STUDENT HANDBOOK for students matriculating in 2013

NOTE: It is the responsibility of every student to be familiar with the student handbook and policies within; to maintain up-to-date contact information with the Curriculum Office; and to read email and correspondence from the School of Medicine on a daily basis. Furthermore, the School of Medicine reserves the right to amend policies when needed to fulfill the educational mission of the institution. Unless otherwise specified, amended policies are applied to all students effective the date of review and acceptance by the School of Medicine Curriculum Council. GENERAL INFORMATION

Faculty Roles & Responsibilities

Dean, School of Medicine: The Dean is responsible for the day-to-day operations of the School of Medicine and is the chief academic officer. Senior Associate Dean for Medical Education and Student Affairs: The Senior Associate Dean for Medical Education and Student Affairs is appointed by the Dean and is responsible to the Dean in all matters pertaining to the curriculum and student services in the School of Medicine. He/she is the principal academic officer. Associate Dean of Student Affairs: The Associate Dean of Student Affairs is appointed by the Dean of the School of Medicine and is responsible to the Senior Associate Dean for Medical Education and Student Affairs in all matters pertaining to medical student services. This includes student counseling and advising concerning personal and career matters, tracking the progress of all students, maintaining records, and reporting to the AAMC liaison to the National Board of Medical Examiners and other university offices. Assistant Dean for Pre-clinical Medical Education: The Assistant Dean for Pre-clinical Medical Education guides the M1/M2 Course Directors and MS1/MS2 Course Masters and Directors who are responsible for organizing and overseeing the teaching of their disciplines or areas, counsels first and second-year students who encounter academic difficulties and provides one-on-one counseling to prepare for Step 1 of the USMLE. Assistant Dean for Clinical Medical Education: The Assistant Dean for Clinical Medical Education is responsible for coordinating the third-year clinical clerkships and for overseeing the overall evaluation and teaching of clinical skills across clerkships. The Assistant Dean also counsels students who encounter academic difficulties. In addition, the Assistant Dean is responsible for all required fourth year activities. Assistant Dean for the Curriculum: The Assistant Dean for the Curriculum is responsible for overseeing the overall administrative and support functions of the Office of Curriculum, including student counseling, course scheduling, testing and grading. Course & Clerkship Directors: The Course & Clerkship Directors are nominated by the Department Chair after consultation with the Senior Associate Dean for Medical Education and either of the Assistant Deans of Medical Education. They are appointed by the Dean of the School of Medicine and are responsible for overseeing the teaching of their discipline in the curriculum. Directors are responsible for determining the goals and objectives for their course/clerkship, organizing the faculty in their course/clerkship, coordinating the instructional units, proctoring examinations or arranging for proctors, advising students, and student evaluation. Course Masters/Division Directors: The Course Masters are nominated by the Department Chair after consultation with the Senior Associate Dean for Medical Education and the Assistant Dean for Pre-

Clinical Medical Education. They are appointed by the Dean of the School of Medicine and are responsible for overseeing the integration of the course within a given block (e.g., “The Scientific Foundations of Medicine.”). The Division Directors are immediately responsible to the Course Masters. Curriculum Consultants: Curriculum consultants represent the Basic and Clinical Sciences in their integration across the four years of the medical school curriculum. Department Chairs: Department Chairs offer leadership and set the tone for the educational effort in their respective departments. In some departments, time is regularly set aside at faculty meetings to consider educational issues and the teaching effort of faculty. Faculty evaluations and performance reviews are conducted annually in each department. The Department Chair determines the weight given to teaching in the faculty evaluation. An effort is made to provide comprehensive and reliable information to chairs on faculty teaching effectiveness. The Department Chairs take an active role in gathering such data and acting to facilitate any changes that are indicated as necessary.

Course/Clerkship Descriptions The MS1 student takes a semester long course called the Scientific Foundations of Medicine. This course is the base upon which the remainder of the pre-clinical curriculum is built. There are five Divisions in this course: The Molecular Basis of Health and Disease, Principles of Physiology, Principles of Autonomics and Pharmacology, Immunity and Infection and the Foundations of Disease. The Molecular Basis of Health and Disease introduces the basic building blocks of life: amino acids, carbohydrates, nucleotides, lipids and fatty acids. Students will also learn the principles of genetics and genetic diseases. They will then be introduced to cell biology and the structure of cells and tissues. This course is taught by faculty from the Departments of Biochemistry and Molecular Biology, Anatomy and Neurobiology, and Human and Molecular Genetics. The Principles of Physiology covers an overview of membrane biology, cell signaling, transport, and nerve and muscle structure and physiology. This is taught by faculty from the Department of Physiology and Biophysics, and Anatomy and Neurobiology. The Principles of Autonomics and Pharmacology introduces students to the fundamentals of drug therapy. The Autonomic nervous system is used to demonstrate how drugs work. This division is taught by faculty from the Departments of Physiology and Biophysics and the Department of Pharmacology and Toxicology. Immunity and Infection covers bacterial, viral, fungal and parasite pathogens and the immune defense mechanisms to fight these organisms. It is taught by the Department of Microbiology and Immunology and the Division of Infectious Diseases in the Department of Internal Medicine. The final division of the semester is the Foundations of Disease. Students will be introduced to the pathologic principles of disease. Students will learn that there are patterns of response to the mechanisms of disease that will be seen repeatedly throughout the remainder of their medical school education. This division is taught by faculty from the Department of Pathology. All divisions will be taught using a variety of educational techniques such as lecture, small group problem solving, case based learning, POGIL (Process Oriented Guided Inquiry Learning), TBL (Team Based Learning), laboratories and simulation. Students will have multiple assessments during the course. In addition to the exams for each Division, at the end of the semester, students will take a cumulative USMLE-style examination. The MS2 course of study is the Applied Medical Sciences, a yearlong course integrating the normal anatomy, histology and physiology with pathophysiology and pharmacology in the various organ systems. The first is Marrow and Movement. Marrow is a combination of Hematology and Oncology taught by the Departments of Internal Medicine and Pediatrics (Divisions of Hematology-Oncology) and the Department of Pathology. Students will learn the normal development, and maturation and function of blood cells, pathophysiology of blood cell disorders, normal hemostasis and related

disorders, and pathophysiology of hematopoietic malignancies. The foundation of the oncology unit will cover topics including cancer epidemiology; cancer genetics and immunology; and principles of cancer therapeutics (radiation oncology, stem cell transplantation, chemotherapy and molecularly-targeted therapy). Movement is the musculoskeletal system. Students will begin gross anatomy and dissection with the back and limb structures. As they study each part of the body, they will learn the pathophysiology and pathology in that part of the body, from trauma to tumors to arthritis. They will learn normal skin histology and then study skin diseases. Although treatment is not emphasized in the MS2 year, students will learn the basic principles of treatment of these diseases. This course will be taught by faculty from the Departments of Anatomy and Neurobiology, Dermatology, Microbiology and Immunology, Orthopedic Surgery, Pathology, Pharmacology and Toxicology, Physical Medicine and Rehabilitation, and Internal Medicine (Division of Rheumatology). The next course is Glands and Guts. This multidisciplinary course will cover three divisions: Gastrointestinal, Endocrine and Reproductive Systems. It will start with the Gastrointestinal System and dissection of the abdomen. Students will then study normal gastrointestinal anatomy, histology, physiology and pathophysiology of gastrointestinal diseases. The students will learn what happens to food from the moment we put it into our mouth, through digestion, absorption and metabolism. They will learn the metabolic disorders such as diabetes. This will include a diabetes immersion during which student will experience the effect of having diabetes on daily living. Students will learn about normal and abnormal liver function and the management of liver disease. This division of the course is taught by the Departments of Anatomy and Neurobiology, Biochemistry and Molecular Biology, Physiology and Biophysics, Internal Medicine (Divisions of Endocrinology and Gastroenterology), Pharmacology and Toxicology and Pathology. The Endocrine system follows with students learning about the hypothalamic-pituitary-gland axis and disorders of the pituitary, adrenal and thyroid glands. They will learn normal calcium metabolism, parathyroid diseases and metabolic bone diseases. They will also learn about normal breast physiology, lactation and breast cancer. This Division is taught by the Department of Internal Medicine (Division of Endocrinology), Department of Pediatrics (Division of Endocrinology), Pathology and Surgical Oncology Departments. The final division of the first year is Reproduction. Students will learn the anatomy, histology, physiology and pathophysiology of the female and male reproduction systems. This course is taught by the Departments of Anatomy and Neurobiology, Obstetrics and Gynecology, Endocrinology, Pediatric Endocrinology, Pathology, Pharmacology and Toxicology, Physiology and Biophysics and the Division of Urology in the Department of Surgery. After a summer vacation in which students are encouraged to pursue research, students will continue their MS2 year with the second half of the Applied Medical Sciences. The year starts with the Circulation, Respiration and Excretion course. In Circulation, students will learn the physiology, pathophysiology, and pharmacology of the Cardiovascular System. This course is taught by the faculty from the Division of Cardiology in the Department of Internal Medicine and the Departments of Anatomy and Neurobiology, Pathology, Pharmacology and Toxicology, Physiology and Biophysics, and the divisions of Cardiothoracic and Vascular Surgery in the Department of Surgery. Following this is Respiration. In this course, students will learn the physiology of the mechanics of breathing and gas exchange, and pathophysiology and pathology of lung disorders. It is taught by the Departments of Pathology, Division of Pulmonary and Critical Care Medicine in the Department of Internal Medicine, Anatomy and Neurobiology, Division of Otolaryngology in the Department of Surgery, Division of Pediatric Pulmonology in the Department of Pediatrics, Physiology and Biophysics, Pharmacology and Toxicology and Radiology. The Excretion course will cover the renal and genitourinary systems. Students will learn the physiological mechanisms behind glomerular filtration and function of the

kidney, the renal tubules and the collecting system. They will learn the diverse variety of disorders related to the renal system from problems with abnormal lab values, to kidney stones, infections and renal failure. This course is taught by the Division of Nephrology in the Department of Internal Medicine, and the Departments of Physics and Biophysics, Pathology and the Division of Urology in the Department of Surgery. The final course of the MS2 year is the Mind, Brain and Behavior course. In this course the students will learn about normal and abnormal brain development, neurological and psychiatric disorders. It is taught by faculty from the Departments of Anatomy and Neurobiology Physiology and Biophysics, and Psychiatry. At the completion of the MS2 year, students will have a brief period of review that will be done via case-based exploration. The students will then prepare for and complete Step 1, and take a brief vacation before entering their MS3 clerkships in the clinical concentrations. The Longitudinal Courses: The Practice of Clinical Medicine has replaced the Foundations of Clinical Medicine as the course that teaches medical students the clinical skills, behaviors and attitudes they will need to evaluate patients in their clinical years and the remainder of their career. It consists of an 18 month course in which students will work in small groups learning to obtain histories and the different components of the physical examination and then will practice these skills at first on standardized patients and then on patients in their community preceptor’s office. Students will learn the intricacies of the doctor-patient relationship and will have a chance to practice their skills in a low-stress environment. The Physician, Patient and Society is a four-year long course that integrates aspects of medicine that enhance responsiveness to the whole human experience. Spirituality, complementary medicine, ethics, cultural competency, palliative care, health care disparities, aspects of human trauma, and the physician-patient relationship are among topics explored. The goal of the course is to foster the development of the humanistic physician. This course will be taught by a combination of lecture and small group lessons. This course will include Project HEART (Healing with Empathy, Acceptance, Respect and integrity) which focuses on the health and well-being of the student and nurturing the caring and compassion for their future patients that they bring with them to school. While Project HEART sessions have required attendance, there is no grade attached to this component of the course. Population Health is also a four year long course. It will teach subjects such as epidemiology, statistics, public health, health disparities, global health issues and critical appraisal of the medical literature. It will also introduce students to different health systems and the problems of access to care. Students will learn research methodology and the fundamentals of basic, clinical and translational research. The course will also focus on educating students regarding the importance of incorporating public health principles into their future clinical practice. This course will also combine both large and small group teaching methods. M3 Clerkship Descriptions (Applies only to classes matriculating in 2012 or earlier) Students who participate in the clinical care of patients are responsible and accountable at all times to a licensed member of the VCUHS/VAMC and Inova hospital staff or licensed community physician. All preceptors have a faculty appointment in the School of Medicine. Family Medicine This four-week rotation covers the basic principles of Family Medicine: Caring for individuals in a community setting and understanding the epidemiology of the most common health issues affecting one's clerkship community. Students learn the required common complaint objectives through comprehensive self-assessment exercises and complete an Observed Structured Clinical Examination

(OSCE) at the end of the month on one of the self-assessment cases. Students are issued a Personal Digital Assistant (PDA) to use as resource to record clinical activities. Family Medicine also loans a laptop computer so that students may complete electronic cases and participate in online discussions. In addition, students create a self-directed project for the office and preceptor. Students are placed at various sites around Virginia where housing is provided. A listing of sites can be found on the FM clerkship website via the SOM eCurriculum. At the beginning of the year, all students submit an interest survey. The clerkship committee uses the submitted survey in assigning students to clerkship sites. Family Medicine-Inova Campus This four-week rotation covers the basic principles of Family Medicine: Caring for individuals in a community setting and understanding the epidemiology of the most common health issues affecting one's clerkship community. Students learn 19 common complaints through comprehensive self-assessment exercises and complete an OSCE at the end of the month on one of the self-assessment cases. Family Medicine loans a laptop computer so that students may complete CD-ROM interactive cases and participate in electronic discussions. In addition, students create a self-directed project for the office and preceptor. Internal Medicine Each third-year student spends 12 weeks on the Internal Medicine rotation. The rotation is divided into three four-week blocks. Four weeks are spent on the VCU Health System wards (general medicine or hematology-oncology), four weeks on the Veterans Affairs Medical center (VAMC) wards, and four weeks in an outpatient setting. The ambulatory month involves rotations in general medicine and subspecialty clinics, or the students may elect to do a month in the community. There are multiple conferences specifically for the M3 students, as well as multiple grand rounds, subspecialty, and house staff conferences. The goal of the clerkship is for students to be exposed to a broad array of Internal Medicine clinical problems, to have the ability to apply pathophysiology to patient care, to be able to research and evaluate clinical questions, to take appropriate responsibility for the care of patients, and to feel confident that progress has been made in the journey to becoming a mature physician. Internal Medicine-Inova Campus The IM rotation at Inova campus consists of a 12 week rotation. Students spend 4 weeks working in ambulatory clinics. They are assigned to a primary preceptor who is typically a general internist. They focus on preventive issues and on long term management of chronic medical problems in ambulatory patients. In addition, the students also spend half-days every week rotating through subspecialty clinics which include Infectious Diseases, Gastoenterology, Nephrology, and Cardiology. They also spend two afternoons with the nutritionists in the hospital. The 8-week inpatient rotation is divided into two 4-week blocks. The inpatient rotation is based in Inova-Fairfax Hospital. Students are part of a call team which typically includes a senior resident, one or two interns, and an acting intern. They take overnight call including weekends on a every fourth day cycle. They admit and follow the patients until discharge. The students have the opportunity to participate in their own third year student morning report, Monday-Friday, where they present cases. Along with their teams, they also participate in daily noon conferences, chief of service rounds once a week, and auscultation rounds once a week. The students have their core topic lectures at 2pm every Monday and Friday. Neurology The Neurology Clerkship seeks to educate medical students in the diagnosis, treatment, and care of patients with a wide variety of neurologic conditions. This is accomplished through direct patient contact, didactic lectures, interactive teaching sessions, assigned text, and other reading and electronic media. Students are taught by full-time Department of Neurology faculty and house officers. Case studies covering a core neurologic curriculum are given daily to M3 students.

During the one-month rotation, students are assigned to the VCU Medical Center campus or to the McGuire Richmond Veterans Affairs Medical Center (VA). At the VCU Medical Center campus students spend two weeks on the Adult Neurology Inpatient Service, which includes patients admitted to the Neuroscience ICU, one week on the Adult Neurology Consult Service or one week on the Child Neurology Service, and one week in outpatient clinics. Some students assigned to the VCU Medical Center campus may have some clinics at McGuire VA. At the VA, students will have an experience integrating Neurology Service inpatients, consults, and outpatient clinics. Outpatient clinics, at the MCV Campus and McGuire VA, include both general and subspecialty neurology clinics, including the Movement Disorders, Neuromuscular, Seizure, Neuro-Ophthalmology, and Multiple Sclerosis Clinics. Students are also exposed to the indication for and basic understanding of tests and procedures frequently used in the evaluation of patients with neurological conditions including lumbar punctures, neuroimaging studies, electroencephalography, electromyography, and duplex carotid studies. Students are evaluated based on clinical performance and the NBME neurology shelf exam. Neurology-Inova Campus The Neurology clerkship seeks to educate medical students in the diagnosis, treatment, and care of patients with a wide variety of neurologic conditions. This is accomplished through direct patient contact, didactic lectures, interactive teaching sessions, assigned text, and other reading and electronic media. During the one-month rotation, students work with the teaching faculty at the Alexandria Fairfax Neurology practice, where they spend time in an outpatient clinic as well as the neurology service at Inova-Fairfax Hospital. Students are also exposed to the indication for and basic understanding of tests and procedures frequently used in the evaluation of patients with neurological conditions including lumbar punctures, neuroimaging studies, electroencephalography, and duplex carotid studies. Students are evaluated based on clinical performance and the NBME neurology shelf exam. Obstetrics and Gynecology The Obstetrics and Gynecology rotation is a six-week rotation designed to give an overview of primary and tertiary care of women. The VCU Health Systems clerkship is divided into three two-week blocks. Students spend two weeks on the Obstetrics rotation that includes prenatal care, inpatient care, and labor and delivery. The students care for pregnant patients in the hospital and clinic, participate in vaginal and cesarean deliveries, and follow patients after delivery. The second block, Gynecology, incorporates office practice, ambulatory surgery, benign surgery, and inpatient women's care. Students participate in the assessment and management of women in the office, hospital, and operating room. Gynecologic Oncology and a night float make up the third block. The Oncology rotation introduces students to tertiary care of cancers of the cervix, uterus, ovaries, vulva, and vagina. Students see some of the presentations of these diseases as well as their surgical and medical treatments. The night float week in labor and delivery is additional time to care for laboring patients. It also exposes students to gynecologic admissions and consults within the hospital. In addition to the informal teaching on these services, students are expected to attend didactic sessions and ground rounds. Students are evaluated by clinical performance and written evaluations (National Board of Medical Examinations shelf exam). Obstetrics and Gynecology-Inova Campus The Obstetrics and Gynecology rotation is a six-week rotation designed to give an overview of primary and tertiary care of women. The Inova Fairfax Hospital Clerkship is divided into antepartum, day float and night float, labor and delivery, emergency room experience, benign gynecological surgery, gynecology, and ambulatory services. The students care for pregnant patients in the hospital and clinic, participate in vaginal and cesarean deliveries, and follow patients after delivery. In addition to the labor and delivery experiences, day float and night float exposes students to gynecologic admissions and consults within the hospital. Gynecology incorporates office practice, ambulatory surgery, benign surgery, and inpatients women's care. Students participate in the assessment and management of women in the office, hospital, and operating room. Gynecologic Oncology rotation introduces students

to tertiary care of cancers of the cervix, uterus, ovaries, vulva, and vagina. Students see some of the case presentations of these diseases as well as their surgical and medical treatments. In addition to the informal teaching on these services, students are expected to attend didactic sessions and grand rounds. Students are evaluated by clinical performance and the National Board of Medical Examiners shelf exam. Pediatrics The Pediatrics clerkship is an eight-week rotation of which four weeks are spent on the inpatient service and four weeks on the outpatient service. The objectives of these rotations are for the student to learn to sharpen their history and physical examination skills as they apply to children of different ages and settings. The inpatient rotation at MCVH will allow the student to see patients on the general pediatrics service as well as patients on specialty services. During the four weeks the student will learn how to write comprehensive admission notes, including assessments and treatment plans. For the outpatient month, two weeks are spent in the office of a community pediatrician. Here, students will see well child visits and also common acute care problems and learn about the scope of the community based practice. The remaining two weeks are divided between the newborn nursery, the pediatric emergency room, and the subspecialty clinics. Each week all students will meet with the Clerkship Director during a 3 hour case conference. Patients seen by the students will be presented and discussed at that time. A series of core lectures are available to the students on DVD or through the Electronic Curriculum website. The evaluation of students is based on their ward performance (40%), their outpatient work (25%), and a written exam provided by the National Board of Medical Examinations (NBME) (35%). Pediatrics-Inova Campus The Pediatrics clerkship is an eight-week rotation of which four weeks is inpatient and four weeks are outpatient. During the inpatient month, the goals are to learn about the management of acute and chronic conditions that are treated in the hospital setting, to sharpen history taking and physical exam skills as they apply to children of different ages, and to learn to write comprehensive admission notes including assessments and plans. For the outpatient month, two weeks are spent in the office of a community physician where students see well child visits and common outpatient complaints under the supervision of their preceptor, and learn how a pediatric office functions. The remaining two weeks are divided between the newborn nursery, the pediatric emergency room, and the subspecialty clinics. The evaluation of students is based on their ward performance (40%), their outpatient work (25%), and the written exam provided by the National Board of Medical Examinations (NBME) (35%). Psychiatry The goal of the Psychiatry rotation is for students to become competent in the fundamentals of psychiatric diagnosis and treatment necessary for practice within a primary care setting. The clerkship represents a continuation of the development of the Behavioral Sciences curriculum. Students learn to apply the principles of normal development, using the biopsychosocial model, in the diagnosis and treatment of patients with various forms of psychopathology. Students are assigned to one of seven rotation sites where they work within interdisciplinary teams. There is a didactics series on Friday morning followed by Psychiatry grand rounds. Students also participate in on call experiences and observe electroconvulsive therapy. Student grades will also include a written shelf exam provided by the NBME and an OSCE. Psychiatry-Inova Campus The goal of the Psychiatry rotation is for students to become competent in the fundamentals of psychiatric diagnosis and treatment necessary for practice within a primary care setting, as well as preparation for those who plan to apply for a psychiatry residency. The clerkship represents a continuum of the development of the Behavioral Sciences curriculum. Students learn to recognize, diagnose and treat patients with various forms of psychopathology.

Students at the Inova Campus spend one month on the inpatient psychiatry service, two weeks on the psychiatry consultation-liaison services, and one afternoon a week in the outpatient community mental health clinic adjacent to the hospital. Students will participate both in team learning modules as well as problem-solving case presentations linked to specific lectures. Students also participate in on-call experiences and electroconvulsive therapy. Student grades are based on their clinical evaluations, one final psychiatric admission write-up, and OSCE, and a written shelf examination. Surgery The goal of the Surgery Clerkship is to provide an experience in the principles and practices of surgery in eight weeks. Students spend four weeks on a general surgery rotation and two weeks on each of two surgical subspecialty rotations. Students are expected to assume responsibility for patient care and participate in the evaluation of patients and the decision-making process, further developing interviewing and physical diagnosis skills. Students are expected to read the required textbook, ask questions, and participate actively in the learning process. In addition, there is opportunity for students to gain expertise in the performance of basic procedures such as IV and NG insertion. While on the general surgery rotation, students have the opportunity to make clinical presentations at the weekly divisional conferences. The required core curriculum lecture series is available on the Surgery website, and faculty present clinical case discussions based on these lectures on Thursdays. Students are required to attend scheduled conferences, including weekly Grand Rounds, M&M conference, and small group sessions with faculty. The department gives the (NBME) Shelf Exam at the end of the eight-week period. Surgery-Inova Campus The goal of the Surgery Clerkship is to provide an experience in the principles and practices of surgery in eight weeks. Students spend four weeks on a general surgery rotation and four weeks on a surgical subspecialty or community surgery month. Students are expected to assume responsibility for patient care and participate in the evaluation of patients and the decision making process, further developing interviewing and physical diagnosis skills. Students are expected to read the required textbook, ask questions, and participate actively in the learning process. While on the general surgery rotation, students make a weekly case presentation to the chair. There is a core curriculum lecture series available on the Surgery website, and a faculty present clinical, case-based discussion on these lectures on Mondays and Thursdays. Students are required to view on-line lectures as well as attend scheduled conferences, including weekly Grand Rounds and M&M (Kaizen) conferences. In addition, each service has conferences specific to their specialty. M4 Year Requirements (Applies only to the matriculating classes of 2012 and prior): During the M4 year, students must complete two acting internships (AI), a critical care selective (an Intensive Care Unit [ICU], emergency medicine, or anesthesia month), and the Capstone course. ICU months and emergency medicine (EM) rotations can count as both an acting internship-level experience and a critical care selective. Anesthesia counts as a critical care selective. Students must complete their critical care selective at VCU (including the VAMC and Inova-Fairfax). Away months may qualify as acting internship-level experiences but not as critical care selectives. The supervisor from the away month will need to attest that the away month is an acting internship-level experience through a form available in the Curriculum Office. Some possible ways to meet the requirements above:

• A ward AI + an ICU or EM month • An ICU month + an EM month • Two away AIs + anesthesia • An away AI + a ward AI here + anesthesia

In addition, all students must complete the Capstone Course, scheduled at the conclusion of the M4 year. If a student wishes to miss a portion of a required M4 course, he/she must submit an exception request form to the Curriculum Office. This includes the required Capstone Course. The Assistant Dean for Medical Education may approve these requests. Other absence requests should be made through the Curriculum Office.

Academic Success The School of Medicine is committed to creating a learning environment that will enhance the academic success of all students. To that end the School offers a variety of programs to support students who may be at risk of or experiencing academic or professional difficulty. The summer prior to matriculation, the School of Medicine offers a pre-matriculation workshop geared towards students who may have difficulty adjusting to the rigors of medical school. This may include students who have had less exposure to the basic sciences; attended a college or university where there has been limited experience in taking standardized, multiple choice examinations; students from rural Virginia, attended small colleges, with an MCAT of 27 or lower, and disadvantaged students; or feel a need to develop enhanced study skills to address the rigors of the medical school curriculum. The workshop allows students the opportunity to participate in typical educational activities; take a medical school assessment; and, better understand learning styles and skills for success. These topics are addressed again during the MS1 orientation to medical school. In addition, during orientation, students complete the Meyers-Briggs and participate in workshops to understand how their scores correlate with approaches to studying and learning. Student academic achievement is monitored through monthly Student Progress Committee Meetings. These meetings are attended by the Senior Associate Dean for Medical Education and Student Affairs, Associate Dean for Medical Education (Inova Campus), Associate Dean for Student Affairs, the Assistant Deans for Medical Education (VCU and Inova Campuses), the Assistant Dean for Student Affairs (Inova Campus), the Assistant Dean for the Curriculum, the Director of the Curriculum Office (Inova campus), and representatives from the Division for Academic Success and the Office of Student Outreach Programs (see below). Any student who is demonstrating any problems related to academic and professional development is discussed, a plan for immediate intervention is developed, and the student is contacted by a member of the committee for counseling and more comprehensive recommendations. In addition, any student who has participated in the pre-matriculation workshop and experienced difficulties will be offered a plan to enhance their success. Students experiencing academic and professional difficulties are counseled as to whether academic, physical illness, personal, financial or emotional problems are factors in the observed problems and referrals are made for the provision of services based upon this counseling. In some cases, students may be counseled to take a leave of absence to resolve personal, financial, emotional, or medical problems. Once a student has been identified and academic assistance is offered, the student bears the responsibility for seeking and following up on the assistance program. Students who are experiencing academic or professional difficulties are encouraged and counseled to use the following resources:

Course/Division Faculty: The course/division faculty often provides the primary assistance for students having difficulty with particular course content. Students are encouraged to seek help from faculty whenever questions arise. If a student feels he/she is having difficulty understanding the course content in general, he/she is encouraged to meet with the Course/Division Director, and together decide upon the appropriate method of assistance. Other approaches may include regular meetings with the Course/Division Director or other course faculty, tutors, directed reading assignments, special problem solving practice, or working with a group of students with faculty support. Clerkship Directors: The faculty in charge of a clerkship should be contacted if a student is experiencing academic or professional difficulties during the M3 year. Counseling and referrals, as appropriate, will be made. Tutoring: Small group and individual tutoring provided by M4s and MD/PhDs may be recommended to assist MS1, M2 and MS2 students experiencing academic difficulty or who are deemed at risk for experiencing academic difficulties. Students should contact the Assistant Dean for Curriculum to arrange for tutoring services. Administrative Services: Students are actively encouraged to seek counsel from the Assistant Deans for Medical Education, Assistant Dean for Curriculum, Assistant and Associate Deans for Student Affairs, Associate Dean for Medical Education (Inova Campus), and the Senior Associate Dean for Medical Education and Student Affairs. Appointments may be made by calling or email, and some administrative staff has regular office hours where students may walk in without an appointment. In addition, each student is assigned to a Society Director who also serves as a resource for counseling about areas impacting the personal and professional development of students. Division for Academic Success (http://www.healthsciences.vcu.edu/das/): The Division for Academic Success provides an array of services for medical students, including academic counseling, self-assessment materials, review materials, stress management, test-taking skills, study skills, time management, learning strategy implementation, and note-taking techniques. Students may refer themselves to the above programs for individual assistance. Other resources include specialized software (Kurzweil 3000, Dragon Naturally Speaking Zoomtext and Openbook) on four computer workstations at the Tompkins-McCaw Library. All workstations are available for use by any student. Students with Disabilities: Virginia Commonwealth University under Section 504 of the Rehabilitation Act of 1973 and The Americans with Disabilities Act of 1990 (the "ADA"), as amended by the ADA Amendments Act of 2008 provides reasonable accommodations and services to any student who discloses a disability. Students who have a disability are provided the opportunity to voluntarily identify themselves. Students with a disability and wish to identify themselves as such, must contact the Division for Academic Success. The University is not obligated to provide accommodations and services to the student until this contact and notification is made by the student. It is the student's responsibility to seek information about reasonable accommodations and services available to him/her from or through the University. All documentation and disclosures are confidential. Documentation guidelines can be found in the VCU Handbook for Students with Disabilities, which is available online at http://www.specialservices.vcu.edu/pdfs/StudentHandbook.pdf.

Students may identify themselves before the start of classes or any time after their enrollment in the School of Medicine. Accommodations are not provided retroactively. If students are seeking accommodations they should register with the office at least four weeks in advance of classes. Upon receipt of the appropriate documentation and/or disclosure from the student, the Division for Academic Success makes a determination as to whether or not the student qualifies for services and/or accommodations. The Division for Academic Success may confidentially confer with the Senior Associate Dean for Medical Education and Student Affairs to determine if the School of Medicine may reasonably provide the accommodations without significantly altering the normal educational program. Reasonable accommodations are determined on a case by case basis. The University is not required to significantly alter academic requirements imposed by the curriculum nor is it considered reasonable to make accommodations that significantly lower the Technical Standards of the School of Medicine. The Senior Associate Dean for Medical Education and Student Affairs has the discretion to require a student’s healthcare provider to certify or recertify that the student with a disability meets the Technical Standards of the School of Medicine, either with or without accommodations. The Technical Standards may be found at http://www.medschool.vcu.edu/audience/documents/VCUSOMTechnicalStandards.pdf. If the student qualifies, the Division for Academic Success provides the student with a confidential memo that identifies the student as having a disability, and includes a list of approved accommodations. New accommodation letters must be requested by the student prior to the beginning of each semester. The student is required to present the confidential memo to the Assistant Dean for Curriculum prior to the beginning of each semester so that necessary arrangements can be made for the student’s accommodations during preclinical years. Students are required to provide a copy of the letter to each clerkship director/coordinator in order to request accommodations during the clinical years. This process does not dispense with the need to file the necessary curriculum exemption request forms. University Counseling Services--UCS (www.students.vcu.edu/counsel): University Counseling Services provides a wide range of psychological services to meet the personal, social, vocational, emotional and intellectual needs of students. The goals of the UCS staff are to promote positive growth and self-understanding of students, as well as to assist students who are experiencing stress or crisis in their daily lives. Besides individual, couples, and group counseling, the UCS staff offers a number of programs and workshops designed to meet specific needs of students. Typical offerings include anxiety management, career development, and communication skills. Services are free except for a small fee for some assessment services. Services are provided on a limited basis for students who may benefit from consultation by a staff psychiatrist and medication management. The University Counseling Services staff adheres to professional, legal and ethical guidelines established by professional organizations and state laws. The MCV Campus office is open 8 a.m. to 5 p.m. daily, Monday, Wednesday, Thursday and Friday and 11 a.m.-8 p.m. Tuesday. Summer hours are 8 a.m. to 4:30 p.m. Monday - Friday. Consent of the student is required for all communication between University Counseling Services and the administration of the School of Medicine if such communication is deemed in the best interest of the student. All services provided by University Counseling Services are confidential; there is no reporting on the Medical Student Performance Evaluation that student have sought counseling services. Office of Student Outreach Programs (http://www.medschool.vcu.edu/admissions/md/outreach/index.html):

The Office of Student Outreach Programs is committed to the recruitment, admission, education and retention of qualified students from populations that includes those under-represented in medicine, from rural backgrounds and considered non-traditional and which address the diversity mission of the School of Medicine. This office not only serves as a resource, but also acts as a liaison and works closely with other offices within the school to meet the needs of students, works to enhance the career advisement and mentoring, and coordinates retention initiatives to ensure successful completion of medical school. Most activities and efforts are coordinated through the collaborative efforts of Admissions, Curriculum and the Diversity Access Programs Offices. Activities and programs include: • serving in an advisory capacity to VCU’s undergraduate minority pre-health society (MAPS) • providing tours and orientation for special interest groups • providing advising and counseling services to prospective students about the admissions process • sponsoring yearly pre-med programs for Virginia’s undergraduate schools • sponsoring a "Second Look" Program for accepted students • offering a mentoring program for minority students with minority physicians • working closely with VCU/MCV’s Student National Medical Association (SNMA) chapter on

recruitment initiatives and community programs • representing the medical school at local and national conferences University Student Health Services (www.students.vcu.edu/health): The mission of the University Student Health Services is to provide quality outpatient medical care and public health services including health education programming, which empowers student to become full participants in their health care. Student health accomplishes this mission by targeting services in the following areas: medical services, public health, preventive medicine, health education, teaching and research. Monitoring & Evaluation: Students who have been identified as having academic and professional problems are monitored on a monthly basis by the Student Progress Committee and by semester or year, by the Pre-Promotions and Promotions Committees. Ultimately, it is the responsibility of the student to take advantage of opportunities to harness success . Emergency Preparedness--What to know and do to be prepared for emergencies at VCU

• Sign up to receive VCU text messaging alerts (www.vcu.edu/alert/notify). Keep your information up-

to-date. • Know the safe evacuation route from each of your classrooms. Emergency evacuation routes are

posted in on-campus classrooms. • Listen for and follow instructions from VCU or other designated authorities. • Know where to go for additional emergency information (www.vcu.edu/alert). • Know the emergency phone number for the VCU Police (828-1234). Report suspicious activities and

objects. Virginia Commonwealth University School of Medicine Educational Objectives and Technical

Standards

Medical education requires the acquisition and development of scientific knowledge along with specific skills and competencies. The VCU School of Medicine has a responsibility to society to educate the best

possible physicians. To that aim, the faculty has developed a set of educational objectives in six domains which are required of all graduates: Professionalism: The ability to understand and demonstrate the nature of professional and ethical behavior in the act of medical care. This includes respect, responsibility, accountability, excellence, honor, integrity, altruism, leadership, cultural competency, compassion, maintenance of professional boundaries and confidentiality. Students who are graduated from Virginia Commonwealth University School of Medicine will:

• Provide compassionate care to patients with respect for their privacy and dignity • Display honesty, integrity, and responsibility in all educational settings and in interactions with

patients, their families, and colleagues • Demonstrate altruism by consistently advocating for the patient’s best interest • Summarize and put into practice the principles of ethical decision-making • Demonstrate accountability to the patient, society, and the profession through a commitment

to excellence and on-going professional development • Appraise threats to the medical profession posed by the conflicts of interest inherent in the

various financial and organizational arrangements within the practice of medicine • Participate as an active member of the learning community and facilitate the learning of peers

and other health care professionals • Demonstrate knowledge of the psychological and physical risks and stressors of the practice of

medicine • Identify possible impairments in function and practice techniques for harm reduction

Patient Engagement & Communication (Interpersonal & Communication Skills): The ability to engage and communicate with patients, their families, and professional associates, using interpersonal skills to build relationships for information gathering, guidance, education, support and collaboration. Students who are graduated from Virginia Commonwealth University School of Medicine will:

• Create and sustain therapeutic and ethically sound relationships with patients and their families • Employ effective oral and written communication skills to elicit and convey information while

building rapport with patients, their families, and professional associates • Build collaborative relationships across both educational and clinical environments with

patients, their families, and professional associates • Demonstrate the ability to engage in shared decision making with patients and their families or

individuals designated to fulfill this responsibility for the patient • Demonstrate techniques of patient education and counseling in basic lifestyle changes and

disease prevention Application of Scientific Knowledge & Method (Medical Knowledge): The ability to discuss the biomedical, epidemiological, and social-behavioral aspects of clinical science and apply this knowledge to patient care. Students who are graduated from Virginia Commonwealth University School of Medicine will:

• Use the scientific method to analyze basic, translational, and clinical research • Delineate the molecular basis for the functions of organs and systems in health and disease • Describe, apply, and integrate the normal and pathologic structure and function of each organ

system of the body • Describe, apply, and integrate the ways in which organ systems are affected by the various

causative mechanisms of disease • Recognize the clinical, laboratory, radiographic, and pathologic manifestations of disease

• Describe, apply, and integrate the scientific basis of disease prevention and treatment, including intended and unintended effects

• Apply evidence-based medicine to determine the causation of disease and the efficacy of traditional and non-traditional therapies

• Appraise the impact of social-behavioral factors on health maintenance, causation of disease, and therapeutic outcomes

Patient Care: The ability to provide patient care that is appropriate and effective for the treatment of health problems and the promotion of health. Students who are graduated from Virginia Commonwealth University School of Medicine will:

• Be able to obtain a complete history and perform a comprehensive physical/mental status examination

• Utilize a focused history and physical and mental status examination to obtain relevant clinical information in an efficient manner

• Recognize patients with immediate life threatening or serious conditions that require critical care and outline an initial course of management

• Discuss with and provide to patients and their families information and counseling aimed at disease management, prevention, and wellness

• Identify the epidemiology of common conditions within a defined population and apply systematic approaches to help reduce the incidence and prevalence of these conditions

• Describe the indications, risks, limitations, complications, and interpretation of commonly used diagnostic tests

• Perform routine procedures competently and identify the indications, risks, limitations, justifications, complications, and interpretations of these procedures

• Construct appropriate assessments, differential diagnoses, and treatment plans for patients across the spectrum of medical presentations

• Gather, interpret, and apply ongoing relevant clinical information in the care of patients • Select appropriate tests for detecting patients at risk for specific diseases and determine

strategies for responding appropriately • Utilize information technology to gather patient data, support patient care decisions, and

educate patients and their families Putting Care in Practical Context (Systems-based Practice): The ability to provide clinical care within the practical context of a patient’s age, gender, personal values, family, health literacy, culture, religion, and social and economic circumstances. This goal includes consideration of relevant ethical, moral, and legal perspectives, patient advocacy, public health concerns, and resources and limitations of the healthcare system. Students who are graduated from Virginia Commonwealth University School of Medicine will:

• Obtain patient histories including information about patients’ culture and other factors that may influence the appropriate course of care

• Perform culturally-sensitive physical exams • Identify cultural barriers that are perceived by patients as impacting health and health care • Develop plans of care that take into account pertinent cultural attributes of patients and

address barriers perceived by patients • Compare and contrast various approaches to the organization, financing, and delivery of health

care • Demonstrate understanding of the legal framework within which physicians function • Describe the various roles and responsibilities of members of the health care team

• Interact effectively with all members of the health care team to provide the best possible care for patients

• Relate the effect of public policy actions to individual health and health care systems as a whole • Define the methods used by individuals and systems to improve quality of care • Practice a commitment to provide care to patients who are unable to pay and to advocate for

access to health care for members of underserved populations • Recognize and appropriately address gender and cultural biases in themselves and others and in

the process of health care delivery Self-directed Learning & Self-Assessment (Practice-based Learning & Improvement): The ability to assess and understand ones learning style, to self-identify areas of strength and weakness, to independently identify and evaluate resources to engage in lifelong learning, and to critically appraise the evolving body of medical knowledge. Students who are graduated from Virginia Commonwealth University School of Medicine will:

• Demonstrate the understanding of the limitations of one’s own knowledge and skills and seek to engage in lifelong learning and the advice and teaching of more experience medical practitioners to address those limitations

• Demonstrate the understanding of the limitations of the role of a physician • Demonstrate the understanding of the limitations of the evolving body of medical knowledge • Retrieve, critically review, and utilize biomedical and biopsychosocial information • Identify means to maintain a healthy balance between professional and personal responsibilities

to optimize mental, physical and emotional well-being. To attain the objectives, the School of Medicine has a set of minimum technical standards expected of matriculants and ongoing students which were formulated with the following aims: • Applicants and enrolled students should present outstanding qualifications for the study and

practice of medicine. • Successful completion of the entire medical school curriculum is necessary for all students. • All students should meet both academic standards and technical standards to progress through

school and graduate. Technical Standards I. Observation The candidate must be able to observe demonstrations and experiments in the basic sciences, including but not limited to physiologic and pharmacologic demonstrations in animals, microbiologic cultures, microscopic studies of microorganisms and tissues in normal and pathologic states, observe x-rays, cadavers, live human case presentations and patient interview, physical exams, using a variety of medical instrumentation such as stethoscopes, otoscopes, etc., rectal and pelvic exams, live surgical procedures, childbirth, on-line computer searches. A candidate must be able to observe a patient accurately at a distance and close at hand. Observation necessitates the functional use of the sense of vision and somatic sensation. It is enhanced by the functional use of the sense of smell. II. Communication A candidate should be able to speak, to hear, and to observe patients in order to elicit information, describe changes in mood, activity, and posture, and perceive nonverbal communications. A candidate must be able to communicate effectively and efficiently in oral and written form with all members of the health care team. A candidate should be able to effectively communicate in settings when the time span available for communication is limited. Examples of areas where skillful communication is required might include (but are not limited to) answering written and oral exam questions, eliciting a complete

history from a patient, presenting oral or written information to preceptors, attending and other members of the health care team, participating in fast-paced small and large group discussions, talking with patients and families about medical issues, interacting in a therapeutic manner with psychiatric patients, interacting effectively and compassionately in stressful situations with colleagues, other health care providers, clerkship administrators and patients. III. Motor/Tactile Function: Candidates should have sufficient motor function to attend and participate in all class and small group functions which are part of the curriculum, read and write, elicit information from patients b palpation, auscultation, percussion and other diagnostic maneuvers. A candidate should be able to perform basic laboratory tests (urinalysis, CBC, etc), carry out diagnostic procedures (proctoscopy, paracentesis, etc.) and read EKGs and x-rays. A candidate should be able to execute motor movements reasonably required to provide general care and emergency treatment to patients. Examples of emergency treatment reasonably required of physicians are cardiopulmonary resuscitation, the administration of intravenous medication, the application of pressure to stop bleeding, the opening of obstructed airways, the suturing of simple wound and the performance of simple obstetrical maneuvers. Such actions require coordination of both gross and fine muscular movements, equilibrium and functional use of the senses of touch and vision. IV. Intellectual - Conceptual, Integrative, and Quantitative Abilities These abilities include rational thought, measurement, calculation, reasoning, analysis, organization, memory, clinical and ethical reasoning, sound judgment and synthesis. Problem solving, the critical skill demanded of physicians, requires all of these intellectual abilities. In addition, the candidate should be able to comprehend three dimensional relationships and to understand the spatial relationships of structures. Examples include being able to recall, understand and synthesize materials presented in class and in meetings with preceptors and faculty, successfully passing written and oral exams, understanding ethical issues, interpreting test results, analyzing complicated physical situations such as cardiac arrest and determining the appropriate sequence of events for successful treatment, understanding methods for various procedures, exhibiting sound judgment in clinical settings, making concise and cogent presentations on data collected on a patient, and understanding how to organize and present on service, understanding how to work effectively both alone and as a member of a team. V. Behavioral, Social and Professional Attributes A candidate must possess the emotional health required for full utilization of his/her intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care of patients, the development of mature, sensitive and effective relationships with patients, colleagues and other health care professionals. Candidates must be able to tolerate physically taxing workloads and to function effectively under stress. They must be able to adapt to changing environments, to display flexibility, and to learn to function in the fact of uncertainties inherent in the clinical problems of many patients. Compassion, empathy, integrity, concern for others, interpersonal skills, interest, and motivation are all personal qualities that are assessed during the admissions and education processes. The School of Medicine has a set of professional standards that all candidates are expected to meet once enrolled (www.medschool.vcu.edu/professionalism/). The evaluation of candidates seeks to assess their abilities to conform to the professionalism standards. Examples of professionalism standards are: showing up for required experiences on time and prepared, refraining from violation of the school’s honor code, treating faculty, staff and other students with respect, making an effort to understand prejudices and preconceptions that might affect patient and colleague interactions (especially in areas of race, ethnicity, gender, sexual orientation, disability, age and religious differences), developing successful working relationship with faculty, colleagues, and staff and accepting constructive feedback, respectful speech, professional dress and demeanor, respecting patient

confidentiality, developing empathic listening skills, advocating for patients when appropriate, and using clinical and hospital resources appropriately. Qualified students with disabilities can be accommodated and some accommodations may involve an intermediary or an auxiliary aid. However, these accommodations may not provide cognitive support, substitute for essential clinical skills or supplement clinical or ethical judgment. In other words, accommodations may not eliminate essential program elements. An example of acceptable intermediaries would include a sign language interpreter (provided they offer only translation and do not perform selective, analytic or interpretive functions). A deaf student would thus be able to listen, but would still be personally responsible for essential communication within the curriculum. An auxiliary aid might be that a paraplegic student would use a standing wheelchair or variable height table to examine a patient. Any student who has questions about University accommodations, or wishes further information about meeting these standards may review the website for the Division for Academic Success at http://healthsciences.vcu.edu/DAS/ or may contact the office at (804) 828-9782. Year-Out for Biomedical Research

There are a number of medical students who have had significant research experience in college and/or the years before attending medical school. Many of them are interested in careers in academic medicine but do not want to participate in the MD/PhD Program. In addition, many students are interested in clinical and translational research rather than in pure basic science. In response to these needs, the School of Medicine has created a program in which a medical student can take a year off from medical school to do research after either the M2 or M3 year. At the end of this time a Master’s Degree will be awarded. The details are as follows: Structure

• A full year of time dedicated to research under the mentorship of research-active faculty. • Student would receive instruction in the responsible conduct of research, participate in journal

clubs, develop presentation and writing skills and take limited appropriate coursework. • The year would take the form of existing master’s degree programs in the basic sciences or the

proposed master’s degree in Clinical Research. The student cohort would enroll as full-time graduate students in the appropriate M.S. program.

Selection Students will be chosen each year and the process will be competitive and highly selective. Students would apply either in the spring semester before at the end of the M2 (more focused on basic science research) or the M3 (focus on clinical research) year and return to M.D. training at the normal start of M3 or M4 years, respectively. Elective time in M4 might be used to complete M.S. degree requirements. Support The School of Medicine would provide a stipend of $15,000 and pay applicable fees and tuition. Full-time enrollment in the graduate school ensures that loan payback deferrals remain in place. Special Requirements

In lieu of preparing a formal thesis, students will write up their year's work as a manuscript suitable for submission to an appropriate journal. A degree will not be awarded until this requirement has been fulfilled to the satisfaction of the faculty mentor/advisor. OFFICE OF CURRICULUM POLICIES AND PROCEDURES

Absences and Exception Requests for MS1 & MS2

Background: It is incumbent upon the School of Medicine to establish policies that minimize student absences from academic activities and equitably afford students the opportunity to be excused from required academic activities for legitimate reasons. Furthermore, it is the responsibility of the School of Medicine to monitor students who have numerous absences that may be impeding their academic progress. Policy: To request a postponement or make-up of an examination, Practice of Clinical Medicine (PCM) session, graded assignment or required course session, students must submit an Exception Request Form to the Curriculum Office. Exception requests may be submitted for reasons that include: 1. Your own illness; 2. Your own wedding; 3. Attending or presenting at a conference related to education; 4. An illness or death in your immediate family; 5. Accommodations Letter approved absences (a copy of the accommodation letter must be attached to the exception request form); 6. Religious holidays. Exceptions must be requested as far in advance as possible; every effort will be made to work with emergency situations. Requests for exceptions due to religious holidays must be made in accordance with the University academic calendar: http://academiccalendars.vcu.edu/. Travel arrangements should be made after 5 p.m. for all examinations. Travel and attendance at family events/reunions are not considered excused absences. Requests are treated on an individual basis and may be discussed with the appropriate individuals (Senior Associate Dean for Medical Education and Student Affairs, Assistant Dean for Medical Education, Practice of Clinical Medicine (PCM) coordinators and the Assistant Dean of Curriculum). Students who postpone an exam, PCM small group/workshop/preceptor visit for illness or other assessment activity must provide documentation from either a private physician or Student Health stating they were seen for an office visit. Students who are absent from a required course session due to a doctor's appointment must provide documentation from either a private physician or Student Health stating they were seen for an office visit. Students who postpone an exam, PCM small group/workshop/preceptor visit or other assigned activity for any other reason may also be requested to provide documentation (travel documents, etc.) Making up these activities will be decided based on the requirements of a course or on a case-by-case basis. Not all sessions may be made up. Students should check with the Curriculum Office about whether an activity has a make-up available or if they will miss it, lose points, etc. Exception requests for conference attendance must be submitted 30 days in advance. Evidence of conference attendance must be submitted to the Curriculum Office (registration form prior to conference) otherwise the absence will be documented as unexcused.

If the student's circumstances are found to affect his/her ability to take the examination or other graded experience on the scheduled date, the student will be granted permission to take the make-up examination, usually within one business day of the scheduled exam date. For example, if the course examination is scheduled for a Friday, the student would be required to take the make-up exam on the following Monday, circumstances permitting. The Assistant Dean for Curriculum sets the date and time for make-up examinations. Students do not determine the length of the exam extension. Make-up examinations cannot be scheduled during required curricular activities (e.g. PCM small group or workshop). Exception request forms will be placed in the student's file, recording the student's request for a make-up exam, reason for request, and outcome. Students should reach closure on each course as quickly as possible to ensure that they will not fall behind in other courses. Make-up deadlines are established in an effort to help students stay on track. In the case of illnesses or family problems that require an extended absence, students should consider requesting a leave of absence or withdrawing (see Withdrawal/Leave of Absence). If a student does not take an examination or other graded experience at the designated time and fails to contact the Curriculum Office to file an exception request, the student will receive a zero on that assessment. If a student does not attend a PCM workshop, small group or preceptor session and fails to provide prior notice to the PCM Office or the Curriculum Office, the absence will be unexcused. Points will be deducted from the student's final PCM grade for all unexcused absences. If the absence is unplanned due to illness, an Exception Request Form must be completed and submitted to the Curriculum Office within 24 hours of return, along with a doctor’s note attached. Once a student has requested three exceptions in an academic year, he/she will be required to meet with the Senior Associate Dean for Medical Education and Student Affairs for counseling regarding repeated absences. Academic Probation

Background: It is the responsibility of the School of Medicine to have a system to place students on notice who are not making satisfactory academic progress. Furthermore, the School must have a policy to delineate the lack of renewal of merit-based scholarships for students failing to make satisfactory academic progress. Policy: A student may be placed on academic probation by the Senior Associate Dean for Medical Education after consultation with the Dean of the School of Medicine, and if appropriate, the Promotions Committee when it is believed the student is at risk for: not being promoted to the next academic year/semester; repeating an academic year/semester; dismissal; repeated or a single egregious breech of professionalism; or not graduating. This will be noted in the student’s permanent record. A student will be removed from academic probation once the conditions for the action have been resolved. A student may be placed on academic probation for the following reasons:

• A student is in a year/semester where he/she has three less than passing grades. • A student is in a year/semester where he/she has two less than passing grades, must take

reexaminations and pass those reexaminations to be promoted. • A student is in a year/semester where he/she has a failing grade and must take a reexamination

and pass that reexamination to be promoted.

• A student has failed Step 1 of the USMLE. • A student has failed Step 2 CK/CS of the USMLE. • A student deemed by the Office of Student Affairs to have more than one professionalism

concern or a single egregious professionalism concern. Students who are placed on academic probation will forfeit all awarded merit-based scholarships until their academic status is restored. Accessing Important Class Information

Background: There should be an efficient means for communication between the administration/faculty of the School of Medicine and students, and amongst students. Guidelines should be established to define approved lines of communication and etiquette for using these media. Policy: Electronic Curriculum Bulletin Board (eBoard): All announcements for M1, M2, M3, and M4 and MS1, MS2, MS3 and MS4 students are made via the Electronic Curriculum Bulletin Board and the Announcements page on the eCurriculum. The Office of Curriculum recommends that students check this site daily, as this is the official method for making class announcements. There are sections for student announcements, as well. Examples of appropriate postings include items for sale, announcements of organization meetings, class activities and concerns, housing availability/requests and other items. This website also consists of discussion forums set up for each M1/MS1 and M2/MS2 course. Students may e-mail questions to the Course Director/Master who may then choose to post them to the entire class for discussion. Other noteworthy information is also posted about the courses. Confidential concerns involving individual students will be handled via the university e-mail accounts, which students should check daily. The SOM exclusively uses the official university e-mail addresses. The bulletin board is a university resource established for the students, specifically for announcements to the class. The university standards of etiquette and the SOM Professionalism standards apply. Students should recognize that this is a public forum and that while access is limited, it is not a chat room. Email: Students should check their university e-mail accounts daily for requests and information that may be unsuitable for a public medium such as the Electronic Curriculum Bulletin Board. Personal Student Messages/Pagers: Due to limited staffing in the Curriculum and Student Affairs Offices and the varied locations of the class due to labs, small groups, etc., it is not reasonable to expect office staff to deliver personal messages. Students should not expect to receive personal phone calls in either of these offices and should not list office phone numbers as personal numbers. In the case of an extreme emergency (e.g., serious illness of an immediate family member) someone from one of these offices will attempt to locate a student. MS1 and MS2 students who must be contacted frequently by family or friends should consider investing in a personal cell phone or pager; pagers are required for MS3 and MS4 students. It is the responsibility of the student to update contact information regularly. This includes local, permanent and emergency contact information. Students may make changes directly on the Student Record System (SRS) or inform either the SOM Registrar’s Office or Curriculum Office. Local and emergency contact information must be reviewed and updated as necessary by the first day of class/rotation each year and each time there is a change in mailing addresses. Official mail from the

University or School of Medicine will be mailed to the address on record and also sent electronically. Timed responses will be based on the date of mailing, either electronic or by US mail, not receipt. Class Rank and Standard Scores

Background: There should be a uniform process for notifying students of their relative class rank. Policy: The School of Medicine does not "rank" students, other than for awards or honors, such as Alpha Omega Alpha Honor Society, or the A.D. Williams Award given to the student who is first in his/her class and on the Medical Student Performance Evaluation. Upon request, students may learn their relative rank, e.g., in the top quartile of the class, from the Associate Dean of Student Affairs or the Assistant Dean for Curriculum. Students may also use standard scores and exam histograms to assess their standing relative to other students for each examination or course. When the distribution of scores is approximately normal (bell shaped) a standard score of 50 indicates that a student is performing at the class average. A standard score greater than 50 indicates performance in the top ranks of the class and a score below 50 indicates performance in the bottom ranks of the class. Computer Requirements (Applies to matriculating class of 2013 and all students matriculating

thereafter): Background: It is a goal of the School of Medicine to provide an educational environment that promotes the knowledge and skills needed to thrive in technologically advanced clinical and research workplaces. To that aim, students should be provided with requirements for their own personal computers and expectations for use of this technology in the learning environment. Policy: All students are required to own a laptop computer. Minimal laptop requirements include: • Less than two years old • Three GB of RAM or greater • Operating System:

o Windows 7 minimum o Windows 7 Professional strongly preferred o Windows 8 strongly discouraged o Mac OSX 10.6 or greater

• Connectivity: o 10/100 Ethernet port or better o Wi-Fi 802.11G or better

• Video out o HDMI for Windows laptops o HDMI or Thunderbolt/Mini DisplayPort for MacOS laptops

In addition to the above laptop requirements, students must be able to take part in web conferences on their laptops. Students are required to provide their own headsets during testing sessions. Students are required to provide their own Ethernet cable to connect to Ethernet ports during testing sessions.

Students are required to maintain their laptop and ensure it is virus free. Students will use this laptop throughout the four years of medical school from viewing course materials, to daily class participation, to taking high stakes exams. Students will be expected to bring this laptop to class every day for use in classroom activities, self-paced learning materials, case studies, exams, quizzes, conferences, presentations and evaluations. Students who do not have access to their laptop when a graded assignment is given will receive the grade of “zero” for that particular assignment. Students will be required to bring their laptop on each exam day. All exams will be completed online. Failure to bring a fully operational laptop computer to an examination will result in either a deduction of points from the final grade or a reduction in time to take the examination. Students will also be required to utilize their laptops during the MS3 phase for NBME shelf exams. iPads and other tablets, netbooks, Chromebooks, smart phones, eReaders and similar devices are not suitable replacements for a laptop computer. During MS1 Orientation, students will be introduced to the variety of software programs that will be used through the MS1 and MS2 courses. Curriculum Council

Background: Per the Liaison Committee on Medical Education (LCME) standard ED-33: “There must be integrated institutional responsibility in a medical education program for the overall design, management, and evaluation of a coherent and coordinated curriculum. The phrase ‘integrated institutional responsibility’ implies that an institutional body (commonly a curriculum council) will oversee the medical education program as a whole. An effective central curriculum authority will exhibit the following characteristics:

• Faculty, medical students, and administrative participation • Expertise in curricular design, pedagogy, and evaluation methods. • Empowerment, through bylaws or decanal mandates, to work in the best interests of the

institution without regard for parochial or political influences or departmental pressures. The phrase ‘coherent and coordinated curriculum’ implies that the medical education program as a whole will be designed to achieve its overall educational objectives. Evidence of coherence and coordination includes the following characteristics:

• Logical sequencing of the various segments of the curriculum. • Content that is coordinated and integrated within and across the academic period of study (i.e.,

horizontal and vertical integration). • Methods of pedagogy and medical student assessment that are appropriate for the

achievement of the program’s educational objectives. Curriculum management signifies leading, directing, coordinating, controlling, planning, evaluating, and reporting. Evidence of effective curriculum management includes the following characteristics:

• Evaluation of program effectiveness by outcomes analysis, using national norms of accomplishment as a frame of reference.

• Monitoring of content and workload in each discipline, including the identification of omissions and unplanned redundancies.

• Review of the stated objectives of each individual course and clerkship, as well as the methods of pedagogy and medical student assessment, to ensure congruence with programmatic educational objectives.”

Policy: A curriculum council shall oversee the management of the School of Medicine curriculum in accordance with LCME standard ED-33.

• Membership: 1. The council shall consist of voting and non-voting (ex officio) members. 2. Voting members shall consist of:

a. Chair representative from the Basic Sciences (Term of two years) b. Chair representative from the Clinical Sciences (Term of two years) c. Faculty representative from the Basic Sciences (Term of four years) d. Faculty representative from the Clinical Sciences (Term of four years) e. Council chair (Term of four years) f. Faculty representative from the McGuire Veteran’s Administration Medical

Center (Term of four years) g. Faculty representative from the Fairfax Inova campus (Term of four years) h. Student curriculum representatives from each class in addition to a

representative from the Fairfax Inova campus 3. Ex officio members shall consist of:

a. Senior Associate Dean for Medical Education and Student Affairs b. Associate Dean for Student Affairs c. Assistant Dean for Pre-Clinical Education d. Assistant Dean for Clinical Education e. Associate Dean for Medical Education (Inova Campus) f. Assistant Dean for Medical Education (Inova Campus) g. Assistant Dean for Student Affairs (Inova Campus) h. Assistant Dean for Curriculum i. Associate Dean for Professional Instruction and Faculty Development j. Associate Director of Education and Outreach Services (Tompkins-McCaw

Library) k. Associate Dean, Office of Assessment and Evaluation Studies l. Director of the Simulation Center m. Director of Academic Information Systems n. Chair, Pre-Clinical Subcommittee o. Chair, Clinical Subcommittee

4. Faculty voting members shall be solicited from the faculty and selected by the existing curriculum council.

5. Student curriculum representatives shall be solicited from each class/campus and selected by their peers.

• Subcommittees: A preclinical and clinical subcommittee shall be responsible for a critical review of all courses and clinical rotations, respectively, on an annual basis. The review shall cover all appropriate areas as designated in ED-33 and be presented to curriculum council for approval. Members of the subcommittees shall be faculty solicited from the general faculty and approved by curriculum council, and student curriculum representatives. Specifically, membership shall be as follows:

1. Pre-clinical subcommittee: Chair (Term of four years)

Two faculty representatives from Basic Sciences (Term of four years) Two faculty representatives from Clinical Sciences (Term of four years) Senior Associate Dean for Medical Education and Student Affairs Assistant Dean for Pre-Clinical Education Assistant Dean for Medical Education (Inova campus) Representative of the Simulation Center Representative of the Office of Assessment and Evaluation Studies Student curriculum representatives from the pre-clinical years

2. Clinical subcommittee Chair (Term of four years) One faculty representative from Basic Sciences (Term of four years) Three faculty representatives from Clinical Sciences (Term of four years) Representative of the Simulation Center Representative of the Office of Assessment and Evaluation Studies Student curriculum representatives from the clinical years

• Curriculum Review: All courses, required clinical rotations/activities, methods of pedagogy and medical student assessments will be reviewed annually to assure that the educational objectives of the school are being met and to determine that there are no unnecessary redundancies or omissions in the curriculum. In addition, national benchmarking data including performance on USMLE examinations, review of the AAMC Graduation Questionnaire, the AAMC Missions Management Tool, etc. will be reviewed annually. At least every ten years, the curriculum council will sponsor a retreat for all faculty to perform a comprehensive review of the curriculum.

• Chief Academic Officer: The Dean of the School of Medicine, in his/her capacity as the chief academic officer, reserves the right to veto any decisions made by curriculum council that are deemed to not be in the best interest of the missions of the enterprise.

Exception Requests for MS3 Exams

Background: There should be a fair and equitable process for absences from assessments during the clinical concentrations. Policy: All MS3 students are expected to take clerkship examinations on time. Requests for delaying oral, written, or standardized patient exams must be made with the clerkship coordinator or director using the Exception Request form. The Curriculum Office will have final approval and may consult with the Associate Dean for Student Affairs as the School of Medicine's chief executive proctor for the National Board of Medical Examiners (NBME) shelf exams. If, for any reason, students request to take the exam on a day different from the date scheduled, they may have to pay a fee charged by the NBME. All clerkship examinations that have been postponed, regardless of reason, must be completed by the third Friday of December of the MS4/MS4 year. Exceptions to this date must be approved by the Senior Associate Dean for Medical Education and Student Affairs. M4 Definition of an Acting Internship

Background: Criteria shall be established to delineate a clinical experience as an acting internship.

Policy: An acting internship is a capstone clinical experience focused on experiential learning for medical students nearing graduation. During this rotation, students should demonstrate:

• The knowledge, skills, and attitudes expected of someone who has completed core clinical clerkships

• The ability to create an independent diagnostic and therapeutic plan • The ability to implement the plan of care within a complex healthcare system as allowed by

regulatory and licensure requirements • The professionalism, communication skills, and self-awareness necessary to succeed during an

internship in a rigorous residency training program PCM Equipment Policy

Background: There should be a policy to inform students about the types of medical equipment needed in medical school. Policy: Stethoscope MS1 students are eligible to check out a stethoscope from PCM during the first year of medical school. A limited supply is available on a first-come first-serve basis. The full Stethoscope Loan Policy is posted on the MS1 PCM resources page on the eCurriculum. MS2, MS3 and MS4 students are required to purchase or have access to a stethoscope. Diagnostic Kit Whether to purchase a diagnostic kit is the student’s decision. PCM does not require students to purchase a kit, and PCM does not endorse a specific model or brand. Students do need access to a kit for several MS2 PCM events, such as the Observed H&P, and there are 50 Welch Allyn kits available for loan to students. The full Diagnostic Kit Loan Policy is posted on the MS2 PCM resources page on the eCurriculum. Depending on career choices, students may decide to invest in a diagnostic kit. Students interested in a primary care specialty--such as Pediatrics, Internal Medicine, or Family Medicine--will need a diagnostic kit for residencies and may decide to purchase one. Students interested in Neurology, ENT, or Ophthalmology may also want to buy one. Military students should also consider purchasing one if the military will pay for expense. Surgery, OB/GYN, or Psychiatry related specialties are not likely to need one in the future. Other MS1 students are required to purchase or have access to a watch (digital or with second hand). MS2 students are required to purchase or have access to a watch (digital or with second hand), reflex hammer, penlight, and tuning fork (256 hz). All students are required to have access to a vehicle and be able to drive to locations off campus to participate in clinical activities. Grading Scale for MS1 and MS2 Courses

Background: As all students are encouraged to work to their full potential, the grading system is designed to minimize competition. Students are not graded on a curve or against one another. The

intent of this policy is to create a learning environment that reinforces collaboration, but also defines for students minimum requirements for making satisfactory academic progress. Policy: Grades assigned in the MS1/MS2 years will be Competencies Achieved and Competencies Not Yet Achieved (CA/CN). Competencies will be evaluated using multiple assessment tools. For the purposes of multiple choice examinations, a grade of Competencies Achieved on the examination will be based on the score of 70% or higher. The current system for ranking students based on standard scores will be used and students will be provided with histograms if they would like to review their performance relative to the entire class. For any subject where the student has not achieved competency he/she will be required to remediate by retaking the necessary assessments in the subject. If the student fails to achieve competency on a re-examination, they will be required to repeat the year/semester and pass all courses previously taken. "Incomplete" is not a grade, but a notation that a grade has not been determined since the student has not completed all or part of a course due to extenuating circumstances (e.g., illness, death in the family, etc.). This notation is not used to denote unsatisfactory performance. The Senior Associate Dean for Medical Education and Student Affairs must validate the extenuating circumstances before a student may be granted an "Incomplete." A notation of incomplete will be replaced with a grade if all course materials are completed in the same academic year; otherwise, the incomplete notation will remain and the grade will be reported in the academic year/semester in which all course materials are completed. All incomplete courses must be completed prior to the Promotions Committee meeting of that specific class year/semester. If the material is not completed by the established deadline, the "Incomplete" notation will be converted to a grade of Fail. Students are provided with a grade at the end of each course in the form of a percentage score and final course grade. Students may access their grades through eCurriculum. Final grades for each course are posted for students after a number of tasks have been completed: 1. Scantrons are not reviewed or regraded unless the self-grade was competency achieved and the posted grade is competency not achieved. Only answers on the scantron will be accepted for grading. Answers marked in the test booklet but not accurately transferred to the scantron will not be accepted. (This only applies to the matriculating class of 2012 only.) 2. The Curriculum Office, the Assistant Dean for Pre-Clinical Education and the Course Director(s) carefully review each exam's item analysis and make necessary changes, which might include the acceptance of multiple answers for a question, discarding a question, or the correction of a "mis-key" (typographical error in original entry of the answer to a test question). Student "challenges" or appeals of questions are not accepted. 3. All additional course grade components are entered. This refers to assignments with a pre-established percentage of the final course grade (e.g., lab or written report, peer assessments, etc). 4. All student exam grades are included in the grade report before final grades can be released. Most delays in the reporting of final course grades by the Curriculum Office usually can be attributed to the

entire class not being accounted for in the grade report. Reasons that the entire class may not be represented in the grade report include student(s) taking the test late due to illness, etc. Due to the many tasks, individuals, and offices involved in the grading process, final grades for a course may not be posted for several weeks. Final grades are processed as expeditiously as possible. An announcement will be posted via the Electronic Curriculum Bulletin Board when grades are available. PCM Grading Policy PCM uses the grading model of Competency Achieved / Competency Not Achieved. A student must earn a cumulative final grade of 80% or higher to receive the designation of Competency Achieved. If a student does not earn a cumulative final grade of 80% or higher for the course, he/she will receive the designation of Competency Not Achieved and be required to remediate with a PCM Physician Coordinator and complete an Observed Hospital history and physical and full history and physical write-up. The student must successfully complete this remediation on the first attempt in order to pass or MS2 PCM. Additionally, students must earn a passing grade of 70% or higher for each component to pass PCM. If a student does not earn a grade of 70% or higher for a particular component, he/she will be required to remediate the component and receive a score of 70%. The student must earn a combined passing score of at least 70% to pass the OSCE/CS exam. If the overall combined score is less than 70% the student must remediate. If a student earns below a 70% on one patient but their combined average is above 70%, it will be up to the PCM team to decide if the student will be asked to remediate. Any remediation must be repeated until a passing grade is achieved. Fairfax-Inova/VCU Assignments

Background: There should be a fair and equitable process for determining which students will spend their clinical years on the VCU or Fairfax-Inova Campuses. Policy: Initial Assignments Using a lottery system, students will be placed on either the Inova or Richmond campus for the M3/M4 years. Hardship cases will be taken into consideration in addition to students who express a strong interest in being on the Inova campus. At least 24 students will be placed on the Inova campus for the MS3 and subsequent MS4 years. Should an opening become available to attend Fairfax-Inova, the space will be filled based upon the order in the lottery system. During the MS4 year, students on the VCU campus may take electives on the Fairfax-Inova Campus, and vice versa. Assignment Changes All requests for changes in designation must be accompanied by appropriate justification and made through the Curriculum Office using the Exception Request Form. The Curriculum Office has the responsibility to approve requests for changes in campus designation. Personal circumstances (illness requiring continued therapy in the local area [self, child or spouse], employment status of spouse, child's schooling, primary family relocation, or change in marital status) should be listed on the request form when requesting the campus change. The request will be reviewed and an appropriate course of action will be determined. Approval of requests is contingent upon the reason for the request and the availability of a replacement.

Students who elect to attend Fairfax-Inova will complete all M3 rotations in their entirety on that campus. Students may not switch campuses for rotations without appropriate justification and approval. MS1/MS2 Class Attendance, Etiquette and Professional Behavior

Background: Recognizing that students have different learning styles and that some students study better on their own, the School of Medicine does not require students to attend MS1/MS2 lessons. Class attendance is highly encouraged, however, and students can benefit from the interaction with faculty and students on the material being presented. Students are also expected to conduct themselves in a professional manner in the learning environment. Policy: Attendance at most laboratory, team-based learning, and small group sessions is expected. Most of these sessions will include a peer assessment that counts toward the final grade. In addition, grades from team-based learning activities count towards the final grade for a division and course. PCM, Careers in Medicine, and Learners Involved in Needs of Communities (LINC) courses have their own attendance policies, and students should be familiar with the requirements set forth by the course faculty. MS1/MS2 students are required to attend the Geriatrics Forum held annually. Any absence from PCM, Careers in Medicine, LINC, a scheduled exam or a graded assessment session (CPS session, small group sessions, etc.) requires the student to submit an exception form to the Curriculum Office. (see section Exception Requests and Make-Up Examinations for MS1 & MS2). Students are expected to conduct themselves in a professional manner at all times and observe the following during classes:

• Arrive on time. If arriving late, choose a seat in the back of the classroom/learning theatre. • Turn off, or set to vibrate mode, all communication devices. • Minimize entering or leaving a lesson that is in session. • Do not wear hats or caps. • Do not use seats as foot rests. • Dress appropriately. • No food or beverages other than water may be brought into any of the carpeted learning

spaces. • Use of any electronic device other than the computer being used for administration of an

assessment is prohibited during examinations and assessment. M3 Clerkship Assignments & Attendance

Background: There should be a fair and equitable process for the assignment of students to MS3 clerkships and policies in place to address planned and unplanned absences, holidays and vacations. Policy: Students are given the opportunity to indicate their preferences for their MS3 clerkship rotation schedule in their MS2 year and are assigned to one of 12 schedules using a lottery process. As a general rule, students who are members of the same family (i.e., spouses or siblings) will not be assigned to the same group. Students in dating relationships are strongly encouraged to choose different groups.

Daily attendance is required in all MS3 clerkships. Students are not allowed ‘vacation days’ and clerkships may require that any missed time be made-up during the clerkship or MS4 year. All absences longer than a half-day must be documented with an Exception Request Form available on the eCurriculum and signed by a clerkship director/coordinator and either the Director of the Curriculum Office or the Assistant Dean for Clinical Education. The student must obtain the signature of the appropriate clerkship coordinator or director before submitting it for approval by the Office of Curriculum. Approval by the clerkship does not guarantee approval by the Curriculum Office. The Assistant Dean for Curriculum, the Assistant Dean for Clinical Medical Education, and the Senior Associate Dean for Medical Education and Student Affairs make final approval of these requests. Requests are recorded in the student’s record. PLANNED ABSENCE: When a student needs to request an absence for a day or more of a clerkship or MS3 orientation, a delay in an exam, or a switch of an MS4 elective for an MS3 clerkship, he/she must submit an Exception Request Form to the clerkship leadership and the Curriculum Office. This process should be completed at least two weeks prior to the start of the clerkship. If a need for a planned absence occurs after a clerkship has started, the student should submit the Exception Request Form as soon as possible. PLANNED ABSENCE FOR CONFERENCE ATTENDANCE: Students may request up to a total of four days off during the M3 year for attending validated, school-related conferences, including paper presentations. Students should make every effort to schedule attendance at conferences around M3 clerkship responsibilities, including weekend call and exams. An exception request form, with appropriate signatures, along with proof of conference registration must be submitted to the Curriculum Office at least two weeks prior to the conference. PLANNED ABSENCE FOR EARLY ELECTIVE: A student with a strong academic record applying for match in an early match or competitive residency may request to switch a month of an M3 clinical rotation with an M4 elective. Please review the separate "M3 Clerkship Deferrals Procedure." UNPLANNED ABSENCE: If a student misses time for an unplanned reason (such as illness), he/she must immediately notify: 1) their preceptor, resident or attending, 2) their clerkship coordinator, and 3) the Curriculum Office of their respective campus by 8 a.m. on the day of the absence. An Exception Request Form must be completed and submitted within 24 hours of return. Documentation that the student was seen by a private physician or student health is required for all health related absences for two or more days. HOLIDAYS AND VACATIONS: All holidays and vacations begin at 5PM the day prior to the holiday or vacation. Students are expected to be available to participate in clinical or educational activities until that time. All holidays and vacations end at the beginning of clinical work the day after the holiday or vacation. Students are expected to participate fully in such activities as pre-rounding and rounds on that day. Students on night float rotation may be expected to attend morning round but the night float activities do not begin until the evening following the holiday or vacation. STEP 2 CS: Time off is not granted to take the Step 2 CS exam. Students should plan to take this exam when clinical responsibilities have not been scheduled (i.e. spring break, etc.).

Once a student has requested three exceptions in an academic year, he/she will be required to meet with the Senior Associate Dean for Medical Education and Student Affairs for counseling regarding repeated absences. INCLEMENT WEATHER: All students should follow the decisions of the University regarding closings during inclement weather. If the university is closed, students should not report for clinical responsibilities. If the University is not in session and will not be making a decision to close (for example, during undergraduate spring break), students should follow the decision of the health system. If inclement weather occurs on an on-call evening or weekend and the student is assigned to an inpatient site, he or she is encouraged to report. If this is impossible, students should call/page the resident/attending immediately. If the university is closed due to weather on a test day for the rotation, students should expect to test on the next day that the university is open. If a new rotation is scheduled to begin, students will receive communication from the Curriculum Office or clerkship as to where to report for exams. The orientation for the rotation likely will fall on the following day. Richmond-Based Students: Students should check their VCU email and the VCU alert system for updates. Inova-Based Students: Inova students should follow the Inova Emergency Plan. M3 Clerkship Deferrals Procedure

Background: There shall be a fair and equitable manner for students to defer clerkships to pursue other educational activities in the M3 year. Policy: Students who wish to postpone M3 clerkship time for an early Acting Internship (AI) should meet with the Assistant Dean for Clinical Medical Education to review their plan. For requests that are granted, the student should fill out an Exception Request Form but leave the date section blank. The Exception Request Form should be signed by the Assistant Dean for Clinical Medical Education and submitted to the Curriculum Office without a signature from a clerkship director or coordinator. Students wishing to defer an M3 clerkship should also submit an M3 Rotation Postponement Agreement at this time. Requests will be ranked by the following priority list: 1. Students deferring clerkships for academic, medical, or administrative reasons 2. Students deferring clerkships for AIs in early match residencies (urology, ophthalmology) 3. Students deferring clerkships for AIs in small, competitive fields (dermatology, ENT, neurosurgery, orthopedic surgery, radiation oncology, plastic surgery) 4. Students deferring clerkships for other reasons Within these groups, student requests will then be ranked in the order that the students have submitted an Exception Request Form and Postponement Agreement to the Curriculum Office. Early in the spring semester, the Curriculum Office will contact the students by email in order of rank to offer options for deferral. Each student will have 48 hours to respond with their selection, and changes can only be made after all other students’ initial deferral requests have been addressed. The Curriculum Office reserves the right to deny a student’s request at any time based on scheduling constraints or other logistical issues.

M3 Evaluation Review Policy Background: There shall be a protocol for students to review their written evaluations from M3 clerkships and a method for keeping a record of when students access these evaluations. Policy: Students wishing to review their evaluations may do so under the supervision of the clerkship director or, for certain clerkships, the clerkship coordinator. Students must make an appointment with the clerkship director/coordinator a minimum of one day in advance of the desired evaluation review date to allow the clerkship director/coordinator time to clear his/her schedule in order to ensure student privacy and supervision during the review.

• The clerkship will keep a log of all evaluation reviews including the name of the student reviewing the evaluations, the clerkship team member overseeing the review, and the date and time of the review.

• The student will be allowed access to each evaluation electronically or, if only paper copies exist, on paper. Students may review the content of their evaluations and final grade summary. The clerkship director or coordinator will remain in the office directly supervising the student for the duration of the student’s evaluation review.

• Students may not print or photocopy the contents of their evaluations. If a student would like a copy of his/her educational records, this should be requested through the School of Medicine Registrar.

• Evaluation review provides the student with an opportunity to ask any questions he/she has about his/her final grade or the clerkship’s final grade calculation process. All questions should be directed to the clerkship director, not the clerkship coordinator or individual faculty evaluators. Questions about the grade appeal process should also be directed to the clerkship director.

M3 Grades: Calculation & Release to Students

Background: There shall be a transparent process for calculating and assigning grades in the M3 clerkships, a process for appealing grades and clear guidelines for recording grades on the transcript. Policy: Each clerkship has graded and non-graded evaluations. These assessments are combined to create a letter grade which the individual clerkship committees review to determine the final grade. Graded Evaluations Graded evaluations for all clerkships are divided into two components: ‘Knowledge’ and ‘Performance’. The specific learning activities within each component are defined by the clerkship and will be reviewed with students at the clerkship orientation. For example, the ‘Knowledge’ component generally includes learning activities such as Shelf exams while the ‘Performance’ component includes evaluations of clinical competency by faculty. For each graded activity, an individual student’s performance is compared to the cumulative performance data of all students from the prior academic year and the current academic year’s students who have completed the clerkship as a benchmark population. This comparison will be used to calculate a T-score (mean of 50; standard deviation of 10) for each graded activity. The individual clerkship

defines the weight of each graded activity, which is used to sum all T-scores within the ‘Knowledge’ and ‘Performance’ components. The ‘Knowledge’ and ‘Performance’ components will then be combined to determine the total score with the ‘Knowledge’ component worth 35% and the ‘Performance’ component worth 65%. Each student’s final T-score is compared to the cumulative performance data of the benchmark population. The grading scale standards are: Honors - top 15% or better, High Pass - mean to top 15%, and Pass - less than the mean. Clerkship grading committees may have additional requirements and considerations for each grade. If so, they will be reviewed during that clerkship orientation. Any student receiving an evaluation more than two standard deviations below the mean (T-score < 30) will automatically be assigned a grade of ‘Marginal’ and will be reviewed by the clerkship committee. Other criteria for assigning a less than passing grade are defined by the individual clerkships and will be reviewed at the clerkship orientation. Non-Graded Evaluations Students must successfully complete all clerkship requirements in order to pass the clerkship. These include:

• A rating of ‘met’ on all professionalism evaluations • Passport requirements • Other clerkship-directed assignments or requirements

Students receiving a rating of ‘did not meet’ on professionalism evaluations will receive a non-passing grade. Students not successfully completing any of the other requirements will be reviewed by the clerkship committee. Final Grade Calculation The respective clerkship committees determine final grades and minimum passing standards, including remediation in order to achieve the competencies for the clerkship if the student has a less-than-passing grade. Students should contact the Curriculum Office to schedule clerkship remediation time and the clerkship coordinator to schedule shelf exams retakes. A Marginal grade may be remediated to Pass (P) or a High Pass (HP). A Fail grade may be remediated to a Pass (P). The Marginal or Fail grade will remain on the transcript in the third year. The new grade will be listed next to the original grade on the transcript if the clerkship requirements are completed in the same academic year. Otherwise, the original grade will remain on the transcript for that year and the remediated grade will be reported in the academic year in which the remediated clerkship requirements have been completed. If a student does not pass the remediation assignment, for example the retake of a shelf exam, the student will receive a failing grade in the clerkship and be required to repeat the entire clerkship. Remediation plans may ultimately be rejected by the School of Medicine's Promotions Committee if they believe the plan either does not adequately address the student's academic weaknesses or does not allow a continuity of experiences for the Promotions Committee to assess student progress. If a student receives three less-than-passing grades, the student will be required to repeat the year in its entirety. If a student is in a repeat year, the student must pass all clerkships or be dismissed. A student has the right to appeal a grade. See the "Grade Appeal Process" section below. Incomplete grades are recorded when a student begins a clerkship but does not complete the requirements of a clerkship. The incomplete grade will be replaced with the final grade if the student

completes the clerkship in the same academic year; otherwise, the incomplete notation will remain and the grade will be reported in the academic year in which all clerkship requirements are completed. Grade Appeals Process Students may appeal any component of an M3 grade. The student must file a written appeal with the clerkship director within 30 days of the date that the grade is posted. Students appealing grades assume the burden of proof. The appeal shall state and support with all available evidence the reasons why the student believes the grade should be changed. The student should not approach faculty members or housestaff to appeal a clerkship grade. The Clerkship Director has the option of resolving the appeal, or referring the appeal to the departmental clerkship committee. The Clerkship Director will notify the student and the Curriculum Office about the result within 30 days of receipt of the student's written appeal. If a student chooses to appeal the decision of the department clerkship committee, a second level of appeal is available, if necessary, with the Department Chair reviewing written documentation. The additional appeal and documentation must be received by the Department Chair within 30 days after receipt of the clerkship committee decision. The decision by the Department Chair must be made within 30 days and is final. Grades recorded on the Transcript Per the AAMC guidelines for medical schools regarding academic transcripts, “the academic transcript should reflect the total, unabridged academic history of the student at the institution. All courses should be recorded in the academic period in which the course was taken and graded.” Grades will be recorded as follows if a third year medical student:

• Repeats only the shelf exam due to a Marginal grade, the original M grade remains, and the new revised grade is entered in the repeat column for the M3 Academic Year.

• Repeats part of a rotation due to a Marginal grade, the original M grade remains, and the new revised grade is entered in the repeat column for the M3 Academic Year.

• Repeats an entire rotation (due to a Failing grade for any reason) during the M4 year, the original F grade remains in the M3 year, and the revised grade is entered in the repeat column for the M4 Academic Year.

• Defers part of a rotation to M4 or takes a leave of absence and has an incomplete grade, the INC remains in the M3 year, and the completed grade is entered in the M4 Academic Year.

• Defers an entire rotation to M4, the completed grade is entered in the M4 Academic Year. M3 Late Assignments Policy

Background: M3 assignments must be turned in on time and there should be policy to delineate when assignments are overdue. Policy: • All assignments (including the Passport) are due by 5 PM on the last day of the Clerkship. Each

clerkship will provide a list of required assignments during orientation. • For the midpoint evaluation, the Clerkship will work with the student and the attending physician to

ensure that the assignment is completed on time. • Failure to complete all assignments on time will result in one grade reduction for the Clerkship. (For

example should a student fail to complete all assigned work: honors becomes high pass, high pass becomes a pass, pass becomes marginal).

• After seven days, if the assignments are still incomplete, the student's late assignments and lack of professional behavior will be noted in the Clerkship summary statement and an early professionalism concern note will be filed in the Dean's Office.

• Extenuating circumstances should be discussed with the Clerkship Director prior to the end of the Clerkship. Any appeals can be made through the standard process as outlined in the Medical Student Handbook.

• Reminders will be sent via email prior to the close of the clerkship. Policy for Prevention of Health Professionals Academically Evaluating Medical Students for

Whom They Have Provided Sensitive Health Services

Background: The Liaison Committee on Medical Education Standard MS-27A states: “The health professionals who provide psychiatric/psychological counseling or other sensitive health services to medical students must have no involvement in the academic evaluation or promotion of the students receiving those services.” Policy: Virginia Commonwealth University Student Health Services and University Counseling Services do not employ any health professionals who would be involved in the academic evaluation or promotion of medical students. However, at times students may receive healthcare from professionals outside of these agencies who could potentially be involved in the academic evaluation or promotion process. Virginia Commonwealth University School of Medicine prohibits health professionals who provide sensitive health services to medical students from being involved in the academic evaluation of those students. It is the responsibility and obligation of any health professional that has provided psychiatric/psychological counseling or other sensitive health services to a medical student to recuse himself/herself from any activities involving academic evaluation or promotion of that student. The health professional may engage in teaching activities (e.g., lectures, small group discussions, rounds, etc.) with the medical student, but may not participate in any form of evaluation. The health professional and the medical student are advised to contact the Curriculum Office as early as possible should the potential for this conflict of interest arise. School Closings & Class Cancellation Policy

Background: There should be a method to determine when classes/clerkship experiences will be cancelled and for informing students of such. MS1/MS2

• If the university cancels classes, lessons will not be given. Cancelled lessons may not always be rescheduled. Faculty responsible for the missed lessons (in consultation with the Course Director and the Office of Curriculum) will determine whether the material is sufficiently covered in the course syllabus material, recorded lecture archives or textbooks. If a missed lesson is determined to have been "essential" the lesson(s) will be rescheduled. Announcements will be made to the class, concerning the rescheduled date/time for the missed lesson(s) on the Electronic Curriculum Bulletin Board.

• Laboratories will be rescheduled, if possible. Students should use any canceled lab time to get ahead on other material, so that they can compensate for rescheduled laboratory time. Any change in the testing

or grading of the material is at the discretion of the Course Director. Students will be responsible for and tested on the lesson material that can be found in the textbook, syllabus and or handouts that accompany the missed lesson. School of Medicine Alert Information: For current information on emergency closings, students may consult the VCU alert website (http://alert.vcu.edu/). Students may also call 828-9790 for up-to-date curriculum-related information. University closing information is available at 278-1727. Local TV stations also list school closings. M3

• If the inclement weather is during the week and the university is closed students should not report for clinical responsibilities.

• If the inclement weather occurs on an on-call evening or weekend and the student is assigned to an inpatient site, he or she is encouraged to report. If this is impossible, please call your resident/attending immediately.

• If the weather closes the university on a test day for the rotation, students should expect to test on the next day that the university is open. If a new rotation is scheduled to begin, students will receive communication from the Curriculum Office or clerkship as to where to report for examinations. The orientation for the rotation likely will fall on the following day. Richmond-Based Students: Students should check their VCU email for updates. Inova-Based Students: Inova students should follow the Inova Emergency Plan. M4 On Acting Internships, students should report for duty unless the hospital is closed (i.e. “essential personnel only.”) However, students should use their best judgement – if a student does not feel safe coming in, he/she should notify his/her resident and/or attending immediately. For all other M4 rotations, students should follow the same policies in place for M3 rotations. Terms of Use for eCurriculum

Background: There shall be policy that delineates the use and distribution of intellectual material posted on the e Curriculum. Policy: The lesson recordings, syllabi, PowerPoint slides, and other educational materials posted in the eCurriculum system are for the purposes of personal study. A student shall acquire no intellectual property rights in the recordings, syllabi, and PowerPoint slides or their contents whatsoever, and is absolutely prohibited from posting these materials to an external website, broadcasting or supplying these materials to any other person for commercial gain or otherwise. The content of lessons, lesson syllabi, PowerPoint slides, and other related material may be the intellectual property of the University or individual faculty/tutors, depending in each case on circumstances and interpretation of law. It could be considered a violation of the VCU Honor Code and the Intellectual Property Policy for a student to use these materials except for the express purpose stated above. Any such violation would be punishable as stipulated by the VCU Honor Code, and could include dismissal from VCU.

REQUIREMENTS FOR PROMOTION AND GRADUATION Duration of Degree Completion

Background: The faculty shall determine the maximum amount of time that a student may stay in a program of study toward obtaining the Doctor of Medicine degree. Policy: Students will be allowed six years from the time of matriculation until graduation to complete the requirements of the School of Medicine, or the student will be dismissed. Students are allowed three years to complete the pre-clinical curriculum and three years to complete the clinical curriculum. This is exclusive of time taken for leave of absence or to pursue a dual degree.

Policy regarding United States Medical Licensing Examination (Applies to all students

matriculating in 2012 or earlier) Background: To set parameters to assure that students are making satisfactory academic progress toward attaining national benchmarks for the licensing examination, it should be delineated how often students are allowed to take Step 1, Step 2 CK and Step 2 CS; deadlines by which the examinations must be completed; and allowances for additional study time and outside resources. Policy: All students are required to take the U.S. Medical Licensing Examination Step 1 prior to the start of the clinical rotations. Failure to do so will result in dismissal. The only exception to this policy is students who receive a grade of CN during the M2 year and who must take a repeat examination(s) during the summer break. Those students may postpone the M3 year by up to six weeks for the initial attempt at Step 1. Students are required to pass Step 1 before beginning advanced clinical concentrations. Students are allowed three attempts to pass Step 1. If they do not pass by the third attempt, they will be automatically dismissed. The first attempt must be prior to the start of the M3 year (see exception above). The second attempt must be prior to January 1st of the M3 year and the third attempt must be prior to July 1st of the M3 year. Failure to take the examination by any of the prescribed dates is grounds for dismissal. Students will be allowed up to eight weeks in an Independent Study Elective for preparation prior to both the second and third attempts. Regardless of circumstances, all students must participate in M3 orientation when originally scheduled. Requests to delay the first attempt should be directed to the Curriculum Office and include appropriate justification for the delay. Requests are approved by the Senior Associate Dean for Medical Education and Student Affairs. All students are required to meet with the school designee(s) to prepare an individual study plan for Step 1. After the end of the M2/MS2 year, students are required to take the practice-USMLE examination provided by the National Board of Medical Examiners prior to beginning a plan of study. Students are required to report their results to the school designee(s). Subsequently, students will be required to repeat the examination and report results as deemed necessary by the school designee(s). Students are responsible for the costs incurred to take the practice examinations. All students are required to take the U.S. Medical Licensing Examination Step 2 CK and CS for the first time after completion of their M3 year or by November 1st of the M4 year. Failure to do so will result in dismissal. Students are required to pass USMLE Step 2 CK and CS for graduation. Students are allowed three attempts to pass Step 2 CK and CS. If they do not pass by the third attempt, they will be automatically dismissed. The first attempt for both must be prior to November 1 of the M4 year. The

second attempt for both must be prior to January 15th of the M4 year and the third attempt for both must be prior to April 15th of the M4 year. Students who do not take the examination by these dates may be subject to dismissal for failure to make satisfactory academic progress. Students will be allowed up to an eight-week period in an Independent Study Elective for preparation prior to both the second and third attempts of Step 2 CK. Students will be allowed up to a four-week period in an Independent Study Elective for preparation prior to the second and third retakes of Step 2 CS. Time off from clerkships/elective rotations is not granted to take the Step 2 exam. Students should plan to take this exam when clinical responsibilities have not been scheduled (e.g., spring break, etc.) Students, who for whatever reason, are not on the traditional calendar trajectory for graduation (e.g. dual degree students), will have individualized plans for retaking the USMLE based on the time guidelines above. Students who fail Step 1 or Step 2 may request additional financial aid to take a commercial board prep course. Additional funds will be granted one time only. Studetns must be actively enrolled in the School of Medicine to be eligible to take Step 1 or Step 2 CK/CS, but are not required to be registered in classes (i.e., may take the examination during an approved leave of absence.)

Promotion/Advancement and Graduation, and the Appeals Process

Background: There should be a fair and equitable process to review student progress and for students to appeal adverse actions related to academic promotion/advancement and graduation. Policy: For classes matriculating in 2012 or earlier, the pre-promotions committees (consisting of the M1 and M2 Course Directors for the Pre-Clinical Years and the Clerkship Directors for the Clinical Years) review the progress of every student annually and make recommendations to the Promotions Committee regarding promotion/advancement, dismissal or repeating a year. The pre-promotions committees are chaired by the Assistant Dean for Pre-Clinical Education and Assistant Dean for Clinical Education, respectively (ex officio, non-voting members). The committees evaluate each student who earned an unsatisfactory grade, has demonstrated unprofessional behavior or an overall pattern of failure to make satisfactory academic progress and makes recommendations to the Promotions Committee regarding promotion/advancement, remediation, dismissal or repeating a year. Students who are at risk for an adverse outcome are strongly advised to meet with the Associate Dean of Student Affairs and submit a written letter to the Pre-Promotions and Promotions Committees describing the circumstances from their perspective. The School of Medicine Promotions Committee meets within 48 hours of the Pre-Promotions Committee. The Promotions Committee, consisting of the Chairs of the Basic Science and Clinical Departments, will review the recommendations of the Pre-Promotions Committees and make all final decisions about promotion/advancement, repeating an academic year/remediation and dismissal. The Promotions Committee is chaired by the Senior Associate Dean for Medical Education and Student Affairs (ex officio, non-voting member). The Promotions Committee is charged to give careful attention to all aspects of student achievement, effectiveness, behavior and attitude since matriculation. The Promotions Committee shall not promote/advance any student who has failed to meet the requirements of the preceding year/semester or who appears unfit for the practice of medicine. In consideration of one's fitness for the practice of medicine and in recognition of the critical role of professionalism in being an effective physician, the Promotions Committee shall not promote/advance any student who has demonstrated a significant lack of either integrity or

professionalism as outlined in the School of Medicine Standards of Professional Behavior and the competencies of the School of Medicine. When the Promotions Committee determines by majority vote that a student will not be promoted/advanced, it then recommends remedial activities or dismissal in instances where no remedy is perceived. A student repeating the entire year/semester is expected to achieve competency in all courses taken previously or be immediately dismissed. The Promotions Committee typically uses decisions reached in years past as guidelines for determining its recommendations. For classes matriculating in 2013 or later, the pre-promotions committee consisting of the MS1 and MS2 Course Directors will review the progress of every student at the end of the Scientific Foundations of Medicine, first semester of Applied Medical Sciences and second semester of the Applied Medical Sciences and make recommendations to the Promotions Committee regarding promotion/advancement, dismissal or remediation. This committee will be chaired by the Assistant Dean for Pre-Clinical Education (ex officio, non-voting member). The clerkship directors will serve as the pre-promotions committee for the Clinical Concentrations and Advanced Clinical Concentration and review student progress annually, making recommendations to the Promotions Committee regarding promotion/advancement, dismissal or remediation. This committee will be chaired by the Assistant Dean for Clinical Education (ex officio, non-voting member). Otherwise, the protocol remains the same. Graduation: The degree of Doctor of Medicine will be conferred by Virginia Commonwealth University upon candidates who, in the opinion of the medical faculty, have:

• Attained the School's educational competencies as evidenced by satisfactory completion of prescribed courses, clerkships, clinical experiences and examinations, by proven clinical skills and responsibilities, and by ethical standards.

• Passed Step1, Step 2CK and Step 2CS of the U.S. Medical Licensing Examination before graduation (May of the M4 year).

• Attended the School of Medicine for a minimum of two years, one of which must be an academic year of clinical rotations.

• Discharged all financial obligations to the University. • The School of Medicine requires candidates to be present at both the VCU commencement

exercises and the School of Medicine's own convocation exercises unless excused by the Dean. For classes matriculating in 2013 or later, the following guidelines will apply. It should be noted that these only serve as guidelines for the Promotions Committee which may recommend other remediation or dismissal: MS1/MS2: For the Scientific Foundations of Medicine, the student must achieve competency in each division and have an overall course score of 70% to be promoted to the level, MS2a. If the student fails to obtain competency achieved in one division, they will be allowed to take a re-examination in that division. The re-examination will occur upon return from the Winter Break and if the student scores 70% or higher on the exam, they will be allowed to advance to the next level. If a student’s overall grade in the Scientific Foundations is less than 70% or they have a score of less than 70% in more than one division, or the student fails a re-examination in a single division in which competency is not achieved, they will be required to repeat the entire course the next academic year. The cumulative examination at the end of the course will count 10% toward the final grade in the Scientific Foundations of Medicine. Failure to score 70% on the course cumulative exam will not require remediation of the

exam nor the Scientific Foundations of Medicine course, provided the student has a cumulative average of 70% or higher in the overall course. Students must pass every division in a repeat semester or they will automatically be dismissed. The Applied Medical Sciences is divided into two semesters with two courses scheduled each semester. Students must score 70% or higher in each division of each course and obtain an overall grade of 70% to receive Competency Achieved in a course. If the student does not obtain CA in a single division, they will be allowed to take a repeat examination at the end of that semester in which the CN was received. If they score 70% or higher on the re-examination, they will get Competency Achieved for the course. Failure of a course, failure of more than two divisions in a semester, or failure of the re-examinations will result in the student being required to repeat the semester. Students must pass each division in a repeat semester or they will automatically be dismissed. There are three longitudinal courses: Physician, Patient and Society; Population Health and the Practice of Clinical Medicine. Students must receive competency achieved in each of these courses in order to be promoted to the next level. Failure to obtain CA in these courses will require remediation during the summer. The requirements for remediation will be set by the Course Masters of these courses. Failure to successfully remediate will result in the student being required to repeat the entire year. The Appeal Process Students may appeal decisions of dismissal, except for dismissals by the Honor Council (which should be appealed through the appropriate Judicial Affairs procedures). Students also may appeal decisions to repeat a year/semester or to not be graduated. Such appeals will be heard by the Appeals Committee. The Appeals Committee shall consist of three faculty members, elected by the faculty with staggering terms. One of those members shall be designated by the Dean as the Chair. A student will be granted an appeal hearing only if two senior faculty members selected by the Dean agree that any of these situations occurred:

• The Promotions Committee process was conducted unfairly or without regard to prescribed procedure or protocol.

• There is new evidence or relevant information not available at the time of the Promotions Committee meeting that if consequential, would have altered the decision of the Promotions Committee.

• The original decision was not supported by substantial evidence. • The sanction imposed was disproportionate to the gravity of the situation.

Procedure:

• A student must file an appeal in writing to the Dean's Office within 14 calendar days of the date of the mailing of the student's notice of action of the Promotions Committee. The student will be notified via email and through the postal service. The date of the email marks the official start of the appeal process.

• The student’s appeal will be reviewed by two senior faculty members who will decide if there are sufficient grounds to conduct an appeal hearing. This decision will be made within 14 calendar days of receiving the student’s written appeal.

• If a hearing is warranted, the Appeals Committee will meet within 21 calendar days of the review by the senior faculty members.

• The appealing student has the right to appear before the Appeals Committee, but the time available to him/her may be limited by the Appeals Committee Chairperson. The time limitation will not be less than one-half hour.

• The student may have anyone who would serve him/her as an advisor present during his/her presentation to the Appeals Committee. The advisor may participate in the student's presentation (within the time limits set forth above) and may address questions to the representative of the Promotions Committee.

• The student may have an attorney present, but the attorney may not participate in this academic hearing nor serve as an advisor to the student.

• The appealing student has the burden of proof. The Senior Associate Dean for Medical Education and Student Affairs will present the findings of the Promotions Committee and describe their discussion to the Appeals Committee.

• The student, his/her representative, the Senior Associate Dean for Medical Education and Student Affairs, and the Dean's representative are not present during the deliberations or voting of the Appeals Committee.

• All components of the Appeal Process are recorded except the deliberations. The recording represents the sole, official, verbatim record of the hearing and is the property of Virginia Commonwealth University School of Medicine.

The Appeals Committee will send its findings and recommendation, and the recorded vote to the Dean of the School of Medicine who must act upon the recommendation within 14 calendar days. The Dean’s decision is final and may not be appealed. Students who have been dismissed may reapply to medical school as a matriculating student. Rules Regarding MS1 & MS2 Re-Examinations

Background: There should be a fair and equitable manner for administering re-examinations for purposes of remediation; a designated cut-off for delineating successful remediation; and, a method for indicating successful or unsuccessful remediation on the transcript. Policy: The Promotions Committee may recommend that a student must remediate a poor performance in a course by taking a re-examination that has been prepared by the appropriate Course Director. The re-examination is meant to test the student's knowledge base for a particular course. This method of remediation usually is recommended when a student has earned a grade of Competency Not Achieved. Students who do not pass the re-examination or receive a grade of competency not achieved are required to repeat the year and pass all courses previously taken.

• Unless otherwise stated by the Course Director, a score of 70% or greater is a passing grade on the repeat exam.

• The only grades assigned to re-examinations are competency achieved/competency not achieved. The original grade of competency not achieved for the course will remain on the student's transcript (see "Transcript Entries After Remediation").

• The examination itself must be left with the staff and no part of it may be copied. The answer key is not available to students.

• The examination grade will be disclosed to the student as soon as possible and the grade is final. While the Course Director and the faculty make every attempt to prepare a re-exam that is representative of the course, there is no guarantee that every question would have been emphasized or directly covered in lessons. The re-exams consist primarily of multiple choice question exams, but in some instances may include essay, oral, or practical questions. Students may inquire ahead of time about the nature of the exam so that they may better prepare. Students are encouraged to contact the Course Director of the course in which they must take a re-exam for advice on re-exam preparation and study strategies.

Students may not sit for re-exams until after the Promotions Committee meets to make formal recommendations. MS2 students must successfully complete re-exams prior to taking USMLE Step 1. Withdrawal and Leave of Absence

Background: There should be guidelines and a procedure for students to request a leave of absence and withdrawing from the School of Medicine. Leaves should be limited as to not interrupt the educational program of a student. Policy: A student may not leave school prior to completion of an academic year unless granted a leave of absence by the Senior Associate Dean for Medical Education and Student Affairs or withdrawing. A student who leaves without such permission or who fails to return by the end of the granted term of leave is considered dismissed from the School of Medicine and may return only by applying for readmission as a matriculating student. Typically only one leave of absence will be granted during a student's tenure at the School of Medicine. In an extreme circumstance and with the Senior Associate Dean for Medical Education’s approval, an additional leave of absence may be granted. Students may request a leave of absence for one of the following: 1) Medical/Health 2) Financial 3) Academic 4) Educational/Participation in a joint degree program 5) Personal/Other Students should submit in writing a formal request for a leave of absence and then meet with the Senior Associate Dean for Medical Education and Students Affairs to discuss the leave. Documentation of the need for the leave may be required prior to approval. Students wishing to withdraw from the School of Medicine should submit a letter of intent to the Senior Associate Dean for Medical Education and Student Affairs, and meet with him/her prior to being officially withdrawn. STUDENT AFFAIRS POLICIES AND PROCEDURES

Criminal Background Checks

Background: It is incumbent upon the School of Medicine to determine that matriculating and active students conduct themselves with professional responsibility to the community. Policy: All applicants to The VCU School of Medicine who receive an acceptance will have a criminal background check performed by Certiphi Screening, Inc. If there is a positive finding the student will be notified by Certiphi first, which will allow the student to make corrections to the report and verify the information. If there is no change in status, Certiphi will then notify VCU of their positive findings. The School of Medicine Criminal Background Committee (Senior Associate Dean for Medical Education and Student Affairs, Associate Dean of Student Affairs, Assistant Dean of Academic Affairs Pre-clinical

Curriculum, Director of Admissions and Associate Dean for Admissions) will meet to discuss the Certiphi report to determine if acceptance is to be withdrawn. Certiphi’s report to the school is confidential and cannot be shared with any third parties. Students are encouraged to fully disclose at all times on the AMCAS and supplemental applications as dishonesty will impact the committee’s decision. If a student has a legal finding or institutional action against him/her after the supplemental is submitted, the Office of Admission should be notified immediately. Once an applicant is matriculated full disclosure is also required throughout the time a student is in medical school. Criminal background checks are repeated for all students at the end of the second year and for specific program participations throughout medical school. The same process for review described above is used and evidence of criminal behavior may result in referral to the University Office of Judicial Affairs and/or sanctions up to dismissal from the School of Medicine. HIPAA Requirement

Background: Students shall be trained on federal laws regulating the privacy of healthcare information obtained from patients and their records. Policy: The Health Insurance Portability and Accountability Act (HIPAA) is a comprehensive series of federal laws and regulations dealing with health care issues and the protection of patient medical information. HIPAA requires all individuals having authorized access to patient health information to receive education on new privacy regulations that became effective April 14, 2003. The Virginia Commonwealth University Health System has determined that all students in the schools of Medicine, Dentistry, Nursing, Pharmacy and Allied Health are required to complete the one-hour internet training session. Failure to comply with HIPAA could result in significant fines and liabilities to the VCU Health System. HIPAA establishes criminal penalties (up to ten years in prison) and fines (up to $250,000) on organizations and/or individuals that violate patient confidentiality. Everyone having access to patient health care must be educated about patient confidentiality and be aware of the severe penalties that can be imposed for violating these new laws. HIPAA training is required prior to beginning the M1/MS1 and M3/MS3 years.

Limited Work Hours

Background: Pursuant to LCME standard ED-38, the School of Medicine should have policies in place that define the work hours of students thereby enhancing safety and well-being. Policy: • Students will be on duty no more than an average of 80 hours per week • Students will not spend more than 30 consecutive hours on duty • Students will receive one day in seven free from all educational responsibilities • Students will not be required to take overnight call 2 evenings prior to the end of clerkship subject

exam Mentors/Advisors

Background: The School of Medicine shall have a mechanism in place for advising students throughout the four years of medical school, and in particular, providing advice about electives and career decisions. Policy: Overseen by the Office of Student Affairs, all members of the School of Medicine faculty receive an invitation requesting their participation as a medical student mentor/advisor prior to the start of each academic year. Each faculty member who responds will first be offered training on how to be an effective advisor and then be assigned a group of students. In the M1/MS1 and M2/MS2 years, this is accomplished through Project H.E.A.R.T. (Healing with Empathy, Acceptance, Respect, and inTegrity) where students meet at regular intervals during the academic year in small groups to create caring communities that foster their personal and professional development as physicians. During their M3/MS3 year, students are asked to declare their area of career interest. Students are then assigned a career specific advisor to assist them in creating their M4 elective schedule, help with selection of residency programs in the Match process, and provide general career guidance. The role of the student mentor/advisor is to establish a continuing relationship with individual students, thereby creating a bond and encouraging students to seek advice of all types from a trusted source, referrals being made when appropriate. Often, they are also asked to write letters of recommendation for scholarships, internships, or other programs. The Associate Dean of Student Affairs is also available to assist students with any problems they encounter during medical school and to provide professional guidance with career selection. Medical Student Societies There are four medical student societies that have been designed to create a better sense of community while affording students the opportunity to network longitudinally with fellow students. The societies were named to honor alumnae who made a significant contribution to the field of medicine: Baughman Society: Among the first female graduates of the Medical College of Virginia, Baughman began medical school in 1918 at the age of 44 when MCV first opened its doors to women. She was the second woman to receive an appointment at MCV’s Memorial Hospital before joining the medical school faculty in 1923 as the first female clinical instructor, a privilege she shared with Dr. Charlotte C. Van Winkle. A birth control and family planning supporter, Baughman maintained an active practice in Richmond, participated in variety of community and civic activities, and was widely known for her advocacy of women’s rights. Benacerraf Society: A native of Venezuela, Benacerraf was denied admission to over two dozen medical schools before a family friend secured him an interview with the assistant to the president of the Medical College of Virginia. Benacerraf attended MCV during World War II when the school operated on an accelerated schedule and graduated in 1945. Following graduation, he served in the army before embarking on his remarkable career in medical research. In 1980 Benacerraf with his colleagues Jean Dausset and George D. Snell received the Nobel Prize in Medicine and Physiology. Harris Society: After graduating with honors from Virginia Union University, Harris became the first African American student admitted to the School of Medicine at the Medical College of Virginia. She graduated in the top five of her class earning her degree in 1955. Harris spent three years as an intern and resident at MCV before completing her post-graduate training at the University of Rochester. She served on the School of Medicine faculty during the 1970s before becoming the first African American cabinet member in the Commonwealth of Virginia when Governor John Dalton appointed her Secretary of Human Resources in 1978. The National Governors’ Association recognized her work on the federal and state level by honoring her with the association’s distinguished service award in 1981. At the time of her death Harris was serving as mayor of Eden Prairie, Minnesota.

Warner Society: Warner led the group of four Richmond physicians who organized the Medical Department of Hampden-Sydney College in 1838. A medical graduate of the University of Maryland, Warner taught in Baltimore and at the University of Virginia before relocating to Richmond. He served as the first dean and professor of surgery for the medical school that would become the Medical College of Virginia. Under Warner’s leadership the medical department secured a permanent home with the construction of the Egyptian Building in 1844. Each of the societies has a faculty Society Leader who is available as a resource for students. Job duties of the Society Leaders include:

• serving as an enthusiastic student mentor interested in helping ensure students are receiving academic and personal support using existing university resources;

• helping students plan and implement activities to promote unity and longitudinal peer support within the societies as well as healthy competition between societies;

• promoting wellness including the domains of physical health, emotional wellbeing, proper nutrition, academic support, social life, spiritual life, and community involvement so that medical students can live well-balanced lives;

• serving as a liaison for Project HEART advisors and the Office of Student Affairs to ensure advising is consistent for first and second year medical students;

• serving as a role model professional behavior and be able to assist students address potential mistreatment.

Policy and Procedures for Students with Chronic Hepatitis B

Background: Approximately 800,000 to 1.4 million people in the United States have hepatitis B. 1 In its updated recommendations, the CDC notes several recent instances in which persons with hepatitis B “have been threatened with dismissal or actually dismissed from surgical practice on the basis of their [hepatitis B virus] infection, and others have had their acceptances to medical or dental schools rescinded or deferred because of their infection.” 2Moreover, the Department of Justice and the Department of Health and Human Services have received, and are currently investigating, complaints against medical and dental schools around the country for allegedly discriminating against students and applicants with hepatitis B in violation of the ADA. In fact, the Department of Justice recently entered into a settlement agreement with a medical school and a school of osteopathic medicine resolving allegations that the schools violated the ADA by excluding previously accepted applicants with hepatitis B from their programs. The settlement agreement requires the schools to undertake several actions, including the following: adopt a hepatitis B policy that is consistent with the CDC’s updated recommendations; provide ADA training to their employees; permit the applicants to enroll in the schools; and provide the applicants with a total of $75,000 in compensation and tuition credits. In light of this, the Departments of Justice, Health and Human Services, and Education are concerned that some health-related schools may be making enrollment decisions based on an incorrect understanding of the hepatitis B virus, resulting in unlawful discrimination. On July 6, 2012, the Centers for Disease Control and Prevention (CDC) published the Updated CDC Recommendations for the Management of Hepatitis B Virus-Infected Health-Care Providers and Students. 3 With respect to students with hepatitis B, CDC’s updated recommendations aim to promote patient safety while providing risk management and practice guidance to students and health-care providers with hepatitis B.

Among other things, the CDC provides the following new recommendations for the management of students who have hepatitis B: • Chronic hepatitis B virus infection, in itself, should not preclude the study or practice of medicine, surgery, dentistry, or allied health professions. • Practices that restrict students from the study of medicine, dentistry, or surgery – such as prenotification to patients of the hepatitis B status of their health-care provider – should be discouraged. • Medical and dental students with chronic hepatitis B virus infection (i.e., those who are HBsAg-positive) who do not perform exposure-prone invasive procedures but who practice non- or minimally invasive procedures should not be subject to any restrictions of their activities or study. • While medical and dental students with chronic hepatitis B virus infection may have restrictions imposed on their participation in exposure-prone invasive procedures, exposure-prone invasive procedures are not ordinarily performed by students fulfilling the essential functions of a medical or dental school education. • Standard precautions should be rigorously adhered to in all health-care settings. The CDC recommends that DNA serum levels be relied on, rather than hepatitis B e-antigen status, to monitor infectivity and states that individuals with hepatitis B can conduct exposure-prone invasive procedures if a low or undetectable hepatitis B viral load is documented by regular testing at least every six months. The CDC also recommends that a hepatitis B viral level of 1,000 IU/ml (5,000 GE/ml) or its equivalent is an appropriate viral load threshold for a review panel to adopt. The CDC stresses that for most students with chronic hepatitis B “who conform to current standards for infection control, [hepatitis B virus] infection status alone does not require any curtailing of their . . . supervised learning experiences” because those experiences generally do not include exposure-prone invasive procedures. In fact, the CDC noted that since its last update in 1991, there have been no reports of hepatitis B transmission in the United States or other developed countries from “medical or dental students . . . or any others who would not normally perform exposure-prone invasive procedures.” 4 CDC notes the challenges posed in defining exposure-prone invasive procedures that pose a risk for hepatitis B virus transmission and cautions against defining “exposure-prone procedures too broadly; the great majority of surgical and dental procedures have not been associated with the transmission of [hepatitis B virus].” CDC classifies exposure-prone invasive procedures as “limited to major abdominal, cardiothoracic, and orthopedic surgery, repair of major traumatic injuries, abdominal and vaginal hysterectomy, caesarean section, vaginal deliveries, and major oral or maxillofacial surgery (e.g., fracture reductions).” Policy: VCU School of Medicine students who are determined to have Chronic Hepatitis B upon matriculation to medical school or at any annual health screening performed by the VCU Student Health Center or their private physician will be referred for review by the VCU Health System Blood Borne Pathogens Committee. The committee consists of experts in the field of infectious disease and hepatology as well as representatives from Employee Health, Graduate Medical Education, and VCU School of Medicine Student Affairs. Recommendations will be made on an individual basis concerning the student’s ability to perform exposure-prone invasive procedures based on the latest recommendations from governmental agencies, professional societies, as well as the state-of-the-science.

Written recommendations from the committee concerning the student’s ability to perform exposure-prone invasive procedures and requirements for screening / follow-up will be sent for review by the Dean of VCU School of Medicine; the decision of the Dean is final regarding the written recommendations. The written recommendations will be reviewed on an annual basis while the student in enrolled at VCU School of Medicine, and the student will be required to perform routine testing as documented in the written recommendations. A copy of the written recommendations will be given to the student and will be placed on file in the Office of Student Affairs. The Office of Student Affairs will be responsible for providing a copy of the written recommendations to the clerkship director at the beginning of each clinical clerkship / elective experience where the student’s ability to complete the duties of the clerkship / elective experience may be impacted by the written recommendations. Policy and Procedures Related to Hooding Activities at the School of Medicine Convocation

Ceremony Background: The Virginia Commonwealth University School of Medicine convocation ceremony is a formal and dignified event that publicly recognizes students who have successfully completed the requirements established by the faculty to be eligible for a Doctor of Medicine degree. It is also a ceremony where this is formally recognized with the mantle of medicine, as represented by the green hood, which is passed on from one generation of physicians to those who will be entering this noble profession. Therefore, to protect the decorum demanded by this ritual, and to acknowledge the authority of the medical faculty to bestow this honor, the following policy and procedures will be followed regarding hooding during the School of Medicine Convocation Ceremony. Policy

• The M4/MS4 class will select two honorary hooders from the Virginia Commonwealth University School of Medicine faculty. This selection process will be carried out by the M4/MS4 class officers with oversight by the Associate Dean of Student Affairs. These individuals will serve as the official hooders for the Convocation Ceremony. These individuals will be the only hooders for the Convocation Ceremony.

• Only faculty with a terminal Doctor of Medicine degree may be eligible to serve as hooders. • Hooders must be dressed in full academic regalia including cap, gown and hood from the School

of Medicine from which they were graduated. • Students receiving an MD/PhD will be hooded by the director of that program. • Students from the Inova campus will be hooded by the Associate and Assistant Deans for that

campus. Policy and Procedures Requiring Health Insurance for Undergraduate (First Professional)

Medical Students Enrolled in Virginia Commonwealth University School of Medicine Background: The School of Medicine shall have in place a policy requiring students to have health insurance; defining minimal requirements; and, delineating methods for monitoring compliance. Policy: All first professional medical students enrolled in Virginia Commonwealth University School of Medicine shall be required to have an active health insurance policy. The health insurance policy must provide coverage for a 12-month calendar year. Students are required to purchase the health insurance policy provided by Virginia Commonwealth University or provide the School of Medicine with an affidavit from their personal insurance provider documenting comparable coverage.

Medical students shall provide documentation of the above on an annual basis as delineated under section "Procedure." Procedure: At the time of matriculation, medical students shall provide to the Admissions Office of the School of Medicine documentation that they have either purchased the University health insurance policy or an affidavit from their personal insurance provider that they have comparable coverage. Transfer medical students shall present the same documentation at the time of matriculation to the Office of Student Affairs of the School of Medicine. Within 30-days of the beginning of their individual class academic years, M2, M3 and M4 (MS2, MS3 and MS4) students shall present to the Office of Student Affairs of the School of Medicine documentation that they have either purchased the University health insurance policy or an affidavit from their personal insurance provider that they have comparable coverage. Recertification shall occur annually in accordance with the guidelines afore mentioned. Students who are participating in the M.D./Ph.D. program will follow the documentation and recertification protocol described above for medical students throughout their matriculation at Virginia Commonwealth University. A copy of the documentation required shall also be provided annually by the student to the Office of the Director of the M.D./Ph.D. Program and the academic department in which the Ph.D. degree training is based as appropriate. A comparable protocol will apply to students participating in other joint programs based, in whole or in part, in the School of Medicine (e.g. M.D./M.P.H., M.D./ M.H.A.). Failure to provide the necessary documentation as outlined in previously may preclude matriculation or continuation in a course of study at Virginia Commonwealth University School of Medicine until the documentation is provided. Policy and Procedures Requiring Immunizations and Regular Documentation of Healthcare

Status for Medical Students Enrolled in Virginia Commonwealth University School of Medicine Background: The Code of Virginia (Section 23-7.5) requires all full-time students to provide documentation of their immunization status by a licensed health professional. Furthermore, Virginia Commonwealth University Health System, Medical College of Virginia Hospitals and Physicians has established an Infection Control Policy. The purpose of the policy is to establish guidelines to protect health care workers (HCWs) and patients from communicable diseases that might be acquired in the health care setting. These guidelines apply to all HCWs performing patient care duties at VCU Health System. Although medical students are not employees of the VCU Health System, they perform activities involving patient contact that is in concert with that provided by HCWs. Therefore, to protect the medical students and patients from communicable diseases, it is prudent that a policy be established recognizing the requirements of the Code of Virginia and consistent with that enforced by the VCU Health System. Policy: At the time of matriculation, all medical students are required to present to University Student Health Services a Certificate of Immunization. The Certificate of Immunization requires the following with specific amendments pertinent to medical students:

• All medical students must provide proof of an adult booster dose of the combined Tetanus, Diphtheria and Pertussis (Tdap) Vaccine unless medically contraindicated. A dose of Tetanus, diphtheria (Td) given within the last 10 years is required for those students unable to receive Tdap.

• Hepatitis B series completed within six months of matriculation or serological confirmation of immunity or a signed Hepatitis B vaccine waiver. After completion of the series, serological confirmation of immunity is recommended, but not required. NOTE: Students must present documentation of a completed Hepatitis B series to University Health Services within six months of matriculation if the series was not completed prior to that time. If a student signs a Hepatitis B OSHA vaccine waiver, serological confirmation of status, including a Hepatitis B surface antigen, must be provided.

• Measles (Rubeola), two doses of vaccine required (after first birthday and 1967) or serological confirmations of immunity (lab report must accompany the Certificate of Immunization).

• Mumps, two doses required, after first birthday and 1967 or serological confirmation of immunity (lab report must accompany the Certificate of Immunization).

• Rubella, two doses required, after first birthday and 1969 or serological confirmation of immunity (lab report must accompany the Certificate of Immunization.

• Meningococcal vaccine or a signed Meningococcal vaccine waiver. • Tuberculosis screening through the administration of a tuberculosis skin test (TST) dated within

3 month of the first day of orientation, is required. Students who have a documented positive TB skin test must submit a copy of their chest x-ray report and complete a symptom review upon arrival on campus. All TSTs and chest x-rays must have been performed in the United States. All medical students are required to participate in annual TB skin testing programs provided through University Student Health. All students with a history of a positive TST, must report annually to University Student Health for a symptom review. The need for additional testing will be at the discretion of the staff of University Student Health.

As specified in Section 22.1-271.C.(II) of the Code of Virginia a physician or health department official may certify that administration of any one or more of the required immunizations would be detrimental to the student’s health allowing for a medical exemption. Any student who objects on the grounds that administration of immunizing agents conflicts with his or her religious tenets or practices shall be exempt from the immunization requirements unless an emergency or epidemic disease has been declared by the Board of Health. An affidavit of religious exemption must be submitted on a Certificate of Religious Exemption (Form CRE-1) which may be obtained at any local health department, school division's superintendent's office or local department of social services. All visiting medical students are required to complete a Certificate of Immunization returned to the Electives Office and copied to University Student Health Services prior to approval of the elective. All students are strongly encouraged to receive the influenza vaccine annually. Varicella screening is required for all medical students. Students with a history of varicella disease should submit serological confirmation of immunity to varicella. Students who have received TWO doses of varicella vaccine are considered adequately immunized as serological screening for immunity is not recommended after vaccination. Students who have had one dose of varicella vaccine will need to receive a second dose of vaccine and are then deemed fully vaccinated. Procedure: All records on immunizations status and continued immunizations for matriculating, enrolled and visiting students shall be kept in University Student Health Services.

Prior to the beginning of the fall and spring semester of each academic year, the Office of Students Affairs shall provide a roster of all currently enrolled students to University Health Services. University Health Services will check this roster against their record of students' immunizations. If a student is deficient in completion or updating of his/her immunization status, University Health Services shall record this information in University Records and Registration precluding the student from registering that semester until the immunization status has been satisfied. Revised and Approved by Curriculum Council on May 24, 2007. Pre-Preceptorship and Pre-Clerkship Drug Testing

Background: Virginia Commonwealth University School of Medicine is committed to training students to provide safe and efficient patient care in an educational environment that is drug free. Additionally, many local, regional, national, and international programs require students to complete a Drug Test prior to placement in clinical elective and preceptorship opportunities. As such, this policy establishes procedures for Pre-Preceptorship and Pre-Clerkship Drug Testing of all Medical Students upon matriculation to VCU School of Medicine and prior to the start of their Preceptorships and Clinical Clerkships. Policy: All Medical Students upon matriculation to VCU School of Medicine will be required to take a Pre-Preceptorship Drug Test. Additionally, all Medical Students prior to the start of the M3 year will be required to take a Pre-Clerkship Drug Test. A positive Drug Test will be reviewed by the Medical Review Officer for VCU School of Medicine, and results will be released to the Senior Associate Dean for Medical Education and Student Affairs. Positive Drug Test results may result in the dismissal of the student from the educational program. Definitions: The following definitions shall apply for purposes of this policy only:

• Clinical Clerkships: A clinical experience in one of the seven core specialties (Family Medicine, Internal Medicine, Neurology, Obstetrics/Gynecology, Pediatrics, Psychiatry, and Surgery) completed by Medical Students in their third year of training.

• Controlled Substance: A Drug or substance listed in Schedules I through VI of the Drug Control Act of Virginia (Code of Virginia, §§54.1-3446 through 54.1-3456 (1950), as amended) and Schedules I through V of the Federal Controlled Substances Act (21 U.S.C. §812).

• Drug: Any Controlled Substance, or any substance other than alcohol, capable of altering the mood, perception, or judgment of the individual consuming it.

• Drug Test: A laboratory test administered for the purpose of determining the presence of absence of a Drug or its metabolites.

• Medical Student: An individual who is enrolled in VCU School of Medicine and is pursuing degree requirements to obtain a Doctorate of Medicine degree.

• Pre-Clinical Clerkship Drug Test: A Drug Test conducted prior to the start of M3 clinical clerkships.

• Pre-Preceptorship Drug Test: A Drug Test conducted upon matriculation to VCU School of Medicine and prior to starting clinical Preceptorships during the first two years of medical school.

• Preceptorship: A clinical experience required of all medical students during the M1/M2 Foundations of Clinical Medicine course.

Procedures:

• All Medical Students will be informed that their ability to participate in a Clinical Clerkship or Preceptorship is contingent upon taking and passing a Pre-Clinical Clerkship Drug Test and a Pre-Preceptorship Drug test, respectively.

• The Office of Student Affairs will schedule each Medical Student for Pre-Preceptorship Drug Testing to occur during the M1 Orientation Week upon matriculation to VCU School of Medicine, or will provide instructions for alternative testing methods; this testing must occur within 30 days of matriculation to VCU School of Medicine. The Office of Student Affairs will also schedule each Medical Student for Pre-Clinical Clerkship Drug Testing to occur during the M3 Orientation Week prior to the start of Clinical Clerkships, or will provide instructions for alternative testing methods. Medical Students will not be allowed to complete Preceptorships or Clinical Clerkships until the Drug Test is performed and passed.

• Medical Students will be asked to sign a consent form allowing the Drug Test and the release of test results to VCU School of Medicine. Any Medical Student who chooses not to participate in the Drug Testing process will be immediately dismissed from VCU School of Medicine.

• The Medical Director of Employee Health Services who serves as the Medical Review Officer (MRO)/designee, will make the final determination regarding test validity, and may request re-analysis of the original sample or the collection or a new sample.

• Medical Students whose test results are positive will be contacted by the MRO to discuss test results. Medical Students with positive test results will be informed that they have the option of having the same sample retested. New samples may not be submitted unless requested by the MRO. The cost of the initial Pre-Preceptorship and Pre-Clinical Clerkship Drug Tests will be paid by VCU School of Medicine. When a Medical Student requests a retest following a positive test result, the cost of the retest will be the responsibility of the Medical Student.

• If, following discussion with a Medical Student about a positive test result, the MRO determines that a legitimate explanation exists for the result, the MRO will report that the Medical Student has passed the Drug Test and is eligible to participate in Preceptorships / Clinical Clerkships.

• The MRO will share his/her report with the Senior Associate Dean of Medical Education and Student Affairs.

• Medical Students who pass the Drug Test will be eligible to participate in Preceptorships or Clinical Clerkships. Medical Students who do not pass the Drug Test will be reviewed by the Criminal Background Check Committee (refer to policy on Criminal Background Checks) and subject to disciplinary action including referral to the Office of Judicial Affairs to dismissal from the School of Medicine.

• All Drug Testing information will be treated as confidential and shared only with those persons who have a work-related need to know and/or as required by law.

Recommendations for Professional Attire Background: It is important that everyone who is involved in providing clinical serves at Virginia Commonwealth University School of Medicine (VCUHS) present a professional appearance to patients and families. The purpose of the dress code is not to inhibit personal freedoms, but rather to acknowledge the unique role that physicians and medical students have in patient care. Each clinical department or division has the right to establish dress codes specific for their area and patient population, but here are some general guidelines. Policy: Uniforms or business attire, representative of a professional career, are expected and should be clean, neat and of appropriate size. Appropriate dress for male medical students is shirts, ties, and

pants. Female medical students should wear dresses or skirts of knee length or longer or dress pants and blouses. Exposure of the abdomen or chest due to low cut blouses or pants, is not appropriate. Please follow these other specific requirements as well: • Scrubs should only be worn in designated areas. • Jewelry and perfume/cologne should be worn at a minimum or not at all. • Earrings should be worn in a professional manner and are limited to one to two per ear. • With the exception of ear piercing, there will be no visible body piercing, including but not limited to

tongue piercing, nose piercing, and eyebrow rings/bars. • Hair should be clean, well groomed, and worn in such a manner that it will not interfere with patient

care or job duties and will present a professional image. • Facial hair must be trimmed and kept clean. • Hats are not allowed. • Women may wear make-up in moderation. • Fingernails should kept short, clean, neatly manicured and not extend one-quarter inch past the

fingertips. Artificial nails and nail jewelry are prohibited per Health Department regulations in any patient care role. Artificial nails are defined as any application of a product to the nail to include, but not limited to, acrylic, overlay, tips or silk wraps (does not refer to nail polish). Chipped nail polish is not permitted.

• There will be no visible tattoos; any visible tattoo must be covered with a bandage or clothing. • Shoes should be close toed and non-skid shoes of low or moderate heel are recommended. Wearing the VCUCard is required as well. All persons who provide care or services to Virginia Commonwealth University Health System customers must display proper identification that includes their name, job title, and the department to which they are assigned. The VCUCARD MUST be worn at all times, face forward and above the waist, for easy identification. Failure to wear the ID could result in denial of access to clinical assignment areas. Always wear a white coat and name tag, unless in the prison unit or directed otherwise by the unit. Multiple studies have shown that the physical appearance of a physician impacts on the comfort level of the patient. The more comfortable patient is more likely to provide complete and accurate information. A survey of several hundred patients in 2002 showed results similar to those performed 20 years earlier. Characteristics deemed undesirable by patients included sandals, clogs, blue jeans and tennis shoes, regardless of the gender of the health care provider. Long hair, cologne, surgical scrubs and non-traditional hairstyles in male health care providers were also undesirable. Characteristics that were found desirable for both male and female health care providers included the wearing of a name badge, white coat, dress shoes and a traditional hairstyle. For men, dress pants and for women, a skirt or dress was considered most desirable. Refer to the Professionalism website: Recommendations for Professional Attire. http://www.medschool.vcu.edu/professionalism/standards/pro_attire.html

Student Organizations Registration

Background: There should be guidelines for the operation of student organizations, oversight of funding and provisions for nomenclature.

Policy: Students desiring to establish a new organization, reactivate an organization or register an existing organization at the University must complete and submit to the School of Medicine Office of Student Affairs a Student Organization Registration Form. All established and currently existing organizations must complete and submit to the Office of Student Affairs of the School of Medicine a Student Organization Registration Form by September 30th of each academic year. Student Organization Registration Forms for any new or reactivated organization may be submitted anytime during the academic year. Registration forms will not be accepted if:

• The form is incomplete • The form lists officers and members who do not meet the established enrollment criteria • The form contains incorrect information < • The objectives or operation of the organization are inconsistent with the mission of the

University, or in violation of University policies or local, state or federal statutes. By completing the Registration Form, the organization and its members agree that the purpose of the organization is consistent with the mission of the University for student organizations. Registration does not imply University approval of the organization and its goals. The organization will not use the University or School of Medicine name, logo, or an abbreviation of the University or School of Medicine name, in the name of the student organization in such a manner to suggest that the University or School of Medicine sponsors the organization. Student organizations may use "at VCU" following the name of the student organization, so that the location of the organization is reflected in the name. This restriction applies to references to the organization in any medium, including web sites. Members also agree that the purposes and activities of the organization are not in violation of local, state or federal statutes or of University regulations or objectives as published by the University. A registered organization will conduct its affairs in a lawful manner and in accordance with the constitution and bylaws it has on file (or in accordance with procedures as stated on its application) and in observance of the applicable University regulations and local, state and federal statutes. The organization also will be responsible for the observance of all applicable University regulations and other local, state and federal statutes by off-campus individuals or organizations participating in the activities of the student organization. Funds Under no circumstances may a Student Organization use the University's tax-exempt status or federal identification number for purposes of soliciting or obtaining funds. Each organization is responsible for maintaining appropriate financial records. Each organization is solely responsible for any debts incurred by the organization. It is recommended, but not required, that Student Organizations maintain a University account rather than an individual banking account. All organizations obtaining funding through the Medical Student Government of the School of Medicine or the School of Medicine Annual Fund are required to maintain these funds in a University account. Organizations obtaining funding through the Medical Student Government of the School of Medicine or the School of Medicine Annual Fund are required to state on all printed material and in all advertisements that the event or organization is funded fully or in part by the above entities. In addition, organizations obtaining funding through the School of Medicine Annual Fund are asked to use the annual fund logo on all promotional activities. Student organizations should contact the Development Office for the School of Medicine prior to soliciting funds from alumni, major donors, foundations and corporations, including pharmaceutical companies. Student organizations should contact the Student Affairs Office for the School of Medicine prior to soliciting funds from faculty or University departments.

Travel The Annual Fund does not provide money for student travel. However, the American Medical Student Association, the student branch of the American Medical Association, Women in Medicine and the Student National Medical Association have separate lines of funding through the Office of Student Affairs. Funds for SNMA are managed by Donna Jackson, Director of Student Outreach. For AMSA, AMA and WIM funds are managed by the Office of Student Affairs. Prior to travel, a designated representative of the student organization should submit a travel authorization form to the Associate Dean of Student Affairs for signature. After travel, a designated representative of the student organization should submit a travel reimbursement form with the necessary documentation to substantiate expenses. All activities involving travel outside the United States or welcoming/ hosting international guests to Virginia Commonwealth University need to be registered with the Executive Director of the Office of International Education. Other Activities All other activities initiated/conducted by individuals or organizations are considered private events. The individuals or organizations initiating/conducting such activities assume sole responsibility and liability. Student Records

Background: There shall be guidelines for functioning of the registrar; release of student records; and, a protocol for students to challenge the contents their records. Policy: The Registrar regularly updates student records for the School of Medicine including:

1. Change of address and/or change of name 2. Transcripts (unofficial and official) 3. United States Medical Licensing Examination information 4. Marital status

The Registrar, the Student Affairs Office or the Curriculum Office also can officially confirm full-time student status to outside organizations that may require such confirmation (e.g., automobile insurance companies, armed services organizations). Students may update their addresses and other information on eCurriculum. It is the responsibility of the student to make sure the Registrar has the most current mailing address, phone number, marital status and emergency contact information on file. Students may update this information in eCurriculum through the Student Record System. Information contained in student records is subject to the Family Educational Rights and Privacy Act (FERPA). The School of Medicine will only release information publicly as defined by FERPA guidelines. Those with a legitimate educational interest in a student may view a student’s record at the discretion of the Registrar. For all others, the Registrar will require written consent from the student. Students may request to review or make copies of their records by submitting a written request to the Registrar specifically noted what they wish to review or copy. The Registrar will honor such requests within 45 days of receiving it. Students may not access records where they have waived this privilege (e.g., letters of recommendation). Students may request an amendment to the information in their permanent record. This may be done informally through a meeting with the School of Medicine Registrar. If resolution cannot be made, the student may meet with the Senior Associate Dean for Medical Education and Student Affairs who will make a final decision about changing a student’s record. If there are no changes to the student’s record,

the student may submit a written notation of disagreement with the record which will become a permanent part of the student file. Student Scholarships

Background: There shall be a fair and equitable manner for the distribution of student scholarships. Policy: Students are awarded scholarships based on criteria established by donors of the various scholarships. Criteria vary and include such things as financial need and/or academic merit, community service, leadership, geographic considerations, specialty interest, etc., or a combination of these. Chaired by the Assistant Dean of Student Affairs and Financial Aid, the School of Medicine Scholarship Committee is responsible for making the awards of both need and merit based scholarships. The Scholarship Committee is made up of representatives from the Admissions Office, and the Offices of Curriculum and Student Affairs. All students, including those currently receiving scholarships, must file the Free Application for Federal Student Aid (FAFSA) with their information as well as NeedAccess including parental information annually by May 1. It is also important to keep up-to-date the extra-curricular section of the Student Record System so the Scholarship Committee knows the type of interests a student has pursued as this may be germane to the specific criteria for funding.

Students' Bill of Rights and Responsibilities and Mistreatment Prevention Policies

Background: Virginia Commonwealth University is an academic community given meaning through the mutual respect and trust of the individuals who learn, teach, and work within it. Each member of this community is entitled to certain rights and privileges which must be protected through fair and orderly processes and which are best safeguarded when members act in an orderly and responsible manner. Each member of the University community is equally entitled to the protection of this document. The University is committed to providing equal access to educational and occupational opportunities in an environment conducive to academic freedom and free inquiry. The principle of academic freedom requires all persons to respect another’s dignity, to acknowledge another’s right to express differing opinions, to cultivate and to cherish intellectual honesty, and to promote freedom of inquiry and expression. It is therefore the policy of the University that no act of any member of the University community shall serve to restrain or inhibit access to opportunities or the exercise of these freedoms. As provided for in University Rules and Procedures, no person, either singly or in concert with others, shall willfully: • Discriminate against another person on a basis not reasonably related to the educational or job

functions involved on the basis of race, ethnicity, sex, religion, color, creed, disability, sexual orientation, marital status, and age.

• Harass or intimidate any person. • Cause physical injury or threaten any person with force or violence. • Have in his or her possession any firearm, other weapon, or explosive, regardless of whether a

license to possess the same has been issued, without the written authorization of the president of the University. This restriction does not apply to persons whose duties lawfully require the possession of firearms or other weapons.

• Disrupt or prevent the peaceful or orderly conduct of classes, lectures, meetings, or other University functions, or interfere with the lawful freedom of other persons, including invited speakers, to express their views.

• Falsify or forge an official University record or document; or file documents with the University with the intent to mislead.

• Lie, cheat, steal, or plagiarize. Violations of lying, cheating, plagiarism, and stealing will be adjudicated through this or other applicable documents. Student academic violations of lying, cheating, plagiarism, and stealing will be referred to the VCU Honor System for adjudication.

• Violate any duly authorized University rule or regulation issued pursuant to a specific University function, for example, regulations applicable to social events, the library, or University hospitals.

• Incite others to commit any act which has been herein prohibited. • Bring charges against a member of the University community that are spurious, or that are intended

primarily to harass or maliciously defame, or that are designed to intentionally overburden the adjudicatory system.

The Virginia Commonwealth University Rules and Procedures website (http://www.provost.vcu.edu/pdfs/rulesandprocedures.pdf) compiles policies and guidelines developed by Virginia Commonwealth University and the School of Medicine governing many aspects of the learning environment, which help define student rights and responsibilities. A detailed explanation of most policies, how to proceed if a policy is violated, as well as applicable penalties and other disciplinary action may be found in the VCU Resource Guide at http://www.students.vcu.edu/rg/. If not contained in the Resource Guide, a specific link is provided for additional information. Policy: The School of Medicine’s Learning Environment Principles and Guidelines The VCU School of Medicine is committed to diversity and equal opportunity, placing a high value on facilitating an environment conducive to learning for all students. The relationship between teacher and learner bears continued, close examination and requires a commitment to the highest standards of professionalism and ethics. Learning climate enhancement is similarly an important aspect of the Liaison Committee on Medical Education’s accreditation process. Preventing mistreatment of medical students through policies for reporting, investigating and resolving allegations of mistreatment is the responsibility of the Senior Associate Dean for Medical Education and Student Affairs. The objectives of the School of Medicine’s Learning Environment Principles and Guidelines are three fold: 1. To define standards of conduct among all members of the VCU Health System community and participants in medical education on all teaching campuses, specifically the teacher/learner relationship; 2. To administer a process for handling complaints of student mistreatment (reporting, investigating and resolving); and 3. To monitor issues and trends and educate the Health System community on learning environment enhancement and the prevention of student mistreatment. Standards of Conduct: Teacher/Student Relationship

• VCU School of Medicine Standards of Professional Behavior

(http://www.medschool.vcu.edu/professionalism)-- These standards describe behaviors expected from all members of the School of Medicine (SOM) community in all educational, clinical, research and administrative settings. Professionalism is expected during all interactions, whether face-to-face

or via telephone, video, email, or social networking technologies. Conduct, both on and off campus, must adhere to these standards.

Members of the SOM Community will: Recognize their positions as role models for others in all settings. Carry out academic, clinical and research responsibilities in a conscientious manner, make every

effort to exceed expectations and make a commitment to life-long learning. Treat everyone in the SOM community with sensitivity to diversity in culture, age, gender,

disability, social and economic status, sexual orientation, and other personal characteristics without discrimination, bias or harassment.

Maintain patient, research subject, and student confidentiality. Be respectful of the privacy of all members of the SOM community and avoid promoting gossip

and rumor. Interact with all other members of the SOM without arrogance and with respect and recognition

of the roles played by each individual. Provide help or seek assistance for any member of the SOM community who is recognized as

impaired in his/her ability to perform his/her professional obligations. Be mindful of the limits of one’s knowledge and abilities and seek help from others whenever

appropriate. Abide by accepted ethical standards in scholarship, research and standards of patient care. Abide by the guidelines of the VCU Honor System and Rules and Procedures.

• Proper Conduct in Instructional Settings

The University is a community of learners. Students, as well as faculty, have a responsibility for creating and maintaining an environment that supports effective instruction. In order for faculty to provide and students to receive effective instruction in classrooms, laboratories, studios, online courses, and other learning areas, the University expects student to conduct themselves in an orderly and cooperative fashion (http://www.students.vcu.edu/insider.html).

• The Association of American Medical Colleges Definitions of Mistreatment The Association of American Medical Colleges (AAMC) describes eight general areas of student mistreatment: Public belittlement or humiliation Threats of physical harm or actual physical punishment Requirements to perform personal services, such as shopping Being subjected to unwanted sexual advances Being asked to perform sexual favors in exchange for grades Being denied opportunities for training because of gender, race/ethnicity or sexual orientation Being subjected to offensive remarks/names directed at you based on gender, race/ethnicity or

sexual orientation Receiving lower grades or evaluations based on gender, race/ethnicity or sexual orientation The AAMC recommends use of their Graduation Questionnaire, which the VCU School of Medicine embraces and regularly administers. In this way, the School of Medicine fulfills its learning environment guidelines to monitor issues and trends in the area of student mistreatment.

• Harassment

Often students, as well as employees, use the term “harassment” to describe unwanted conduct and behaviors directed toward them by a peer or a superior, which they find offensive or

demeaning. The term can have many meanings, however, and misuse of the term can lead to miscommunication and frustration over the best way to resolve the damage to relationships caused by what is perceived to be harassing behaviors. Unlawful Harassment Unlawful harassment is a legal concept under continual refinement by government policy makers, and particularly the judicial system. Beginning in the 1980’s, Title VII of the Civil Rights Act of 1964 was interpreted by the Equal Employment Opportunity Commission to include workplace sexual harassment as an actionable theory of gender discrimination. Courts have since developed the caselaw under TItles VII and IX, which ensures gender equity in the provision of federally funded educational benefits, and now recognize a causes of action for damages caused by gender based harassment of employees and students. Moreover, harassment based on other the protected traits such as race, religion, national origin and disability also are recognized by the federal and state courts. In recognition of these developments in the law, VCU has developed policies over the years prohibiting workplace discrimination, including sexual harassment, prohibiting student sexual misconduct and regulating consensual relationships between faculty and students. Virginia Commonwealth University policy expressly defines and prohibits sexual misconduct between students. • Student sexual misconduct is defined as unwelcome acts of a sexual nature committed by a

student against another student without consent including, sexual advances, requests for sexual favors and/or other verbal or physical conduct, including written communications of an intimidating, hostile or offensive nature, or action taken in retaliation for the reporting of such behavior.

• Student sexual misconduct may include, but is not limited to unwelcome touching—either of the victim or when the victim is forced to touch another person’s body, directly or through clothing—such as patting, pinching, brushing against the body, attempted or actual kissing or fondling, and any other inappropriate and/or unwelcome touching or feeling; coerced sexual intercourse (e.g., rape, attempted rape, sodomy, or other sexual acts or misconduct); unwelcome sexual propositions, invitations, or other pressure for sex; implied or overt threats of a sexual nature; making gestures of a sexual nature; unwelcome sexual remarks about clothing, body, or sexual activities; and humor and jokes about sex that denigrate women or men in general.

• Acts of physical student sexual misconduct are commonly considered to constitute a form of sexual assault when occurring without consent. To constitute lack of consent, the acts must be committed either by threat, force, intimidation, or through the use of the victim’s physical or mental inability (of which the accused was aware or should have been aware) to understand the situation, consequences of his/her choices, or to express his/her desires.

In addition, the University has adopted a policy aimed at reducing the potential for harm created from consensual relationships that sometimes develop between instructors and their students. (http://www.vcu.edu/provost/pdf/consensual-relationships-policy.pdf). The University is committed to maintaining learning and work environments as free as possible from conflict of interest, exploitation and favoritism. Therefore, employees, whether faculty or staff, are not allowed to engage in consensual relations with students whenever the employee has a “position of authority” with respect to the student in such matters as teaching or in otherwise evaluating, supervising or

advising a student as part of a school program or employment situation. The policy includes reporting requirements aimed at reducing the potential for conflicts of interest.

If a student feels that he/she has been subjected to unlawful harassment, severe and pervasive mistreatment which interferes with access to or attainment of an educational benefit, the student is encouraged to report this to the Senior Associate Dean for Medical Education and Student Affairs or the Associate Dean for Student Affairs in the School of Medicine and or the EEO/AA Office for investigation and resolution.

• Additional Rights and Responsibilities

Appropriate Use of University Premises in the Pursuit of Educational Goals, Occupational

Endeavors, and Recreational Activities (Refer to http://www.provost.vcu.edu/index.html) No person, either single or in concert with others, shall willfully:

• Unreasonably stop or obstruct the free movement of any person or vehicle, or unreasonably obstruct passageway, entrance, or exit.

• Refuse to leave any University premise after being ordered to do so by an authorized member of the University community.

• Destroy or damage land, buildings, or equipment owned or controlled by the University, the personal possessions of any individual, or without proper authorization, use, remove, or fail to return property.

• Without permission, enter any office of an administrative officer, faculty member, or employee, or student office or room.

• Enter into, or remain in, any University premise for other than an authorized purpose.

Access to and Protection of Educational Records (Refer tohttp://www.provost.vcu.edu/index.html ) The Family Educational Rights and Privacy Acts (FERPA) affords students certain rights with respect to their educational records:

• The right to inspect and review the student’s educational records within 45 days of the University receiving a request for such access. Students should submit to the registrar, dean, head of the academic department, or other appropriate official written requests that identify the record(s) they wish to inspect.

• The right to request the amendment of the student’s education record that the student believes is inaccurate or misleading.

• The right to consent to disclosures of personally identifiable information contained in the student’s educational records, except to the extent that FERPA authorizes disclosure without consent.

• A school official may disclose a student’s educational record without consent to other school officials with legitimate educational interests. A school official has a legitimate educational interest if the official needs to review an education record in order to fulfill his or her professional responsibility.

• Upon request, the University discloses education records without consent from directory information such as student name, date admitted, mailing address and telephone number, etc. Students have the right to withhold the release of information designated as “directory information” by submitting to the Office of Records and Registration, no later than 14 days after the beginning of a term, a request written and signed that “directory information” not be released.

• Students have a right to file a complaint with the US Department of Education concerning alleged failures by Virginia Commonwealth University to comply with the requirements of FERPA.

Limited Work Duty Hours During the M3 and M4 Years (Refer to School of Medicine Student Handbook--https://ecurriculum.som.vcu.edu/handbook/)

• Students will be on duty no more than an average of 80 hours per week • Students will not spend more than 30 consecutive hours on duty • Students will receive 1 day in 7 free from all educational responsibilities • Students will not be required to take overnight call 2 evenings prior to the end of

clerkship subject exam.

Proper Off-Campus Conduct(Refer to University Rules and Procedures www.students.vcu.edu/policies.html) When determined to be detrimental to the interests of the University, certain off-campus conduct by students which results in a conviction of a criminal offense or an adjudication of civil liability by a court of law may subject the student to penalties by the University. Such offenses include:

• Theft, destruction, defacing or damaging land, buildings, equipment or property of others.

• Possession, use, sale, or distribution of illegal drugs or substances or the underage possession and/or consumption of alcohol.

• Assault and/or battery, sexual assault, threats, stalking or domestic violence or other offenses causing personal injury or death.

• Breach of the peace (e.g., disorderly conduct, public drunkenness, unlawful assembly, etc.).

Policy for Prevention of Health Professionals Academically Evaluating Medical Students for

Whom They Have Provided Sensitive Health Services (Refer to School of Medicine Student Handbook--https://ecurriculum.som.vcu.edu/handbook/) The Liaison Committee on Medical Education Standard MS-27A states: “The health professionals who provide psychiatric/psychological counseling or other sensitive health services to medical students must have no involvement in the academic evaluation or promotion of the students receiving those services.” Virginia Commonwealth University Student Health Services and University Counseling Services do not employ any health professionals who would be involved in the academic evaluation or promotion of medical students. However, at times students may receive healthcare from professionals outside of these agencies who could potentially be involved in the academic evaluation or promotion process. Virginia Commonwealth University School of Medicine prohibits health professionals who provide sensitive health services to medical students from being involved in the academic evaluation of those students.

It is the responsibility and obligation of any health professional that has provided psychiatric/psychological counseling or other sensitive health services to a medical student to recuse himself/herself from any activities involving academic evaluation or promotion of that student. The health professional may engage in teaching activities (e.g., lectures, small group discussions, rounds, etc.) with the medical student, but may not participate in any form of

evaluation. The health professional and the medical student are advised to contact the Director of the Curriculum Office as early as possible should the potential for this conflict of interest arise.

Process for Handling Complaints of Student Mistreatment It is vital that students report all forms of mistreatment that they perceive or experience from any member of the University community. Retaliation or reprisal for filing complaints or participating in an investigation is forbidden by University policy. A positive and safe environment for learning and the provision of patient care can only be assured if steps are taken to investigate complaints and seek resolution with all parties. • Reporting Complaints It is extremely important that mistreatment be reported and acted on to preserve the learning environment and the safe provision of patient care. There are several ways a student may report mistreatment: Students are encouraged to first contact the Senior Associate Dean for Medical Education and

Student Affairs. On the Fairfax-Inova campus, the Associate Dean for Medical Education should be notified. Sometimes feelings of mistreatment may be based on miscommunication. Concerns may be alleviated through improved communication.

At the end of the third year clerkship evaluations for faculty, houstaff and clerkships, there is a section for reporting mistreatment. It will be anonymous unless the student wishes to disclose his/her name and the name of the offending party. The student should flag the evaluation for review by School of Medicine administration. Unless the complaint is egregious, it will not be acted on until a final grade has been posted for the student. The School and University can be more effective in addressing student mistreatment if the name of the offended party is known, so anonymous reports, while acceptable, are discouraged.

Contact any member of the School of Medicine administration or a member of the faculty for guidance. Many of the issues may also be addressed as a professionalism issue (Please refer to the SOM Professionalism website).

Students may call the School of Medicine hotline. The numbers are: • MCV Campus: (804) 827-TALK (8255) • Inova Campus: (804) 776-TALK (8255) • University General Complaints: (804) 828-3976 • EEO/AA Complaints: (804) 828-1347

Students may file an informal or formal complaint with the University Office of Judicial Affairs. They will conduct an investigation, and if necessary, arrange for a hearing of the complaint.

For instances of discrimination based on gender, age, race or ethnicity, or alleged sexual harassment involving faculty, staff or employees, the EEO/AA Office may be directly contacted.

For instances of sexual misconduct involving another student, students are encouraged to report to the Title IX Coordinator for Students, Ms. Kendall Plageman, at 837-8753.

If a student believes he/she has been subjected to a criminal offense, the student may contact the VCU Police and or City of Richmond Police Department (call 911 for emergencies or (804) 646-5100 for non-emergencies). On the Fairfax-Inova campus, campus security may be contacted at 776-3180 of if needed Fairfax County Police (call 911 for emergencies or (703) 691-2131 for non-emergencies).

Students are encouraged to also contact the Senior Associate Dean for Medical Education and Students Affairs (828-9791) or a member of his staff whenever any form of mistreatment occurs. All complaints filed should be reported to this office so that appropriate monitoring can occur.

• Investigation For students who file complaints with the Office of Judicial Affairs, EEO/AA Office, the VCU or Richmond Police, or the Fairfax Campus security or Fairfax County Police, their established protocols for completing an investigation will be followed. The School of Medicine will monitor these investigations. For complaints filed with the Senior Associate Dean for Student Affairs or his staff, the following procedures will be followed: All complaints will be initially evaluated by the Senior Associate Dean for Medical Education and

Student Affairs or his/her designee. Those deemed to require additional investigation, will be investigated by the Senior Associate Dean for Medical Education and Student Affairs or his/her designee through discussions with all affected parties. For the Fairfax-Inova campus, this will be conducted by the Associate Dean for Medical Education or his/her designee.

For instances of discrimination based on gender, age, race or ethnicity, or alleged sexual harassment, the Senior Associate/Associate Dean may refer the matter to the EEO/AA office and/or collaborate in order to complete the investigation.

The results of the investigation will be reviewed by a committee appointed by the Dean of the School of Medicine. The committee may ask for additional information, in order to render an opinion to the Dean as to whether or not mistreatment occurred. Recommended resolutions may include, but is not limited to informal agreements between the parties, referral for training and disciplinary action.

The Dean will review the material from the ad hoc committee and render a final decision; or refer the matter to the Office of Judicial Affairs or to the EEO/AA Office.

Student Fellowships

Background: Opportunities are available for study and investigation under the tutelage of faculty members in their laboratories during the summer vacation and as an extracurricular activity during the school year. These studies are supported by the School of Medicine Summer Research Fellowship endowment. Policy: The purpose of this fellowship program is to expose promising students in the School of Medicine, to an active and productive research atmosphere, and to serve as an avenue for exploring options for future academic and research careers. Although the project and the scientific contribution a student makes is important, the primary intent of the fellowship is to inculcate and foster an appreciation for and a desire to participate in original and creative research. By so doing, our students and graduates will come to understand the essential part that research plays in the health sciences, and they will be able to appreciate more fully their own responsibilities and opportunities in investigative activity. In order to facilitate the selection of meritorious fellows, the following guidelines have been formulated to aid students and faculty sponsors in applying for School of Medicine Summer Research Fellowships and aid the selection committees in their deliberations. Eligibility & Requirements for Students and Sponsors

• Students in the School of Medicine may apply to the Senior Associate Dean for Research for a summer research fellowship under the supervision of a faculty sponsor.

• Students must have a completed financial aid application to participate. This includes a needs assessment. Students who have other means of stipend support are not eligible. Furthermore, it is emphasized that a fellowship may not be considered by either party as a mere source of technical support in the sponsor's laboratory.

• These fellowships are for a period of at least two months; an exception (six weeks) may be made for rising M3 students. Stipend information is available from the Senior Associate Dean for Research.

• A faculty member may sponsor only one student application per year. • In view of the limited number available, previous holders of a School of Medicine Summer Research

Fellowship are eligible for a second award only if strong justification can be offered. Application Procedure • Application forms for these fellowships are available in the School of Medicine, Office of Research,

Sanger Hall 1-018, starting January 10. • The completed application must be delivered to the Senior Associate Dean for Research by March

31. • Applications will be judged on the quality and suitability of the project, the student's academic

achievement at VCU, and suitability of the sponsor. Evaluation will be by a faculty advisory committee. Notification of awards will be made during the month of April.

Obligations of the SOM Summer Research Fellow • The Fellow will devote full time to the research project throughout the period of the fellowship.

Permission to undertake additional part-time employment will be given individual consideration by the Committee. Any departure from these requirements may result in termination of the fellowship.

• A progress report of not less than 200 words should be submitted by the Fellow to the Sponsor and the Associate Dean for Research at the end of the summer fellowship. The report will summarize the work accomplished on the project and include an evaluation of the summer program. The Fellow should comment on his/ her contribution to the project and what he/she gained from the experience.

• Any publication resulting from this research should acknowledge support by the School of Medicine. • The Fellow is also required to submit an abstract for presentation at Honors Day, which is usually

held in May. All abstracts are judged for presentation Virginia Commonwealth University Honor System

Background: Virginia Commonwealth University recognizes that honesty, truth, and integrity are values central to its mission as an institution of higher education. The Honor System is built on the idea that a person’s honor is his/her most cherished attribute. A foundation of honor is essential to a community devoted to learning. Within this community, respect and harmony must coexist. The Honor System is the policy of VCU that defines the highest standards of conduct in academic affairs. Policy: All students are expected to be familiar with the VCU Honor System. Any suspected infractions are to be reported immediately to the Office of Judicial Affairs and Academic Integrity. For all work, the instructor shall encourage all students to sign the official Honor Pledge of the VCU Honor System. However, neither the presence nor the absence of a signed pledge statement shall prevent a student from being charged under the VCU Honor System for a violation of the VCU Honor System.

The Honor System in its entirety can be reviewed on the web at http://www.provost.vcu.edu/pdfs/Honor_system_policy.pdf or http://www.students.vcu.edu/insider.html. The University honor pledge is: "On my honor, I have neither given nor received aid on this assignment." The student's signature should follow the above statement. The following shortened version of the Honor Pledge is also acceptable and carries the same meaning as the full Honor Pledge: "Honor Pledge" followed by the student's signature. All medical students must pledge and sign the bubble sheets that are collected by the Curriculum Office for each exam. Submitting a computer exam implies that the student took the exam under the Honor Code. The Student Handbook in total was approved by the School of Medicine Curriculum Council on June 27, 2013. If specific material has been added or revised, the date of approval by Curriculum Council is noted.