answers to administrative evaluation questions
  5. Official reports of misconduct on or off campus
  6. Reports of unprofessional behavior
  7. Academic and administrative files from external educational experiences
  8. Police or security reports
  9. Any public information (news, social media, etc.)

 

VI.  PROCEDURES for PROBATION, SUSPENSION, and DISMISSAL 

When SSC is scheduled to review a student’s record for consideration of probation, suspension, and dismissal, the student will be notified at least ten days before the review date. Notification will include:

  1. the date and time when the meeting will be held
  2. the information which will be presented to SSC
  3. the possible outcomes which may occur as a result of SSC’s review
  4. any requirement for the student to attend the meeting for a personal presentation

The student is strongly encouraged to be accompanied by a PSOM faculty member. The student should give the faculty member’s name to the Associate Dean for Student Affairs one week before the meeting date. The Associate Dean will brief the individual so they understand their role in the process.

Following the presentation of student information and the student’s presentation, SSC will meet in closed session to deliberate and make a decision on the student’s status and/or the appropriate course(s) of actions. If SSC votes to place the student on probation, the Chair will notify the student in writing within ten business days. Notification is considered to have occurred when the letter is emailed to the student.

If SSC votes to suspend or dismiss the student based on academic deficiencies or professionalism issues, the Chair of SSC notifies the student in writing within ten business days, with a copy also sent to the Dean. Notification is considered to have occurred when the letter is emailed to the student.

 

VII. APPEALS PROCESS for DECISIONS of the STUDENT STANDARDS COMMITTEE

Students may appeal a decision of SSC that is a disciplinary action, or if SSC requires a notation in the Medical Student Performance Evaluation in the Academic History Section (either as relayed information without disciplinary implication or in the Medical Student Performance Evaluation as a disciplinary notation), or other requirement or decision that impacts the student’s permanent record.

A student who wishes to appeal a decision of SSC must submit a written request for appeal to the Senior Vice Dean for Medical Education stating the specific ground on which the appeal is based. The appeal must be based on new information or prejudicial procedural error. At any time, the student may consult with a faculty advocate, including the Associate Dean for Student Affairs. The request for an appeal must be submitted within ten business days after the student receives written notice of SSC’s decision. 

The PSOM Appellate Committee is a three-person panel comprised of PSOM standing faculty who are not active members of SSC. The Appellate Committee and its two alternate members are appointed by the Senior Vice Dean for Medical Education for up to a three-year renewable term (until fully staggered and then moving forward, all will be a three-year renewable term), with one of the three faculty members serving as Appellate Committee Chair.

The Appellate Committee will review the minutes of the SSC meeting, the student’s written appeal request, and may choose to meet with the student and/or others. The Appellate Committee will determine whether to accept the appeal or uphold the SSC decision. The decision of the Appellate Committee is final. The Chair of the Appellate Committee will notify the student in writing of the decision. The Dean will be notified in writing of all decisions related to suspension and dismissal.

If the appeal for a suspension or dismissal is accepted, the student is referred back to SSC to develop a plan of remediation and student status determination.

 

VIII. MANDATORY REPORTING

Because patient safety is a priority and privilege, any student whether enrolled, on a short-term break or leave of absence, or returning from a short-term break or leave of absence who has a DUI or who is arrested for any reason (including behavioral, drug, or other) must notify the Associate Dean for Student Affairs within 48 hours in order to assess any impact on student well-being, the learning environment and patient care.  Students’ civil rights will be respected and, until the matter is adjudicated, students have the option for a leave of absence until the matter is resolved with referral to SSC for re-entry. Should a student wish to continue in school while the matter is under review, in order to determine any impact on patient safety and in consultation with the Senior Vice Dean for Medical Education, further evaluation may be required to maintain active student status, and may include behavioral health evaluation, referral to Physicians Health Program (PHP), review by SSC, and, if there is an impact on patient care, could result in administrative or non-involuntary leave. Failure to report could result in a disciplinary action. See above requirements for reporting for dual degree students in OMFS and MD/PhD programs.

 

IX. BEHAVIORAL HEALTH and STUDENT HEALTH PROGRAM ACCESS

Voluntarily – Students who identify as needing behavioral health treatment may voluntarily seek it through Counseling and Psychological Services (CAPS), personal providers, or seek guidance through student health, or student intervention services. This is a confidential service, protected by HIPAA and no information will be shared with school personnel.

By Referral – At their request, students may be referred to CAPS or other services assisted by faculty, staff, peers or family. The clinical assessment would be confidential.

Other – The Senior Vice Dean for Medical Education, at the request of SSC or other administrative leadership, may recommend that a student undergo evaluation and treatment for suspected health problems. Any clinical relationship would be held as confidential.

Please see above for request of an Administrative (non-clinical) evaluation.

Involuntary: PSOM may invoke the University’s policy of Involuntary Leave of Absence, which could prompt a required evaluation, wherein information related to the outcome of the evaluation will be considered private, but not necessarily confidential when determining requirements for a leave: https://catalog.upenn.edu/pennbook/involuntary-leave-of-absence/