The University of Texas Rio Grande Valley

EAA018 Medical Student Evaluation, Promotion, and Graduation Policy

Policy Number: EAA018
Policy Title: Medical Student Evaluation, Promotion, and Graduation Policy

A. Purpose

The University of Texas Rio Grande Valley School of Medicine (UTRGV SOM) has an obligation to evaluate students pursuing the M.D. degree as thoroughly as possible for their cognitive and non-cognitive abilities, their academic and professional knowledge and skills, their integrity, and their suitability for the practice of medicine. This policy addresses conduct and performance that is academic and/or professional in nature.

B. Persons Affected

The policy will cover the students participating in the UTRGV SOM curriculum. Where applicable, UTRGV policies and regulations shall apply to students in the School of Medicine.

C. Implementation Date

This policy is effective with the UTRGV SOM Inaugural class, the Class of 2020, and will remain in effect for future classes unless otherwise amended.

D. Authority and Responsibilities

The Policy on Medical Student Evaluation, Promotion and Graduation is set by the Central Curricular Authority Committee (CCAC) and is implemented by the Medical Student Evaluation and Promotion Committee (MSEPC).

E. Definitions

Definitions and examples of conduct and behavior relating to and/or affecting the professional practice of medicine may be found in some or all the following documents: this policy, the School of Medicine website, UTRGV and School of Medicine regulations and policies, admission materials, course syllabi, course materials, and lectures.

All references in this policy to the Dean of the School of Medicine, Associate Dean for Student Affairs and the Associate Dean for Educational Affairs shall refer to those individuals within the School of Medicine and shall be deemed to include their designees.

Academic Deficiency: Academic deficiency refers to either a No-Pass (NP) or Incomplete (I) grade for a course in the pre-clerkship or clerkship curriculum.

Marginal Pass: Module and Clerkship Directors will identify the students passing with grades between 70 and 74. Students in this score range will be designated as having received a "marginal pass" for internal tracking and monitoring purposes only. Marginal grades are considered a full pass on the transcript; however, marginal grades are tracked by the Office of Student Affairs as part of an early warning system to identify students at risk for academic difficulty.

Monitored Status: A student who has two or more marginal passes in different courses and clerkships in an academic year will be placed on Monitored Academic Status and may have mandatory academic counseling as directed by the Associate Dean for Student Affairs. Assistant Dean for Educational Affairs, Pre-Clerkships or Clerkships will also be notified.

Medical Student Evaluation and Promotion Committee (MSEPC)The Medical Student Evaluation and Promotion Committee (MSEPC) is charged with the review of the academic progress and professional development of each student during all components of the four-year medical education program. The Committee has primary responsibility for recommending for graduation only those candidates who have satisfactorily completed all graduation requirements and demonstrated the professional conduct appropriate for a physician. The committee, acting under the authority delegated to it by the Dean, shall be responsible for decisions on leaves of absence, and/or curriculum deceleration, promotion or termination of students in the academic program, and/or remediation of medical students. Students may appeal any decisions set forth by the MSEPC to the SOM Dean, whose decision is final. Module and clerkship directors are not eligible for membership. 

If a voting member of the MSEPC has already taken an action (e.g., awarded a failing grade in a course/clerkship) that contributes to the adverse action being proposed against the student, or served as the student's faculty academic mentor, the voting member must disclose this to the committee chair and recuse themselves from discussions and voting.

F. Policy

Qualifications for Promotion and Graduation

The Medical Student Evaluation and Promotion Committee (MSEPC) monitors the progress of students throughout the four-year medical education program. Students must meet all academic requirements for each year of the medical education program to be promoted to the next academic year.

Promotion from Year 1 to Year 2:

  • Students who have met all academic standards and curricular requirements of MS Year 1 are eligible for promotion to MS Year 2.

Promotion from Year 2 to Year 3:

  • Students who have met all academic standards and curricular requirements of MS Year 2 are eligible for promotion to MS Year 3.

NOTE: Students must take the USMLE STEP 1 examination before the start of their MS year 3. Students who do not take the USMLE STEP 1 examination before the start of the MS year 3 will not be permitted to begin the clerkship curriculum.

Promotion from Year 3 to Year 4:

  • Students who have successfully passed their USMLE STEP 1 and have met all academic standards and curricular requirements of MS Year 3, are eligible to be promoted to MS Year 4.

Graduation Requirements

Graduation from UTRGV SOM requires the successful completion of pre-clerkship requirements (years 1 and 2), successful completion of the clerkship rotations (years 3 and 4), passing of the USMLE STEPS 1 and 2, the demonstration of a degree of professionalism deemed to be essential for all physicians, and satisfactory adherence to all University standards.

See EAA082 for requirements for passing USMLE Steps 1 and 2.

Upon recommendation by the Medical Student Evaluation and Promotion Committee, the Faculty Assembly is responsible for recommending candidates for certification for graduation by the President of the University of Texas Rio Grande Valley, the Chancellor of The University of Texas System, and the Board of Regents of The University of Texas System.

Candidates must:

  1. Be at least 18 years of age at the time the degree is awarded
  2. Present evidence of good moral character
  3. Offer evidence of having satisfactorily fulfilled all academic requirements of the four- year medical education program
  4. Comply with all necessary legal and financial requirements
  5. Abide by federal, state, and local statutes and ordinances both on and off campus.
  6. Refrain from behavior incompatible with the responsibilities of the medical profession
  7. Follow the Student Code of Professional Conduct established by The University of Texas System Rules and Regulations of the Board of Regents, Rule 50101 (see Medical Students Code of Professional Conduct) and UTRGV SOM prescribed Attributes of Professionalism (see Attributes of Professionalism at EAA081).
  8. Complete the medical education program within six (6) years unless the student is granted an exception (see below – heading).
  9. Complete all required courses and clerkships and the designated minimum number of elective and selective courses with Satisfactory (passing level) performance.
  10. Take the USMLE STEP 1 examination before the start of their MS3 year.
  11. Pass the USMLE STEP 1 examination within 3 attempts.
  12. Pass the USMLE STEP 2 examination within 3 attempts (see EAA082).
  13. Demonstrate consistent evidence of professionalism as assessed by the MSEPC.
  14. Receive the MSEPC's recommendation for graduation and receipt of the MD degree.

  The MSEPC shall consider a request to extend matriculation beyond 6 years for a student with an extraordinary opportunity for career development through research or scholarship in fields related to medicine. The chair of the MSEPC may appoint an ad hoc committee of faculty (not members of the MSEPC) to meet with the student, gather more information about the student's plan, and formulate a recommendation for the MSEPC. In its deliberation, the MSEPC shall evaluate the student's academic record, prospect for successful completion of the scholarly activity, commitment to complete the course of study for the MD degree, and any other information an ad hoc committee may provide.

  If the MSEPC denies the student's request for extended leave the student may file a written appeal to the Dean of the SOM within five (5) business days from receipt of the MSEPC written decision. The student's appeal portfolio must include a justification statement for appeal and all documentation provided to the MSEPC. Upon review of the student's record and appeal portfolio, the Dean may elect to: 

  a. Take no action, allowing the MSEPC decision to stand

  b. Modify the MSEPC decision

c. Make an alternate decision

  d. Impanel an ad hoc committee to review the matter and make recommendations

Within fifteen (15) business days from receipt of the student's appeal, the Dean will provide a written decision to the student and the Chair of the MSEPC. The decision of the Dean is final appellate review.

Degrees will be conferred once a year on Commencement Day in the spring. Students completing requirements for a degree earlier in the year will be conferred the degree on the following Commencement Day but may request the Registrar to provide a Certification of Completion on the date of graduation. Students who fail to meet graduation requirements by the published degree conferral date/Commencement Day may petition the Associate Dean for Educational Affairs (or designee) to consider an alternate degree conferral date under extenuating circumstances when the graduating student is expected to begin an internship or residency in July.

Students' academic and behavioral performances are equally subject to evaluation. Students are expected to be honest, conscientious, respectful, and reliable in carrying out their assignments. Their behavior toward colleagues, faculty, staff, patients, and others with whom they interact in their roles as medical students is expected to be appropriate, reasonable, and considerate---consistent with medical professional standards.

Consequences of Failure to Meet Academic, Professional and Behavioral Requirements and Standards

This section describes the consequences for medical students who fail to meet the academic, professional and behavioral requirements and standards and are subject to a review of concern by the MSEPC. In addition to those consequences imposed under University Regulations, policies or procedures, medical students may be subject to one or more of the following consequences imposed by the MSEPC.

Issues around academic integrity are first investigated by the University, under UT System policy STU 02-100, "Student Conduct and Discipline." See School of Medicine Policy EAA005 "Medical Student Dishonesty and Plagiarism," for a description of the collaboration of the SOM and the University in the investigation and adjudication of these matters and the appeal righted of affected medical students. 

Emergency / Interim Measures

The Dean of the School of Medicine or the Associate Dean for Student Affairs (or their designees) has the authority to take appropriate immediate action when a student's presence in the School of Medicine or in an affiliated clinical site poses a danger to the health, safety or welfare of the student, the community or the student's patients.

Emergency/Interim Measures include but are not limited to, one or more of the following:

  1. Interim Suspension. A student under interim suspension may not attend classes, may not be on or come onto University property or an affiliated clinical site (where such student may be participating in a clerkship), may not participate in any University activities or organizations, and may not use University facilities, equipment or resources.
  2. Interim Removal from University Housing. A student under interim removal from University Housing may not reside in University Housing and may not come into University Housing facilities and/or adjacent areas of University Housing.
  3. If the Dean of the School of Medicine or the Associate Dean for Student Affairs (or their designees) determines that other Emergency/Interim measures are appropriate to protect the health, safety or welfare of the student in question, others in the community, or patients, the Dean or Associate Dean for Student Affairs (or their designees) may:
    1. restrict or bar attendance of any or all classes or participation in clinical education;
    2. restrict or bar access or contact with individuals in the University community or affiliated clinical sites or patients;
    3. restrict or bar access to University property, places, facilities or equipment or affiliated clinical sites;
    4. restrict or ban participation in University activities or organizations or clinical education; or otherwise restrict conduct or ban access to University resources.
  4. A student subject to Emergency/Interim Measures shall be furnished:
    1. Written notice of the Emergency Measure and the reason(s) for the action.
    2. The opportunity to participate in student conduct proceedings or MSEPC proceedings or to present relevant information for consideration of his/her case.
  5. Emergency/Interim Measures may be taken at any time prior to the conclusion of the University student conduct proceedings or MSEPC proceedings including during the appeal process.

Academic Deficiencies

The MSEPC expects every student to meet the requirements and standards stated in this policy.

For the purposes of this policy, academic deficiencies refer to either a No Pass (NP) or Incomplete (I) grade for a course or a clerkship. Consequences of academic deficiencies are described below. However, even without an academic deficiency, a student with poor academic performance may incur consequences as severe as a recommendation for dismissal for failure to meet these requirements and standards. Decisions by the MSEPC for promotion to the next academic year or for recommending graduation from the School of Medicine are contingent upon the successful remediation of all academic deficiencies and completion of all academic requirements.

One Deficiency in an Academic Year:
A student who has one deficiency (NP or I grade) per year will be required to remediate the grade successfully prior to promotion to the next year. If the final grade earned in a course or clerkship is No Pass (NP) or Incomplete (I), a formal plan ("Plan for Remediating Failing Performance" for a grade of NP, or "Plan for Completing Course Requirements" for a grade of (I) will be established by the module or clerkship director and the student and submitted to the Associate Dean for Student Affairs. The plan, including expectations for work to be performed, student assessment, passing level, and time period for the remediation, must be developed and submitted to the Associate Dean for Student Affairs within two weeks of the initial grade of NP or I, being posted. The first remediation attempt must be completed within 5 weeks of the end of the academic year.

If the student fails to successfully remediate, the student will receive an NP in the course or clerkship and will be referred to the MSEPC for review. A second grade of No Pass in the same repeated course in years 1 and 2 may result in dismissal of the student from the School of Medicine M.D. program. Further remediation, if allowed by the MSEPC, must be by repetition of the course. A second grade of No Pass in the same repeated clerkship in years 3 and 4 will result in dismissal of the student from the School of Medicine M.D. program.

Two or More Deficiencies in an Academic Year:
A student who has more than one deficiency (NP or I grade) per academic year may be dismissed from the program or be required to repeat the entire year or a part of the year. The MSEPC will determine a plan to resolve the deficiencies merited by the situation and will place the student on formal “At Risk" status (see below).

Multiple Deficiencies across Academic Years:
A student who has had multiple deficiencies during enrollment will be reviewed for the severity of the overall problem and a recommended course of action for the individual will be made by the MSEPC. Consistency of performance is also evaluated. Any student who records two or more deficiencies (NP or I grade) throughout enrollment in the School of Medicine M.D. program will be reviewed on an on-going basis by the MSEPC, will be placed on At Risk status, and may be subject to further MSEPC action.

Students with academic deficiencies and/or professionalism concerns are given the opportunity to submit written documentation for MSEPC consideration and/or attend the MSEPC meeting at which their case will be discussed, in-person, to provide their perspective.

Referrals to Counseling (Tutorial) and Study Skills Service:
Students are encouraged to take responsibility for their own learning and will be provided with formative assessment results throughout the M.D. program. All students are encouraged to avail themselves of tutorial and study skills services without referral. However, when students are presented as having difficulty at an MSEPC meeting, they are strongly encouraged to avail themselves of these services, and in some instances, will be directed to do so in writing. If a student is repeatedly urged to arrange tutoring, counseling or study skills help, but does not do so and subsequently does not pass a course or clerkship, this will be made known to, and taken into consideration by, the MSPEC to assist in the evaluation of the student’s overall performance and professional attitudes.

If a student is directed to seek these referral services, the student has a choice of utilizing UTRGV services or private resources. In addition to the SOM Office of Student Affairs, course/clerkship representatives to the MSEPC are responsible for providing the committee with reports of referrals made by course/clerkship faculty as well as the student's utilization of referral services. Verification that the student has utilized these referral services may be required. In addition, the MSEPC may require that the student have his/her tutor submit information and/or a recommendation to the MSEPC relating to the student's academic program.

 

Other Consequences
Other consequences of failing to meet the academic, professional and behavioral requirements and standards include, but are not limited to, the following:

1. At Risk Status:

"At Risk" status indicates that the MSEPC recognizes that the student is at risk of failure to successfully remediate deficiencies. If the student successfully remediates the deficiencies, the fact that the student was placed on "At Risk" status will not be included in the student’s Medical Student Performance Evaluation, or other information transmitted to outside entities (e.g., certifications of training) but will remain in the student's permanent records in the School of Medicine.

2. Probation:

Probationary status (probation) may be imposed by the MSEPC under various circumstances including, but not limited to, when it has significant concerns that failure to remediate deficiencies will result in dismissal of the student from the School of Medicine M.D. program. The notification to the student of probationary status will be accompanied by a plan for remedial action and specific performance requirements specified by the MSEPC. A successful conclusion of the remedial work normally ends the probationary status following the recommendation to do so by the MSEPC. However, the fact that the student was placed on probation will be included in the student's MSPE or other information transmitted to outside entities (e.g., certifications of training) and will remain in the student's permanent records in the School of Medicine. While a student is on probation, if he/she receives another academic deficiency, or is cited for professional misconduct, he/she will immediately undergo a dismissal hearing.

Remedial interventions in a student's curriculum by the MSEPC are designed to fit particular academic deficiencies and may include, but not be limited to, the following: a specific study or reading program, remedial work and re-examination, changes in the student’s curriculum, additional training in a set of clinical skills, assignment to clinical sub-internships, repetition of all or part of the curriculum, reorganization of the student’s curriculum (especially during the fourth year), and supervision by an advisor designated by the MSEPC.

3. Suspension:

The MSEPC may conclude that the student should be suspended from the UTRGV SOM for a period of time to be determined in its reasonable discretion. Reinstatement to the UTRGV SOM is contingent upon completion of all requirements stipulated under the suspension. The Dean of the SOM will either determine that these requirements have been met or seek a recommendation from the MSEPC on the matter. If a recommendation from the MSEPC is sought, the MSEPC shall review the circumstances surrounding the suspension and potential reinstatement, make a determination as to whether the terms and conditions of the suspension have been met, make a determination as to whether the student possesses the potential to pursue the MD degree successfully, and recommend whether the student should be reinstated.

4. Dismissal:

The MSEPC may determine that student be dismissed in the following cases:

  1. Failure to remediate deficiencies as described above
  2. Another academic deficiency or professionalism violation is received while on probation
  3. An accumulation of narrative evaluations indicating serious gaps in knowledge and clinical skills and/or inadequate integration of the content of the curriculum
  4. A specific academic deficiency (e.g., an important clinical skill has not been mastered)
  5. Three failed attempts on either the USMLE Step 1 or Step 2 of the USMLE examination
  6. Failure to assume appropriate professional responsibility
  7. Failure to meet professional standards, including those of demeanor and conduct; and
  8. A violation of University Regulations, policies or procedures

In general, prior to dismissal, students would be placed on probationary status and given a plan for remedial action and specific performance requirements by the MSEPC. However, in extraordinary circumstances, the MSEPC may dismiss a student without prior probation.

The student may file a written appeal to the Dean of the SOM within five (5) business days from receipt of the MSEPC written decision. The student must also inform the Associate Dean for Student Affairs of the intent to appeal, also within the same five (5) business days. The student's appeal portfolio must include a justification statement for appeal and all documentation provided to the MSEPC. Upon review of the student's record and appeal portfolio, the Dean may elect to:

  1. Take no action, allowing the MSEPC decision to stand
  2. Modify the MSEPC decision
  3. Make an alternate decision
  4. Impanel an ad-hoc committee to re-examine the dismissal and make recommendations

Within fifteen (15) business days from receipt of the student’s appeal, the Dean will provide a written decision to the student, the Associate Dean for Student Affairs and the Chair of the MSEPC. The decision of the Dean is final appellate review. After academic dismissal, a student may apply for re-admission to the UTRGV SOM only through the standard admissions process.


Appendix A

LCME Standard(s) 9.9 STUDENT ADVANCEMENT AND APPEAL PROCESS

A medical school ensures that the medical education program has a single set of core standards for the advancement and graduation of all medical students across all locations. A subset of medical students may have academic requirements in addition to the core standards if they are enrolled in a parallel curriculum. A medical school ensures that there is a fair and formal process for taking any action that may affect the status of a medical student, including timely notice of the impending action, disclosure of the evidence on which the action would be based, an opportunity for the medical student to respond, and an opportunity to appeal any adverse decision related to advancement, graduation, or dismissal.


Appendix B

Standard Operating Procedure - EAA018 - Student Evaluation, Promotion, and Graduation

  • During an MSEPC meeting at which student's status is reviewed:
  • Student may attend in person
  • Student may submit a written statement 
  • Student may represent themselves

At the beginning of every meeting of the MSEPC (including virtual, in-person, and asynchronous exchanges), members must report real or perceived conflicts of interest with the student(s) under consideration. Conflicts of interest may arise from personal, family, and social relationships; recent past and/or current clinical relationships; and recent past and/or current psychiatric treatment or psychological counseling relationships. Members must recuse themselves from all deliberations pertaining to such students must withdraw from meetings while such deliberations occur. In addition, the chair of the MSEPC or designee has the authority to query a member about a real or perceived conflict of interest and require that member to recuse.  Members must acknowledge their understanding of and compliance with this policy by completing an attestation form. 

MSEPC member(s) who had evaluated or graded student during the period under review must recuse from all deliberations and must withdraw from meetings while such deliberations occur.  

  • Appealable decisions of the MSEPC:
  • repeat module or clerkship
  • repeat an academic year
  • probation
  • suspension
  • dismissal
  • On appealing to the Dean:
  • Student may submit additional information
  • Student may request a meeting with the Dean
  • While appealing a decision by the MSEPC, student shall remain enrolled and continue to attend scheduled curricular sessions

 


Dates Reviewed or Amended

Approved by the Central Curricular Authority Committee (CCAC) on June 08, 2016.

Reviewed, amended, and approved by the Central Curricular Authority Committee (CCAC) on September 13, 2017; June 27, 2018; December 11, 2019; December 09, 2020; March 23, 2022

Non-substantive changes made on February 18, 2021.

Approved by the Dean's Advisory Committee on June 13, 2024.

Approved by the Dean/Chief Academic Officer on June 08, 2016; December 21, 2017; August 03, 2018; December 19, 2019; January 07, 2021; April 11, 2022; June 17, 2024