Doctor of Medicine Student Handbook Student Affairs 2018-2019
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Last Revision: August 2018 The information contained in this section of the handbook is an overview of current policies and procedures of the Eastern Virginia Medical School Doctor of Medicine Program. These policies and procedures are subject to continuous review and improvement. Provisions listed herein are therefore subject to change and should not be construed as a contract between the student(s) and the Eastern Virginia Medical School. Changes will be communicated to students as soon as possible. Please Note: This manual is meant to provide guidance for students and faculty on the usual procedures for day to day conduct in the Doctor of Medicine Program. It does not represent an exhaustive list of all possibilities that might occur for students and faculty in the training and administration of the program. When unique situations will arise, they will be handled in a manner that ensures fairness and mutual respect in all cases. In addition, current institutional policies and procedures will be located on the EVMS Intranet at https://www.evms.edu/education/additional_resources/student_policies_handbooks/. EVMS expressly prohibits discrimination or harassment based on race, color, sex (including sexual orientation, gender identity/transgender status, and pregnancy or parental status), national origin, religion, age, disability, veteran status, genetic information, opposition to unlawful discrimination (i.e. retaliation), or any other protected basis as set forth in federal or state law and/or EVMS policy. Inquiries may be directed to the Title IX and Section 504 Coordinator: Director of Legal Services and Compliance Andrews Hall, 721 Fairfax Ave., Suite 509 Norfolk, VA 23507 Telephone (757) 446-7250
Table of Contents INTRODUCTION.................................................................................................................... 1 OVERVIEW OF THE DOCTOR OF MEDICINE CURRICULUM ..............................................................1 UNIFIED COMPETENCY OBJECTIVES ..............................................................................................1 RESPONSIBILITIES OF TEACHING FACULTY ............................................................................ 1 APPROPRIATE TREATMENT OF MEDICAL STUDENTS ......................................................................1 TITLE IX ........................................................................................................................................2 RESPONSIBILITIES OF MEDICAL STUDENTS ............................................................................ 2 STUDENT STANDARDS OF CONDUCT .............................................................................................2 HONOR CODE ...............................................................................................................................2 ACADEMIC AND TECHNICAL STANDARDS ......................................................................................3 COMPLIANCE ENFORCEMENT .......................................................................................................3 REQUIREMENTS FOR BASIC LIFE SUPPORT AND ADVANCED CARDIAC LIFE SUPPORT TRAINING ......4 DUTY HOURS IN CARE OF PATIENTS ..............................................................................................4 ACCESSIBILITY OF RELIABLE TRANSPORTATION .............................................................................5 POLICY REGARDING ATTENDANCE AND ABSENCES FROM ACADEMIC RESPONSIBILITIES ................5 OTHER STUDENT RESPONSIBILITIES ............................................................................................18 ASSESSMENT AND DOCUMENTATION OF MEDICAL STUDENT PROGRESS ............................ 18 STUDENT ASSESSMENT POLICY ...................................................................................................18 M1 & M2 ASSESSMENT AND GRADING POLICIES .........................................................................22 M3 & M4 ASSESSMENT AND GRADING POLICIES .........................................................................25 PROFESSIONALISM AND PROFESSIONAL IDENTITY DEVELOPMENT ..............................................26 UNITED STATES MEDICAL LICENSING EXAMINATIONS (USMLE) STEP 1 & STEP 2 EXAMINATIONS . 31 CURRICULUM OPT-OUT POLICY FOR FORMER MEDICAL MASTERS STUDENTS ..............................32 RECORDS ...................................................................................................................................33 STUDENT ASSISTANCE ........................................................................................................ 34 ACADEMIC DEVELOPMENT .........................................................................................................34 PEER TUTORING .........................................................................................................................34 STUDENT PROFICIENCY ENHANCEMENT PROGRAM.....................................................................34 CLINICAL REMEDIATION .............................................................................................................35
CAREERS IN MEDICINE ................................................................................................................35 RESIDENCY APPLICATION PROCESS .............................................................................................35 STUDENT WELLNESS PROGRAM ..................................................................................................36 STUDENT REVIEW AND ADVISORY COMMITTEE ..........................................................................36 STUDENT PROMOTION AND PROGRESS TOWARD GRADUATION ........................................ 37 DEGREE REQUIREMENTS ............................................................................................................37 STUDENT REQUESTS FOR CHANGES TO ACADEMIC PROGRESS SCHEDULE ....................................37 DUAL DEGREE PROGRAMS..........................................................................................................37 CERTIFICATION OF ELIGIBILITY FOR GRADUATION .......................................................................37 STUDENT PROGRESS COMMITTEE ...............................................................................................38 STUDENT GRIEVANCE AND APPEALS PROCEDURES ............................................................. 40 APPEAL OF A GRADE OR OTHER ACADEMIC ASSESSMENT ...........................................................40 NON-ACADEMIC GRIEVANCE AND APPEALS PROCEDURE.............................................................41 APPEAL OF A STUDENT PROGRESS COMMITTEE DECISION ...........................................................43
INTRODUCTION OVERVIEW OF THE DOCTOR OF MEDICINE CURRICULUM Eastern Virginia Medical School’s (EVMS) Doctor of Medicine’s (MD) CareForward Curriculum (CFC) is an innovative model of an integrated and case-based curriculum that focuses on improving the care of patients and families and integrates student wellness as a guiding principle. CFC incorporates the use of a virtual community of culturally diverse families into student coursework from the first year of medical school. CFC will help our students learn to see the patient's viewpoint. This course of study will give them experience working in inter- professional teams and encourage them to improve patient-centered outcomes. In addition to being recognized by the American Medical Association with a major grant, this curriculum was one of only two winners of the Teaching Value Challenge, sponsored by the American Board of Internal Medicine Foundation, Costs of Care and The Leapfrog Group. The curriculum continues to produce excellent outcomes and receive high student satisfaction scores. UNIFIED COMPETENCY OBJECTIVES The civic and medical leaders who founded EVMS envisioned an institution that would champion improving the health of the region. Decades later the school celebrates its record of training physicians who are committed to knowledge and skill, and doubly committed to the service of others. Within the context of this institutional philosophy and culture, the faculty has articulated Unified Competency Objectives as the goals and objectives of the curriculum. All medical students are required to become familiar with competencies posted at the following link: https://www.evms.edu/education/medical_programs/doctor_of_medicine/unified_compete ncy_objectives/. RESPONSIBILITIES OF TEACHING FACULTY APPROPRIATE TREATMENT OF MEDICAL STUDENTS The EVMS School of Medicine is committed to maintaining a positive environment for study and training, in which individuals are judged solely on relevant factors such as ability and performance, and can pursue their educational and professional activities in an atmosphere that is humane, respectful and safe. As such, student mistreatment is destructive of these fundamental principles and will not be tolerated within the EVMS community and its affiliated learning sites. EVMS defines mistreatment as behavior that shows disrespect for learners and interferes with their respective learning process. Such behavior may be verbal, emotional, or physical. When assessing behavior that is perceived as mistreatment, students are expected to Page |1
consider the conditions, circumstances, and environment surrounding such behavior. Provision of healthcare is inherently stressful. Medical student training is a rigorous process where the welfare of the patient is the primary focus and that, in turn, may impact behavior in the training setting. Reflective of this philosophy, all EVMS faculty, including community faculty, will abide by the Association of American Medical Colleges Compact between Teacher and Learners of Medicine. Details regarding the Compact can be found in the EVMS Institutional Handbook. TITLE IX In accordance with Title IX of the Education Amendments of 1972, EVMS does not discriminate on the basis of sex and is committed to providing its educational programs and activities in an environment that is free from sex discrimination and sexual or gender-based harassment (including sexual misconduct and sexual violence). Further details regarding Title IX protection and reporting and investigations of possible Title IX complaints can be found in the EVMS Institutional Handbook and the EVMS Title IX webpage found here: https://www.evms.edu/about_evms/leadership/general_counsel/legal_and_compliance/le galcompliance_policies__information/title_ix/ RESPONSIBILITIES OF MEDICAL STUDENTS STUDENT STANDARDS OF CONDUCT EVMS expects its students to assume responsibility for their behavior, to conduct themselves in the highest traditions of health professionals who are engaged in the pursuit and application of knowledge, and to abide by the laws of the United States, the Commonwealth of Virginia, and the rules and regulations of EVMS. Special emphasis is placed on honesty and integrity in testing, research, patient care, and on the appropriate acknowledgement of the contributions of others to one’s own work. Any student, who violates the Student Standards of Conduct, as outlined in the Institutional Handbook, shall be subject to disciplinary action for misconduct/unprofessional conduct. HONOR CODE The student body of EVMS conducts its affairs by means of an Honor Code. Part of the spirit of the human values in medicine philosophy and implicit in such an Honor Code is the fostering of a sense of trust in the EVMS community. The students, faculty, and administration of EVMS join together in support of this Honor Code for the purposes of (a) providing an atmosphere of mutual trust, concern, and respect; (b) fostering honorable and ethical behavior; and (c) upholding and cultivating lifelong professional conduct in the medical and health professions. Any student who fails to abide by the Honor Code or live up to its principles is subject to disciplinary action under this Honor Code. All students, faculty, and staff are obligated to Page |2
support the Honor Code and report any violation thereof to the Honor Council. EVMS’ Honor Code can be found at this link: https://www.evms.edu/media/evms_public/departments/student_affairs/July2012HonorC odeINSTITUTIONALBOV_approved.pdf ACADEMIC AND TECHNICAL STANDARDS In order to progress and graduate, students must fulfill the academic and technical standards of the MD Program, with or without reasonable accommodations. It is the student’s responsibility to request an accommodation through Student Disability Services. Accommodation requests should be made in a timely manner, as accommodations will not be granted retroactively. Students who have, or believe they have, a physical, mental, or chronic health impairment for which they wish to request accommodations under the Americans with Disabilities Act or Section 504 of the Rehabilitation Act must contact the EVMS Disability Officer. For more information about students and disability accommodations, please see the Student Disability Guide at the following link: http://www.evms.edu/education/additional_resources/disability_guide_for_students/ For more information about MD Program Technical Standards, please see https://www.evms.edu/education/medical_programs/doctor_of_medicine/technical_stan d ards/ COMPLIANCE ENFORCEMENT The MD Program has adopted a process of progressive compliance monitoring to identify, address, and correct student compliance related issues. The goals of progressive compliance monitoring are to: 1. Provide students with information on all requirements 2. Ensure students have enough notice to allow them to remain compliant 3. Notify students when they are out of compliance 4. Advise students of the expectations of the corrective action they must take and any necessary steps to achieve compliance 5. Inform students of what action(s) will be taken in the future if the situation remains uncorrected, expectations are not met, or are repeatedly non-compliant during the course of the 4-year program. Students receive instructions regarding compliance at the start of the program, as part of their first-year (M1) orientation process (either in person, in-writing, or both). Students are informed of compliance expectations throughout their entire program, including due dates. Students are given advanced notice via email and announcements in Blackboard to keep up with their compliance requirements. It is ultimately the student’s responsibility to retain a copy of all paperwork related to their compliance (i.e., copy of vaccinations, flu shot verification, etc.), in addition to providing a copy of that paperwork to the appropriate EVMS Office. Should a student miss their deadline, the MD Student Compliance Enforcement Procedure will be initiated. Page |3
REQUIREMENTS FOR BASIC LIFE SUPPORT AND ADVANCED CARDIAC LIFE SUPPORT TRAINING Basic Life Support (BLS) certification is required of all medical students prior to commencing their clinical education experience. Students are required to maintain BLS certification for the duration of medical school. Group training will be held for initial certification in the fall of the first year. If a student fails the course, or does not attend the scheduled class, they will be responsible for the fee when the course is taken. Certification is provided by Eastern Virginia Medical School Sentara Center for Simulation and Immersive Learning (SCSIL) and requires the completion of a combination of online and hands-on training. Registration information will be emailed from SCSIL. Advanced Cardiac Life Support (ACLS) certification is required for graduation. Certification is also provided by SCSIL and requires the completion of a combination of online and hands-on training. Certification will be held during the third-year (M3) Intersession. Registration information will be emailed from SCSIL. Students who have active certification (BLS, ACLS) must ensure that the training center is endorsed by the American Heart Association. Students will be asked to submit copy of the certification card to Blackboard or other electronic application. DUTY HOURS IN CARE OF PATIENTS Duty hours are defined as all clinical and academic activities related to the program, including but not limited to the following: patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled activities, such as conferences. Duty hours do not include reading, preparation time spent away from the duty site, and time completing other assignments (e.g., written history and physicals, CLIPP cases, etc.). The clerkship must design an effective program structure that is configured to provide students with educational opportunities, as well as reasonable opportunities for rest and personal well-being. • Duty hours must be limited to 80 hours per week, averaged over a 4-week period inclusive of all in-house clinical and educational activities. • Students must be provided at least 1 day in 7 free from all clinical and educational responsibilities, averaged over a four-week period. One day is defined as one continuous, 24-hour period free from all scheduled clinical, educational and administrative activities. • Students must be provided adequate time for rest between duty assignments. The rest time should be 10 hours but must be 8 hours. • Students must have at least 14 hours free of duty after 24 hours of in-house call. • Clinical and educational work periods for students must not exceed 24 hours of continuous scheduled clinical assignments at the end of which no new patients may Page |4
be seen. Student may stay on site up to 4 hours to complete activities related to hand over of the care of patients. Students who are subject to violations of the duty hours restrictions should contact their clerkship director. If the violations are not resolved or if the student does not feel comfortable reporting to the clerkship director, the student should contact the Associate Dean for Clinical Education. Students may also report violations through the EVMS Ethics and Compliance Hotline. The hotline is a confidential and anonymous reporting system which may be accessed through https://app.convercent.com/en- us/LandingPage/683edfd1-4bee-e611-80d9-000d3ab1117e or 800-461-9330. Complaints made through Hotline will be investigated by the institutional compliance officer or his/her designee. Students are required to log duty hours for each clerkship using E*Value by the final day of the clerkship. Compliance with duty hour logging is a professional responsibility and noncompliance may result in disciplinary action under the Professionalism and Professional Identity policy. ACCESSIBILITY OF RELIABLE TRANSPORTATION MD students are expected to have access to reliable transportation at the time of matriculation in order to travel to clinical sites throughout their education. Students who are unable to meet this expectation must receive exemption from the Associate Dean for Clinical Education and may be referred to Financial Aid for assistance. POLICY REGARDING ATTENDANCE AND ABSENCES FROM ACADEMIC RESPONSIBILITIES Purpose of Attendance Policy In keeping with the American Association of Medical Colleges’ (AAMC) Core Entrustable Professional Activities for Entering Residency, attendance at academic events is considered an important component of professional development toward knowledge acquisition, as well effective interpersonal and team skills. Students are expected to meet the same standards of professional behavior that are expected of basic science faculty, house staff, and attending physicians. In the M1 and M2 years, students engage multiple modalities of learning to develop their professional knowledge and skills. In this role, students are expected to be active members of their small group teams in recognition that the ability to teach peers benefits all members of the class and prepares students for their future professional responsibilities and in preparation for their clinical teamwork. Accordingly, students are expected to be present for all mandatory academic activities. In the M3 and M4 years, students engage in intensive education in the practice of clinical medicine. In this role, students are expected to be active members of the medical teams Page |5
caring for patients in hospitals, offices, and clinics. Accordingly, students are expected to be present for all scheduled clinical activities, teaching conferences, lectures, examinations, etc. Clinical responsibilities will sometimes require that students be present on holidays, nights, and weekends. In addition, students may be required to be present at times that conflict with family events and other personal obligations and preferences. Mandatory Academic Events Attendance at mandatory academic events in all years will be monitored by badge swipe. • Students are required to have their EVMS badges with them at all times. • If a student forgets their badge or believes their badge did not swipe, it is their responsibility to report their attendance to the curriculum coordinator or other administrator during the academic event. • Attendance will be monitored longitudinally by Medical Education. o Any student who forgets their badge more than 3 days in a semester will be referred to the Student Review and Advisory Committee (SRAC). o Additionally, the student will not receive credit for any subsequent academic event in that semester in which they forget their badge or are not accounted for by the badging system. Institutional Holidays EVMS has a number of institutionally-recognized holidays, including the following: New Year’s Day (observed); Martin Luther King, Jr. Day; Memorial Day; Fourth of July; Labor Day; Thanksgiving and the day after Thanksgiving; and Christmas Day (observed). • During the M1 and M2 years, all holidays are included on the Academic Calendar. Students are expected to attend scheduled academic events, as appropriate, on holidays not included on the Academic Calendar. • During the M3 and M4 years, all EVMS institutional holidays are observed from 5 pm the day before to 5 pm the day of the holiday to accommodate clinical call schedules. Students may be expected to report to clinical duties at 5 pm on the day of the institutional holidays. Inclement Weather Periodically EVMS is closed or has alternate work hours related to inclement weather. • All EVMS medical students, from the M1 through M4 years, follow the EVMS institutional decision regarding reporting to work. • If EVMS’ Liberal Leave Policy is in effect for faculty or staff, students should not endanger themselves trying to attend academic events if road conditions in their home area are unsafe. In such instances, students follow the procedures of an unplanned emergency absence, detailed below (see “Unplanned Emergency Absences on Days of Required Academic Events”). Clinical students will be required to make up the missed days, even with approved absences. Page |6
Excused Absences EVMS recognizes that the academic years can be physically and personally demanding, and substantial scheduled vacation is provided. Students are encouraged to utilize this time for family gatherings, personal business, etc. EVMS also recognizes that circumstances might sometimes require that students be absent from their assigned duties. Necessary absences from academic responsibilities may be approved by Student Affairs as described below. Some absences, by their nature, cannot be anticipated ("emergency absences"), while others can be planned and approved in advance. Specific policies for excused absences for the M1 and M2 years and M3 and M4 years are detailed in the following pages. For the sake of clarity, the following table is provided as a quick glance at the procedures for requesting absences. Students are encouraged to read the entire section of this document related their request prior to making the request. Absences at Quick Glance: Type of Absence M1 & M2 Student Procedures M3 & M4 Student Procedures Birth or adoption of 1. Contact Associate Dean for 1. Contact Associate Dean for child Student Affairs in advance of Student Affairs in advance of leave for planning purposes leave for planning purposes Birth of child by 1. Submit Excused Absence Form 1. Submit Excused Absence Form spouse or partner 2. Inform module director and 2. Inform primary person to whom (3 days excused) curriculum coordinator as soon you report and clerkship as absence is known coordinator as soon as absence 3. Read syllabus regarding is known possibility of make-up activities Death (or serious 1. Submit Excused Absence Form 1. Submit Excused Absence Form illness) of close 2. Inform module director and 2. Inform primary person to whom family member or pet curriculum coordinator as soon you report and clerkship as absence is known coordinator as soon as absence 3. Read syllabus regarding is known possibility of make-up activities 3. Coordinate make-up days with clerkship coordinator for absences of 3-5 days Family care 1. Submit Excused Absence Form 1. Submit Excused Absence Form 2. Inform module director and 2. Inform primary person to whom curriculum coordinator as soon you report and clerkship as absence is known coordinator as soon as absence 3. Read syllabus regarding is known possibility of make-up activities Inclement Weather 1. Submit Excused Absence Form 1. Submit Excused Absence Form 2. Inform module director and 2. Inform primary person to whom curriculum coordinator you report and clerkship 3. Read syllabus regarding coordinator possibility of make-up activities. 3. Coordinate make-up days with clerkship coordinator for absences of 3-5 days Page |7
Interviews for 1. Submit Excused Absence Form at Not applicable summer research least 4 weeks prior the start of (M1s) OR for the module (or as soon as medical/graduate known) school (MMs) 2. Read syllabus regarding possibility of make-up activities. 3. With approval, contact module director in advance of travel for consideration of make-up activities. Interviews for Not applicable 1. Inform primary person to whom residency (M4) you report and course director (up to 5 days total 2. Coordinate make-up days with during 4-week course director for absences of rotations, only) 4-5 days Jury duty 1. Request waiver from Registrar 1. Request waiver from Registrar Mandatory court 1. Submit Excused Absence Form at 1. Submit Excused Absence Form at appearances least 4 weeks prior the start of least 4 weeks prior the start of the module (or as soon as the clerkship (or as soon as known) known) 2. Read syllabus regarding 2. Coordinate make-up days with possibility of make-up activities. clerkship coordinator for 3. With approval, contact module absences of 3-5 days director in advance of appearance for consideration of make-up activities. Medical 1. Submit Excused Absence Form at 1. Submit Excused Absence Form at appointments least 4 weeks prior the start of least 4 weeks prior the start of (planned) the module (or as soon as the clerkship (or as soon as known) known) 2. Read syllabus regarding possibility of make-up activities. 3. With approval, contact module director in advance of appointment for consideration of make-up activities. Medical condition 1. Submit Excused Absence Form 1. Submit Excused Absence Form (emergency) 2. Inform module director and 2. Inform primary person to whom curriculum coordinator you report and clerkship 3. Read syllabus regarding coordinator possibility of make-up activities. 3. Coordinate make-up days with clerkship coordinator for absences of 3-5 days Page |8
Motor vehicle 1. Submit Excused Absence Form 1. Submit Excused Absence Form accident 2. Inform module director and 2. Inform primary person to whom curriculum coordinator you report and clerkship 3. Read syllabus regarding coordinator possibility of make-up activities. 3. Coordinate make-up days with clerkship coordinator for absences of 3-5 days Personal day (M3) Not applicable 1. Submit Excused Absence Form at (one day only) least 4 weeks prior the start of (non-holiday M-F) the clerkship (or as soon as known) Presentations at 1. Submit Excused Absence Form at 1. Submit Excused Absence Form at meetings least 4 weeks prior the start of least 4 weeks prior the start of (2 days only) the module (or as soon as the clerkship (or as soon as known) known) 2. Read syllabus regarding possibility of make-up activities. 3. With approval, contact module director in advance of travel for consideration of make-up activities. Residency interviews Not applicable 1. Inform primary person to whom (M4) you report and course director (up to 5 days total 2. Coordinate make-up days with during 4-week course director coordinator for rotations, only) absences of 4-5 days Schedule requests Not applicable 1. Contact clerkship coordinator (M3) with requests at least 4 weeks in (i.e., weekends off) advance of the start of the clerkship Step 2 Clinical Skills Not applicable 1. Submit Excused Absence Form at (2 days only) least 4 weeks prior the start of the clerkship (or as soon as known) Excused Absences in the M1 & M2 Years Planned Absences during the M1 & M2 Years Planned absences may be excused at the discretion of Student Affairs using the Request for Excused Absence Form, located on the Student Affairs page of the EVMS website (https://evms.us2.qualtrics.com/SE/?SID=SV_eSfB6bGhkTYurC5). Planned absences will only be approved in advance of the absence, when requests are made at least 4 weeks prior to the start date of the module OR as soon as known, if determined less than 4 weeks. Travel should not be arranged until the absence has been Page |9
approved. Exceptions to these time frames will only be considered in extraordinary circumstances. Approvable reasons for planned absences include the following: • Presentations at medical or scientific meetings, including poster or talk or representing EVMS in an official capacity. • Proof of presentation acceptance must be attached to the Request for Excused Absence Form. • Absences will be approved for travel and attendance at the day of the presentation only (i.e., in most situations, two academic days total). • Absences for attendance at medical and scientific meetings without a presentation will ordinarily not be approved. • Scheduled medical appointments or procedures. When possible, students are encouraged to use “Wellness afternoons” to schedule medical appointments. • In the M1 year, interviews for summer research opportunities. o Students are encouraged to schedule these interviews on days that do not conflict with academic events, when possible. o Proof of interview must be attached to the Request for Excused Absence Form. o Absences will be approved for travel and attendance at the day of the interview only (i.e., in most situations, two academic days total). • Birth or adoption of child: o Maternity leave: Each request for maternity leave will be arranged on an individual basis by the Associate Dean for Student Affairs and Medical Education. o Leave for birth of child by spouse or partner: Absences will be approved for three academic days. • Mandatory court appearance. o Proof of court appearance must be attached to the Request for Excused Absence Form. o Absences will be approved for travel (if appropriate) and the day(s) of the court appearance only. NOTE: Students who are called for jury duty should obtain a waiver for duty from the Registrar’s Office. During the M1 and M2 years, the following days should be avoided for planned absences: • Orientation to the module (i.e., first day of the module). o Attendance on the first day of a module is essential for understanding the makeup and expectations for the module. o No excused absences will be approved except for emergency situations. • Academic events in which points are earned for the module grade. o These sessions are planned to incorporate clinical application of material not P a g e | 10
easily learned through recorded or print resources. o If a planned absence is unavoidable during one of these sessions, students can request an Excused Absence. With approval, it is the Module Director’s discretion whether points may be made up. It is the student’s responsibility to (1) contact the Module Director and (2) read the syllabus prior to the absence to discuss the possibility for makeup. Points cannot be made up after the session, except in the case of emergency absences and at the Module Director’s discretion. NOTE: Due to logistical considerations, some activities may not be made up, even if an Excused Absence is granted. o Tardiness to an event where points are earned will result in a reduction of point(s) as determined by the Module Director. o With excused absences, Clinical Skills makeup/rescheduling is determined by the type of event, as follows: Small group session: Small group sessions cannot be made up. Instead the student will complete a makeup assignment, which must be completed the following week or prior to the final exam (whichever occurs earlier). Pre-assigned time slots: Once received, a student has 48 hours to review and request trades. Once the review period is over, the session is rescheduled if possible. If not possible, the student is expected to peer practice on their own, review videos, and complete the quiz. Student sign-up sessions: The session is rescheduled if possible. If not possible, the student is expected to peer practice on their own. The Clinical Skills Director, in cooperation with the module director and SCSIL, will reschedule CSAs. No policy can enumerate all possible reasons for which an approved absence might be granted. Each request will be considered on a case-by-case basis. Failure to follow procedures for approval of a planned excused absence will result in an unexcused absence. Unplanned Emergency Absences on Days of Required Academic Events In the event of an emergency absence, M1 and M2 students should inform Student Affairs of their absence as soon as possible and within two days, using the Request for Excused Absence Form (https://evms.us2.qualtrics.com/SE/?SID=SV_eSfB6bGhkTYurC5). In the event of an unplanned emergency absence, in addition to submitting the Request for Excused Absence Form to Student Affairs, students are responsible for emailing the following individuals as soon as possible before the start of the required academic event: P a g e | 11
• Module director • Curriculum coordinator When communicating the absence, the following information must be conveyed: • The nature of the absence; and • The expected date of return. Emergency absences will be approved only under the following circumstances: • Medical condition. Students are encouraged to refrain from attending classes or clinical duties when ill. o If illness requires that students be absent for three or more academic days, a medical note will be required at the discretion of Student Affairs. o Students with an extended illnesses, who have been hospitalized, or who have undergone surgery will also require notification from a medical provider that they can return to full academic duties. o Extended absences may require a Leave of Absence. o NOTE: We encourage students to communicate with their health care providers regarding their study and test schedules, so that appropriate consideration is given when prescribing medications that may have side effects that impact on these activities. Students who must take medications with side effects that significantly impact sleep or other functions should obtain written notification from their provider as to what accommodations are appropriate and for how long. • Personal need, including but not limited to the following: o Serious illness or death of a close family member o Serious illness or death of a pet o Emergency child or family care o Serious motor vehicle accident • Inclement weather. If EVMS’ Liberal Leave Policy is in effect for faculty or staff, students should not endanger themselves trying to attend academic events if road conditions in their home area are unsafe. Failure to follow the procedures for an unplanned emergency absence will result in an unexcused absence. Excused Absences in the M3 & M4 Years Planned Absences in the M3 & M4 Years Planned absences may be excused at the discretion of Student Affairs using the Request for Excused Absence Form, located on the Student Affairs page of the EVMS website (https://evms.us2.qualtrics.com/SE/?SID=SV_eSfB6bGhkTYurC5). P a g e | 12
Planned absences will only be approved in advance of the absence, when requests are made at least 4 weeks prior to the start date of the clerkship/rotation OR as soon as known, if determined less than 4 weeks. Travel should not be arranged until the absence has been approved. Exceptions to these time frames will only be considered in extraordinary circumstances. Approvable reasons for planned absences include the following: • Presentations at medical or scientific meetings, including poster or talk or representing EVMS in an official capacity. • Proof of presentation acceptance must be attached to the Request for Excused Absence Form. • Absences will be approved for travel and attendance at the day of the presentation only (i.e., in most situations, two academic days total). • Absences for attendance at medical and scientific meetings without a presentation will ordinarily not be approved. • Scheduled medical appointments or procedures. When possible, students are encouraged to use “Wellness afternoons” to schedule medical appointments. • Birth or adoption of child: o Maternity leave: Each request for maternity leave will be arranged on an individual basis by the Associate Dean for Student Affairs and Medical Education. o Leave for birth of child by spouse or partner: Absences will be approved for three academic days. • Mandatory court appearance. o Proof of court appearance must be attached to the Request for Excused Absence Form. o Absences will be approved for travel (if appropriate) and the day(s) of the court appearance only. • United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills (CS) Exam o Proof of exam must be attached to the Request for Excused Absence Form. o Absences will be approved for travel and the day of the exam only (i.e., two academic days total). o No change in clinical placement site will be considered or allowed to accommodate study or sitting for CS. • In the M3 year, student personal day. All M3 students have one excused absence over the course of the year to use for personal reasons (e.g., significant life event, observation of religious holiday, etc.). • In the M4 year, EVMS recognizes that students will miss clinical duties for residency interviews. Interview absences do not need to be approved by Student Affairs. Instead, M4 students should communicate their interview dates as soon as possible to the supervising attending, resident, or other primary individual to whom the student will report for that shift and the course director. o No academic days can be missed during a 2-week rotation. P a g e | 13
o Students can be excused for residency interviews for 3 academic days during a 4-week rotation. Missed academic days include both days of interviews and travel days. o For more than 3 missed academic days during a 4-week rotation, students may be excused but required to make up the missed days at the discretion of the course director and the Associate Dean for Clinical Education. o If students miss more than 3 academic days during a 4-week rotation and are unable to make up the additional missed days, they will be expected to drop the rotation with consultation of the Associate Dean for Clinical Education. NOTE: Students who are called for jury duty should obtain a waiver for duty from the Registrar’s Office. During the M3 year, students receive a minimum of 8 scheduled days off per clerkship for an average 1 day off per week. These days off are in addition to any planned absences. • These scheduled days off cannot be “saved” or taken all at once. • Schedule requests for days off do not follow the Excused Absence Policy. Instead, they should be made at least 4 weeks prior to the start of the clerkship directly to the clerkship coordinator. • Requests for weekends off associated with a personal day (e.g., a personal day on Friday or Monday) should be made directly to the clerkship coordinator. • These requests will be considered but cannot be guaranteed. During the M3 and M4 years, the following days should be avoided for planned absences: • Orientation to the clerkship or course o Attendance on the first day of a clerkship or course is essential for understanding the makeup and expectations for the rotation. o No excused absences will be approved except for emergency situations. • Subject exam(s) or clinical exam(s) • Required clerkship sessions. It is the student’s responsibility to contact the clerkship coordinator for dates of required clerkship sessions before scheduling planned absences. No policy can enumerate all possible reasons for which an approved absence might be granted. Each request will be considered on a case-by-case basis. Failure to follow procedures for approval of a planned excused absence will result in an unexcused absence. Unplanned Emergency Absences on Days of Required Academic Events In the event of an emergency absence, M3 and M4 students should inform Student Affairs of their absence as soon as possible, using the Request for Excused Absence Form (https://evms.us2.qualtrics.com/SE/?SID=SV_eSfB6bGhkTYurC5). P a g e | 14
In the event of an unplanned emergency absence, in addition to submitting the Request for Excused Absence Form to Student Affairs, students are responsible for emailing the following individuals as soon as possible before the start of clinical duties or required academic event via email, telephone, or text, as appropriate: • The supervising attending, resident, or other primary individual to whom the student will report for that shift; and • The clerkship coordinator. When communicating the absence, the following information must be conveyed: • The nature of the absence; and • The expected date of return. Emergency absences will be approved only under the following circumstances: • Medical condition. Students are encouraged to refrain from attending classes or clinical duties when ill. o If illness requires that students be absent for three or more academic days, a medical note will be required at the discretion of Student Affairs. o Students with an extended illnesses, who have been hospitalized, or who have undergone surgery will also require notification from a medical provider that they can return to full academic duties. o Extended absences may require a Leave of Absence. o In the event of 3 missed sick academic days, the student will be required to make up 1 academic day of the M3 clerkship or M4 rotation. o In the event of 4-5 missed sick academic days, the student will be required to make up 2-3 academic days of the rotation, respectively. In addition, the clerkship or course director will review the student’s performance to determine whether learning goals can be met by the end of the M3 clerkship or M4 rotation. o In the event of more than 5 missed sick academic days, the student will be required to repeat the M3 clerkship or M4 rotation and to meet with the Vice Dean for Academic Affairs to develop an Academic Plan. o NOTE: We encourage students to communicate with their health care providers regarding their study and test schedules, so that appropriate consideration is given when prescribing medications that may have side effects that impact on these activities. Students who must take medications with side effects that significantly impact sleep or other functions should obtain written notification from their provider as to what accommodations are appropriate and for how long. • Personal need, including but not limited to the following: o Serious illness or death of a close family member o Serious illness or death of a pet o Emergency child or family care o Serious motor vehicle accident P a g e | 15
• Inclement weather. o If EVMS’ Liberal Leave Policy is in effect for faculty or staff, students should not endanger themselves trying to get to academic events if road conditions in their home area are unsafe. o In the event that the student’s absence was approved on date(s) when the EVMS’ Liberal Leave Policy was in effect for faculty or staff, the student will be required to make up the same number of missed days as the excused absence(s). Failure to follow the procedures for an unplanned emergency absence will result in an unexcused absence. Policy Concerning Absences or Tardiness for Scheduled Examinations Examination schedules are published on the official EVMS Microsoft Outlook calendars. Examinations may include written, practical, laboratory evaluations, or quizzes. Absences from Exams All students are expected to take examinations on the scheduled day and time unless approved by Student Affairs per the procedures for planned or emergency absences described above. Students requesting absences on exam dates must complete the Request for Excused Absence Form via the procedures outlined above. Students excused from exams on the originally scheduled date will be expected to take the exam on the make-up exam day, except in emergency situations as determined by Associate Dean of Student Affairs. Late Arrival to Exams To facilitate a calm educational environment, students are required to badge at least 15 minutes prior to the scheduled exam start time (i.e., badge in by 7:45 a.m. for an 8:00 a.m. exam) AND be seated and have screens ready for exam passwords 5 minutes prior to the scheduled start time. Late arrivals include the following behaviors: • Walking into the examination room during pre-exam announcements • Walking in during exam code reveals • Walking in after the examination start time The following procedures will be used in the event students arrive late to exams: • The Exam Administrator(s) will complete an Incident Report, which includes the students’ names and times of arrival. Incident reports will be tracked by Medical Education for patterns of tardiness. • Clinical students who are late to exams will be reported to the respective clerkship director and professionalism points will be deducted. P a g e | 16
If students arrive to an exam less than 30 minutes late: • Students will be directed to their assigned seat, and given the password to begin the examination. • Late students are expected to complete their exam within the remaining allotted time. Time will not be extended beyond the close of the exam session. If students arrive to an exam at or more than 30 minutes late: • Exam Administrator(s) will not administer the exam to students who arrive more than 30 minutes after the scheduled exam start time. • The student must immediately complete the Request for Excused Absence Form: https://evms.us2.qualtrics.com/SE/?SID=SV_eSfB6bGhkTYurC5 . • Student Affairs will determine whether the student is permitted to make up the exam per the procedures listed below. • Exam Administrators must receive Student Affairs’ approval to administer the exam to students who arrive more than 30 minutes after the scheduled exam start time. Ability to take the exam is also dependent upon availability of Exam Administrators. Make-Up and Retest Examinations Dates and times for make-up and retest examinations are pre-determined and included on the official academic calendars to which all students have access. These exams will be administered on the predetermined scheduled date and time for all eligible students, except in emergency situations as determined by Associate Dean of Student Affairs. Students who fail to take exams as scheduled will be given a score of zero for the exam. Neither make-up nor retest exams will be provided for unexcused absences. Unexcused Absences For all four years of the MD Program, the following incidents will be considered an unexcused absence: • Any absence not explicitly approved as outlined above; or • Tardiness of greater than 15 minutes. Any student with an unexcused absence will be subject to penalty according to the Professionalism Policy and will be referred to SRAC for review and potential intervention. • During the M3 and M4 years, unexcused absences of 1-3 academic days may be made up at the discretion of SRAC. Students will make up the same number of academic days as the number of days of unexcused absence(s). Unexcused absences of more than 3 academic days cannot be made up. • Unexcused absences of more than 3 academic days within a module or clerkship will result in an automatic failing grade for the module or clerkship and referral to the Student Progress Committee (SPC). P a g e | 17
NOTE: Medical Education will track all absences of any type. Any student with an excessive number of absences of any type over the course of an academic year will be referred to SRAC for review and potential intervention. OTHER STUDENT RESPONSIBILITIES Students enrolled in the MD Program are responsible for compliance with all EVMS student policies and procedures as detailed in the Institutional Handbook. ASSESSMENT AND DOCUMENTATION OF MEDICAL STUDENT PROGRESS STUDENT ASSESSMENT POLICY General Assessment Principles Candidates for the degree of Doctor of Medicine must demonstrate the requisite knowledge and skills to complete the prescribed course of study and must also demonstrate the personal characteristics and qualities necessary for the safe and effective practice of medicine. Students will therefore be regularly assessed during their training, both with regard to their academic performance and with regard to their professional development. Satisfactory academic accomplishment and professional development are both essential requirements for graduation. The assessment of students’ academic progress and professional development is a corporate responsibility of the faculty of EVMS. The purpose of academic assessment is to certify students for graduation from EVMS by documenting their competence in the basic and clinical sciences. Assessments will be based on the goals and objectives of the curriculum and will assess the mastery of fundamental concepts as well as the ability to integrate knowledge and skills. Assessments have the following purposes: 1. To assure adequate competence of students in the knowledge, skills, and attitudes essential for the practice of medicine. 2. To provide early detection of unsatisfactory or marginal performance in order to assist students to meet acceptable academic standards, or if necessary, to redefine educational and career goals. 3. To document distinguished performance in a manner that benefits students’ further educational and career planning. 4. To document institutional progress toward educational goals and objectives and provide the information necessary to modify and strengthen the curriculum. The purpose of assessment of professional behavior is to certify students for graduation by documenting judgment, attitudes, and behavior appropriate for the practice of medicine. Professionalism at EVMS includes—but is not limited to—students’ concern for the welfare and dignity of patients, colleagues, and coworkers; trustworthiness and P a g e | 18
responsibility to duty; respect for their patients’ ethnic and cultural diversity; and professional demeanor and conduct. Assessment Methodology In the M1 and M2 years, standards of acceptable performance for individual module assessments are communicated to students at the beginning of each module. In the M3 and M4 years, standards of acceptable performance for each clerkship and elective are communicated to students at the beginning of the clerkship or elective. Standard assessment instruments are used in all clerkships to measure the achievement of shared objectives and for measurement of specific clerkship objectives. Assessment instruments will include regular assessments of patient encounter and procedure logs maintained by students. Unified Competency Objectives for the Skills Assessment exam administered during the clinical years are distributed at the beginning of the M3 year. Standards of acceptable performance for other evaluations as stated by the grading system and as considered in student progress decisions (e.g., USMLEs, Clinical Skills Assessment, professional conduct, etc.) will be communicated to students in advance of such assessments. In support of students’ preparation for the USMLEs, most M1, M2, and M3 written examinations are comprised of multiple-choice questions written by the National Board of Medical Examiners. Institutional, Module/Clerkship Director, and Student Responsibilities for Assessment Multiple entities at EVMS have a role in the implementation of successful assessment practices. The Medical Education Committee is responsible for the following: 1. Developing and regularly reviewing an integrated curriculum that meets the Unified Competency Objectives and the standards of the Liaison Committee for Medical Education. 2. Reviewing all pre-clerkship modules and clinic clerkships on a regular basis to determine effectiveness and ensure a quality experience for students and faculty. 3. Developing an integrated assessment system that gives the student an opportunity to build on strengths and correct weaknesses, particularly in relation to skills that are common to several disciplines (e.g., problem–solving and physical examination skills). 4. Providing regular review of the guidelines for assessment and program evaluation, in consultation with Medical Education. 5. Providing a systematic, legally acceptable appeals process for reviewing a student's failure to meet the institution's academic and/or professional standards. P a g e | 19
Student Performance and Evaluation is responsible for the following: 1. Collecting, storing, and processing all scores on performance assessments that will be used in calculating a final module score. All scores used in calculating a final grade must be reported to Student Performance and Evaluation. 2. Entering all scores in the Student Information System (SIS) and posting the student scores on the EVMS myPortal for students to review. Students must review the results posted on the EVMS myPortal for accuracy and notify Student Performance and Evaluation of any discrepancies. Results posted on any other sites or locations are not considered officially reported scores. The information posted in the SIS is the single source of information for maintaining and reporting student performance data. 3. Calculating the final scores and grades for each module after the final examination and all module scores have been entered into the SIS. Student final scores and grades will be entered in the SIS and posted to the EVMS myPortal within 10 business days of the end of the module. 4. Automatically transferring student scores and grades to the Registrar for student transcripts. The module or clerkship director is responsible for developing and overseeing the assessment process for students for that module or clerkship. This responsibility includes the following: 1. Developing written goals, objectives, standards of acceptable performance, and a systematic objective assessment policy that are communicated in writing to students and faculty and upon which all scores and grades are based. 2. Predetermining and communicating in writing the relative weight of each assessment used to determine the grade. 3. Informing students of their marginal or failing performance in the module or clerkship, giving each an opportunity to respond to any identified deficiencies. 4. Documenting student progress, outstanding accomplishments, and deficiencies in writing with specific examples. Each student at EVMS is responsible for the following: 1. Obtaining the written goals, objectives, standards of acceptable performance, and assessment policy for each module and clerkship. 2. Complying with assessment requirements of each module and clerkship with the comprehensive evaluation requirements established by the institution. 3. Ascertaining his/her performance results. 4. Seeking faculty assistance in correcting unsatisfactory or marginal performance. 5. Initiating the institutional appeals process if the student objects to the institution's response to his/her failure to meet the institution's academic and professional standards. 6. Completing an evaluation of each module, clerkship, and of the faculty who are responsible for a significant amount of teaching in each module or clerkship. P a g e | 20
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