Unit Policy
Title
School of Medicine: Policy on Student Progress Committee Functions
Introduction
Purpose
The purpose of this Policy is to establish the composition of the Student Progress Committee (SPC), its protocol for convening a meeting, and the conditions for Level 1 and Level 2 Actions.
Scope
This applies to the Student Progress Committee members and conduct of its activities.
Policy
General Requirements
Purpose of the SPC
The SOM has established a SPC to review the academic and professional performance of medical students, including compliance with the Technical Standards. For those students experiencing Academic Difficulty or Professional Difficulty, including non-compliance with the Technical Standards, the SPC will consider the totality of the circumstances and determine Level 1 and Level 2 Actions, carefully balancing the best interests of the student, SOM, profession, patients and the general public.
Composition of the SPC
The SPC shall be composed of nine (9) voting members, including the chair, and 5 ex-officio, non-voting members. The term for each member is defined by the SOM Bylaws.
SPC Composition:
- Voting Members:
- Three (3) faculty members from basic science departments and three faculty members from clinical science departments (as defined by SOM Bylaws) appointed by the Dean serve as voting members of the SPC.
- One faculty member from a basic science department and one faculty member from a clinical science department (as defined within the Bylaws) elected by SOM faculty from a pool of experienced educators (prior service as a medical school course or clerkship director and/or a member of the Academy of Educators) also serve as voting members of the SPC.
- The Chair of the SPC, who is appointed by the Dean, serves as a voting member.
- The Dean may also appoint up to four alternate members of the Committee.
- Ex officio non-voting members: The Associate Dean for Student Affairs, the Assistant Dean for Student Affairs, the Vice Dean of the Office of Scholastic Excellence and Equity, the Registrar, the Associate Dean of Curricular Affairs, and the Director of Office of Scholastic Enrichment and Equity serve as ex officio non-voting members. The Student Affairs Deans serve as student advocates. They do not participate in the deliberations involving individual students but participate in the meetings to ensure that the student’s due process rights are respected and that the proper administrative procedures are followed. They are also allowed to provide confirmation of appropriate use of student support services.
- Current Advisory College faculty are excluded from membership to avoid any potential conflict of interest.
Procedural Notes for a Properly Convened Meeting
The SPC reviews all students experiencing Academic Difficulty or Professional Difficulty. The SPC convenes meetings regularly during and at the end of each semester.
Quorum
An SPC quorum, for in person or electronic meetings, is defined as five (5) or more voting members. The SPC may not act without a quorum. The decisions of the SPC are determined by a majority vote of the members present.
Recusal
SPC voting members involved in the following circumstances for a student’s review are required to recuse themselves from voting on any motions concerning that student:
- Healthcare provider to the student;
- Family member of the student;
- Evaluator of student’s performance in a course; or
- Self-identified conflict
- Career advisor to the student
Electronic Vote
The chair may call for an electronic vote if a physical meeting is not possible, except in the instance when a student is required to appear before the Committee.
Committee Members: Meeting Notification and Materials
In advance of a meeting where a student is on the agenda, the faculty advisor, block or course directors, others identified by the student who can provide supportive information, and the Registrar, as appropriate, will provide to the SPC membership confidential access to written information about the academic or professionalism record of each student being reviewed to assist the SPC to render informed decisions.
Students: Meeting Notification, Attendance, and Materials
Students will receive written notification of the concerns leading to an SPC review of their performance, and access to all materials that the SPC will consider, at least 10 business days prior to a scheduled meeting on the matter. Students are invited to appear at the meeting, and in some cases, the SPC may require a student to appear. If a student declines to appear, does not respond to the notice, or is tardy, the SPC will meet as scheduled, and Level 1 or 2 Actions, as discussed below, will be determined in the student’s absence. The student will receive a written copy of the SPC decision.
During the meeting, the student may elect to present any information or documentation deemed relevant. The student may also bring one SOM faculty member of choice to the meeting to serve as an advocate. This faculty member is often a college advisor but may not be a member of the SPC. Attorneys retained by the student cannot attend SPC meetings or meetings with medical school staff in preparation for an SPC meeting either in person or virtually. Meetings may not be recorded by any person including but limited to the student, the college advisor, and committee members.
Level 1 Actions to Address Academic or Professional Difficulty
For any student meeting the definitions set forth for Academic or Professional Difficulty, the SPC may take any of the following Level 1 Actions, alone or in combination. These actions will be reported in the MSPE.
- Require a student to address a first report of Professional Difficulty through assignments and future follow up as determined by the SPC. Completion of assignments in response to a first report of Professional Difficulty will appear on a student’s Medical Student Performance Evaluation (MSPE).
- Recommend that the student be referred for evaluation of difficulties that may impair his/her ability to be a physician, including but not limited to learning disabilities, medical disorders, psychological disorders, substance abuse disorder, and other psychiatric conditions.
- Require the student to remediate a portion of a course or a whole course as recommended by the faculty, the Office of Academic Excellence, and/or the SPC. Remediation is noted in the student’s MSPE.
- Require a student to submit additional written reflection with specific requirements such as improved insight, improved judgement, or more detailed plan moving forward.
- Require a student to return to the SPC at a future date for a check-in on academic or professionalism progress.
- The SPC reserves the right to remove the student from engaging in coursework until all issues before the SPC and all appeals have been resolved. This action will be noted in the student’s MSPE.
Failure to comply with any Action imposed by the SPC may result in a student’s dismissal from the SOM (Level 2 action-see below). (This includes failure to adhere to the student’s support plan including attendance at specified check-ins or meetings.)
Level 2 Actions to Address Academic or Professional Difficulty
The SPC may take any of the following Level 2 Actions alone or in combination. The SPC will request a student to appear at a meeting where any of the following Level 2 Actions may be under consideration. Failure to comply with any action imposed by the SPC may result in a student’s dismissal from the SOM.
- Require the student to decelerate or repeat entire courses. The student may also volunteer to decelerate. Required or voluntary deceleration is noted in the student’s MSPE.
- Recommend that the student withdraw from the regular curriculum to take a review (e.g., Basic Science Review) course or enter an external review program. Withdrawal from the curriculum is noted in the student’s MSPE.
- Require the student to take a leave of absence with defined conditions for returning to the curriculum (See Leave of Absence Policy). Leaves of Absence are noted in the student’s MSPE.
- Require the student to cease or to not perform clinical coursework until all issues before the SPC and all appeals have been resolved. This is noted in the student’s MSPE.
- Recommend or require other actions to appropriately address the Professional or Academic Difficulty at issue. This Level 2 Action is noted in the student’s MSPE.
- Dismiss the student from the SOM. Any opportunity for the student to request a leave of absence or to voluntarily withdraw from the curriculum ends when the SPC meeting is convened. Students who are dismissed from the SOM receive notice within ten business days that they may appeal the decision but may not continue in the curriculum while their appeal is being adjudicated.
A student cannot decelerate a phase more than once whether voluntary or required by the SPC.
The entire curriculum must be completed within six academic years of initial matriculation, excluding approved leaves of absence. Failure to do so will result in dismissal from the SOM unless there are extraordinary extenuating circumstances that preclude the student’s progress and that, in the judgment of the SPC, warrant an extension.
Application of Level 1 and 2 Actions for Specific Circumstances
While the circumstances of an individual case will dictate the appropriate response, the following specific circumstances offer typical, but not universal, Level 1 or 2 Actions applied by the SPC:
- If a student in any phase is in Academic Difficulty, the student may be required to remediate.
- Students who fail required remediation may be required to enter a decelerated curriculum, take a leave of absence with defined conditions for return, or be dismissed from the SOM.
- If a student does not pass the USMLE Step 1 at the end of the Foundation Phase or chooses extended study for STEP 1 study, the student will not be allowed to begin Application Phase until
- a passing score on the USMLE Step 1 is recorded by the registrar (see UNC SOM Policy for Completion of USMLE Step Examinations).
- If a student who is participating in a residency matching program does not pass the USMLE Step 2 by November 1st of Individualization Phase, the student may be withdrawn from the Match for that year (see UNC SOM Policy for Completion of USMLE Step Examinations).
- Three failed attempts to pass a single USMLE Step exam will result in dismissal from the SOM absent a finding of exigent circumstances.
SPC Hearings Resulting in No Level 1 or Level 2 Actions
Any activities or reports which were reviewed by the SPC but resulted in no Level 1 or Level 2 actions will NOT be included in the MSPE and will not result in any disciplinary actions.
Relationship to the Appeal of SPC Actions Policy
Appeal procedures for Level 1 and 2 Actions are covered in the Appeal of SPC Actions Policy.
Relationship to the University’s Honor Code
If a student’s alleged conduct potentially constitutes a violation under the University’s Honor Code, the matter must be referred to the Student Attorney General. If, in the SPC’s reasoned professional judgment, the alleged conduct, if true, would constitute a risk to patient care or safety, the SPC may suspend the student from patient contact pending the outcome of the Honor Court case.
If, upon review of the matter, the Student Attorney General determines there is insufficient evidence to pursue a charge against the student or that the alleged conduct does not constitute an offense after the Honor Court review, there will be no notation in the MSPE. The SPC, however, may address conduct that calls into question the student’s professional fitness for the practice of medicine pursuant to this policy, the Technical Standards, or other applicable SOM or University policies. If the SPC were to confer an Action based on the Honor Court’s investigation, this would be noted in the student’s MSPE, subject to the procedures in this policy and any applicable appeals under the Appeal of SPC Action Policy.
If the Attorney General initiates a charge against the student and the Honor Court finds the student guilty for the offense charged, there will be a notation in the MSPE. The SPC may also review the student’s conduct if that conduct calls into question the student’s professional fitness for the practice of medicine pursuant to this policy, the Technical Standards, or other applicable SOM or University policies. Such consideration shall not begin until all Honor Court proceedings, including any appeals, have concluded. The SOM may impose additional actions after the conclusion of the University Honor Court review and those additional actions will be noted in the MSPE, subject to the procedures in this policy and any applicable appeals under the Appeal of SPC Action Policy.
Relationship to the Policy on Prohibited Discrimination, Harassment and Related Misconduct
The University’s Policy on Prohibited Discrimination, Harassment, and Related Misconduct prohibits discrimination or harassment on the basis of an individual’s age, color, disability, gender, gender expression, gender identify, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Students who want additional information regarding the University’s process for responding to allegations of discrimination or harassment should contact the University Compliance Office (UCO) for assistance:
University Compliance Office
Telephone: (919) 966-3576
Email: eoc@unc.edu
Website: compliance.unc.edu/
Any administrator or supervisor, including a department chair, associate dean or other administrator, who receives a student’s complaint about prohibited harassment or discrimination, must notify the UCO. If a student alleges prohibited harassment or discrimination as a cause of the circumstances giving rise to the Academic or Professional Difficulty under review by the SPC, the SOM must consult with the UCO before rendering a decision regarding the imposition of Measures or Actions.
Definitions
Technical Standards: Technical Standards establish the personal attributes and capabilities required for admission to, promotion within, and graduation from the UNC School of Medicine (SOM). Medical students are required to attest that they understand and will comply with these standards on an annual basis.
Academic Difficulty: The presence of any of the following:
- One or more failing grades in:
- courses (including electives and selectives) or portions of courses
- the USMLE Step 1 or 2
- NBME subject shelf examinations
- Application Phase OSCE
- PCC final examination
- Other summative examinations
- Failure to meet the requirements of any extramural academic activity approved and authorized by the Associate Dean of Student Affairs (e.g., requirements of the School of Public Health for the MPH degree or for other approved dual degree programs).
- Documented difficulties in clinical performance in any course that leads to an incomplete or failing grade.
This includes delay of more than one summative examination in Foundation Phase (CRE, NBME, PCC final exam), Application Phase (NBME subject shelf examination, OSCE), or Individualization Phase (formative OSCE)
Professional Difficulty: The presence of behavior, including behaviors inconsistent with the Technical Standards, which interferes with the student’s responsibilities and progress through the curriculum or that may have influenced a failing or incomplete grade. Examples of behaviors that may establish professional difficulty anytime during enrollment include but are not limited to:
- Habitual and unexcused lateness or absenteeism;
- Inappropriate responses to feedback or inappropriate language used in providing feedback
- Unprofessional or inappropriate interactions with health care team members, community members or patients;
- Failure to submit assignments;
- Missing deadlines;
- Dishonesty;
- Lack of responsiveness to communications from instructors or administrative staff;
- Findings of "guilty” by the Honor Court;
- Convictions of criminal activity;
- Findings of professionalism lapses by the Compliance Office or other professionalism entities associated with any of our healthcare partners (i.e. HIPAA violations, noncompliance with health and safety requirements, falsifying documentation for immunizations);
- Findings of professionalism lapses by any of our community partners, including but not limited to student housing entities, UNC Office of Student Conduct or other community partners (i.e. sanctions from UCO, destruction of property on UNC Campus, violation of student alcohol policy);
- Findings of professionalism lapses (not meeting deadlines, falsifying documents) related to Health and Safety Compliance;
- Findings of professionalism lapses which could affect progression through a medical career or future practice such as violent behavior, disrespectful language, inability to regulate oneself in stressful situations, etc.; and/or
- Findings of professionalism lapses even while on leaves of absence including but not limited to graduate leave, away rotations, research leave or even personal leave.
Community partners may levy adverse actions against our students based on their own policies and using their internal procedures within their jurisdiction. Upon any finding of professionalism difficulty, the Student Progress Committee may levy additional adverse actions related to the student’s progression (or non-progression) through the curriculum, ability to take courses at specific sites, academic suspension or other. Additionally, the Student Progress Committee may make recommendations to help the student make amends with community partners including but not limited to offering apologies, writing reflections, etc.
Faculty and staff members with formal or informal knowledge of behavior(s) that may constitute Professional Difficulty must document and report such conduct to the SPC.
Action: Decisions made by the SPC that can either be classified as Level 1 or Level 2. Any adverse action levied by the SPC will be included in the Medical Student Performance Evaluation (MSPE).
- A Level 1 Action is made by the SPC in response to a student’s Academic or Professional Difficulty
- A Level 2 Action is more severe and may include such sanctions as deceleration, or dismissal.
Honor Court Sanction: Penalty imposed by the University Honor Court as a result of a finding of "guilty”. Honor Court sanctions are noted in the MSPE.
Remediation or Remediate: Repetition of a portion of a course or a whole course
Deceleration or Decelerate: Repetition of a time period of study. A student can voluntarily Decelerate or be required to do so by the SPC.
Dismissal: Student is administratively and permanently withdrawn from SOM. A student can voluntarily Withdraw from SOM or be Dismissed. Students may not continue any courses at SOM once this decision has been made. They can appeal the decision (see Appeal of Student Progress Committee Action Policy) but cannot attend class while appeal is in process.
Related Requirements
External Regulations
Unit Policies, Standards, and Procedures
- Appeal of SPC Actions Policy
Contact Information
Primary Contact
Name: Arlene Davis
Email: Arlene_Davis@med.unc.edu
Other Contacts
Name: Kim Nichols
Email: Kimberley_nichols@med.unc.edu