Progress and Promotions

Promotional Guidelines

A student is considered to have achieved satisfactory academic progress if they pass the sequence of courses and clerkships and other requirements established by the Executive Curriculum Committee. The assessment of academic progress includes the domains of knowledge, skills, behaviors, and attitudes – as expressed in the form of SPAs published in the student handbook. Professionalism is an integral component of many SPAs and is a factor in consideration of academic progress. Independent of the final grade, unprofessional behavior may be the sole criterion for which a student receives a sanction as described throughout this document.

Students must be aware that the designation of academic probation or suspension may result in the loss of federal financial aid.

Progress and Promotions Committee

The Progress and Promotions Committee (P&P) monitors the progress of students during the EUSOM curriculum to ensure that students are performing at an acceptable level to successfully complete their present phase and advance to the next phase of the medical curriculum. The committee reviews all students’ academic progress and discusses students who may not be making adequate progress. The committee makes decisions as to whether each individual student can advance based on school policies outlined below. P&P committee decisions are communicated to the Executive Associate Dean for Medical Education and Student Affairs (EAD)or their designee who then provides letters written by P&P to individual students.

Academic Advancement

1. All EUSOM students’ academic records are reviewed regularly to ensure satisfactory academic progress across the EUSOM curriculum. At the end of each phase, the institution reviews each students’ progress across institutional criteria to determine whether an individual is ready to progress to the next phase of the curriculum (e.g., Foundations to Applications). Those who have not satisfactorily met all requirements will be sent to and discussed by the P&P committee. The committee will consider all aspects of a student’s performance, including course grades and adherence to the Emory School of Medicine (SOM) Conduct Code, Honor Code, and medical school student policies.

2. The P&P determines whether a student meets criteria to advance to the next phase using the following criteria:

   1. Adequate Progress: Students with passing grades in all courses/clerkships.
   2. Inadequate Progress (these students would not be promoted):
      1. Students who failed a course or clerkship and have not satisfactorily remediated;
      2. Students who have not completed course or clerkship requirements;
      3. Students who failed to complete any P&P mandated activities on which promotion is contingent;
      4. Students who are on suspension.

During the academic year, the P&P will also regularly review the progress of all students to assess whether they are making adequate progress toward attaining the achievement levels required for promotion to the next phase of the EUSOM MD curriculum. Upon review of academic progress, the P&P members will take a more thorough review of any students who:

• Have two or more incompletes in any phase
• Have one or more failures in courses and/or clerkships
• Have professionalism violations
• Have received actions from P&P in the past so that their progress can be updated

Academic Actions

Letter of Concern

When the P&P begins to have concerns about a student’s academic or professional performance, a letter of concern will outline the deficit areas and recommended resources for support. The letters are meant to foster a growth mindset but also to clearly delineate the consequences if the student does not improve their performance. Letters of concern will be included in a student’s internal academic file but will not appear on the Medical Student Performance Evaluation (MSPE).

The following is a non-exhaustive set of examples in which a student would be considered for a letter of concern:

• A student is required to remediate two Foundations examinations;
• A student has a professionalism or performance issue that is a pattern of poor behavior. This may include, but are not limited to:
  • Habitual or unexcused absences
  • Inappropriate responses to feedback
  • Lack of response to faculty or administrator communications

Academic Warning

When a student’s deficiencies are of a more serious nature, the P&P committee may give the student an Academic Warning. The entirety of the student’s academic performance is factored into this decision. Notification of this status is intended to alert the student that, without improvement, they may not succeed in medical school. Academic Warning will be included in a student’s internal academic file but will not appear on the MSPE.

Although not an exhaustive list, an Academic Warning may be considered when a student:

• Must remediate three Foundations examinations and the summed credit hours for the three courses is 6 or more. For the purposes of this determination and those interventions below, a single anatomy exam will count as 1 credit hour.
• During the Application/Translation phases, an academic warning will be recommended when a student is noted to have a deficiency in their clinical skills over more than one clerkship or course (e.g., difficulty synthesizing clinical information); or, when a student receives a grade of C in two clerkships/courses.
• Is noted to have a deficiency in their clinical performance over more than one clerkship or course (e.g., difficulty synthesizing clinical information, poor shelf exam performance, etc).
• Received an Academic Deficiency in the Foundations phase and continues to struggle in a later phase
• Misses deadlines during Discovery
• Has recurrent professionalism problems or a single, more significant professionalism transgression. This may include, but is not limited to:
  • Inappropriate interactions with a member of the healthcare team and/or a patient
  • Failure to meet deadlines
  • Dishonesty
  • Lack of adherence to a course or clerkship policy
  • Lack of, or poor communication with, faculty or administrators

Academic Probation

When the P&P has significant concern about a student’s performance and, without improvement, the student is in danger of having to repeat the curriculum or to be dismissed, the student will be placed on Academic Probation. This serves three functions:

1. Provides official documentation that the student is deficient in areas related to academic or professional performance;
2. Provides a pathway and defines a timeline that the student must follow to regain good standing. This may include, but is not limited to, remediation, maintaining appropriate performance standards and/or adhering to professional expectations;
3. Describes the consequences that will result if a student does not meet stated expectations

Academic Probation will be included in a student’s internal academic file but generally will not be reported on the MSPE unless a student receives an Unsatisfactory grade in a clerkship. It will be reported to residency programs that are in states that request this information.

The following is a non-exhaustive list of academic difficulties for which a student would be considered eligible for Academic Probation.

• A student is required to remediate four Foundations examinations (end of course and/or Anatomy) and the total for the courses is 10 credit hours or more.
• A student receives a U in a clerkship or course in the Application, Discovery, or Translation phases. The student will not progress in the phase until they have completed remediation of the clerkship or course.
• A student who is required to repeat a phase will do so with Academic Probation status
• A student has a professionalism issue that the P&P members judge to be significant and highly concerning. This may include such issues as:
  • Unexcused absences during a clerkship
  • An unprofessional response to a communication sent by a faculty member or administrator

Repetition

Students with ongoing academic difficulty may need to repeat a course, clerkship, or phase of the curriculum. There are two primary reasons for repetition. 1) Students may voluntarily repeat a phase because of specific events (e.g., health, personal or family issues). This voluntary repetition can only be approved by the EAD or the EAD’s designee. In these cases, the student can repeat the phase without any academic penalty (i.e., not under Academic Probation. 2) Students may be required by the P&P to repeat a course or phase, due to a concern that the student has not mastered the relevant learning objectives. Repetition will be recorded in the student’s internal file and will be apparent on the student’s transcript. The student will do so under Academic Probation.

The following is a non-exhaustive list of actions for which the P&P would require a student to repeat a phase or course in the curriculum:

• A student is required to remediate five or more Foundations examinations
• A student fails to receive a satisfactory grade on the second retake exam during remediation of a Foundations course
• A student receives a grade of U in the Discovery Phase
• A student receives a grade of U in a clerkship or course in the Application or Translation phases

Academic Suspension

Academic Suspension is considered for serious academic issues when the student’s academic performance or professional behavior would benefit from time away from the curriculum to manage external distractions or other concerns. The period of suspension is recommended by the P&P and will require specific conditions to be met before the student may restart the EUSOM curriculum. Students on Academic Suspension cannot restart the program until the concerns that placed them on suspension have been resolved.

Dismissal

Dismissal is considered for either serious breaches in professional conduct or significant academic concerns. Prior to voting on dismissal, the P&P chair will contact the student and invite them to meet with the P&P committee. The student will be advised to bring a mentor/advocate with them.

To be considered for dismissal from EUSOM by the P&P committee, a student must demonstrate an inability to resolve their academic or professional areas of concern, including but not limited to the following situations:

• Academic
  • Required remediation of four courses totaling at least 10 credit hours for a student who is repeating the Foundations Phase under Academic Probation
  • An Unsatisfactory grade for a student who is repeating the Discovery phase
  • Two initial Unsatisfactory grades in Application/Translation courses or clerkships
  • An Unsatisfactory grade for one course or clerkship remediation during Application or Translation
• Professionalism
  • A professionalism violation that the P&P members consider gross negligence. This includes negligence that, in the mind of the committee, could have led to the death or serious injury of a patient. It also includes behavior in the clinical setting that is grossly inappropriate by the standards of the profession.

Student Right to Appeal P&P Decisions

Students may appeal interventions by the P&P including Academic Probation, Repetition, Academic Suspension, and Dismissal. If a student wishes to appeal, this request should be presented in writing to the EAD within 14 calendar days of receiving the notification of the action. The appeal may be based on the following grounds:

1. To consider new information or other relevant facts that the person appealing the decision feels the P&P may not have known and that may have influenced their initial decision
2. To allege a procedural error in the P&P process that may have substantially impacted the fairness of the decision

For appeals of Academic Probation, the EAD will make the final decision on the appeal and will notify the student of that decision. For appeals of Repetition, Academic Suspension, or Dismissal, the EAD will convene an ad-hoc appeals panel of three faculty members to consider the appeal. The appeals panel will review the documentation from the P&P and send its recommendation to the EAD whether to uphold the decision of the P&P. The EAD will ultimately make the final decision on the appeal and will notify the student of that decision. All appeal decisions are final.

It should be noted that all appeals should be conducted in a professional manner by the student involved; that is, demonstrating respectful disagreement with the perspective and judgment used by faculty members. Failure to exhibit appropriate professional attitudes may immediately terminate the appeal process and lead to a professionalism report.

Length of Time to Complete Degree

The standard MD program at EUSOM takes four years to complete; however, students may apply to postpone graduation for a year if they want to:

1. Obtain another degree (e.g., MPH)
2. Spend a year doing a scholarly project (or extended Discovery)
3. Take an additional year of formal coursework

Students who need time off for extenuating medical/personal issues are advised to take a Leave of Absence (LOA) from medical school (Section 9). Students may be eligible to be enrolled at EUSOM for additional periods for purposes of remediation or completion of degree requirements.

Students who plan to obtain the MD degree with no additional degrees or certificates must complete all academic requirements of the MD degree within no more than six academic years from the date of matriculation. Approval for a well-planned fifth year is required. The academic records of students who are approaching the deadline of "Time to Degree" for the MD degree will be reviewed by the Registrar and the Progress and Promotions Committee, with enough notice to enable the student to complete the requirement by the end of "Time to Degree".