School of Medicine Policies

Academic Accommodations on Tests and Examinations

After a recommendation for accommodations on examinations has been made by the Office for Student Success' review committee (per policy E-AA-GEN-GEN-PO-00035 [insert link]), the student will receive a copy of the recommendations via letter.

For each examination in which the student intends to utilize accommodations, it is the responsibility of the student to contact the appropriate faculty/staff member or their designee:

• For all National Board of Medical Examiners Subject Exams, the student should contact the Office of Student Affairs, as well as the course director.
• For all other examinations, the student should contact the Course Director and Administrator.

For each instance in which accommodations will be utilized, students should contact the appropriate individual (as detailed above) as early as possible to make these arrangements. A minimum of five (5)-working days' notice is necessary to ensure arrangements can be made for testing space and proctor presence. When possible and reasonable, an exception to the five (5)-working-day rule may be granted by the assistant dean for academic affairs or vice dean of medical education.

As needed, the Office of Student Affairs will coordinate with the appropriate course personnel and student to schedule a time for board examinations that will not interfere with other course work. This will generally overlap with the regular administration time for the examination.

Students receiving accommodations should be aware that the school will only grant the specific accommodation recommended by the institutional committee when it does not present an unreasonable burden to the department or a significant departure from normal educational practice. All other rules and policies surrounding the taking of examinations still apply. The accommodations will only apply to paper or computer-based examinations using ExamSoft unless other types of examinations are specifically addressed in the recommendation.

Consistent with other policies surrounding examinations, unless specifically stated in the recommendation, students should arrive at least ten (10) minutes prior to the scheduled start time to allow for download of the examination from ExamSoft (if applicable) and to ensure there are no technological difficulties. Students who arrive late will remain subject to the pre-scheduled end time for the examination, regardless of the actual time elapsed.

The full procedure is available online in the UMMC Document Center.

Academic Dishonesty

• Suspected cases of academic dishonesty must be contemporaneously documented by the involved faculty or staff and dealt with directly and promptly.
• Course directors should immediately report such instances to the vice dean for medical education or the associate dean for student affairs.

Access to Student Records

A member of faculty or staff must demonstrate legitimate educational interest or a need to accomplish their official work duties to be granted access to a student's educational record.

To initiate the request, the member of the faculty or staff must complete a Faculty/Staff Access to Student Educational Records form. The Faculty/Staff Access to Educational Records form may be obtained on the School of Medicine website on the faculty page. The form is reviewed by the vice-dean or assistant dean for academic affairs for approval. A review of the request with a determination of access will be completed in no more than six (6) business days. The Faculty/Staff Access to Student Educational Records form will be kept as a part of the student's record.

The full policy and procedure can be found online in the UMMC Document Center.

Attendance Policy

Participation in the educational program of the School of Medicine is limited to highly qualified and motivated individuals who seek the knowledge, skills, attitudes, and behaviors required for physicians to provide competent and compassionate care to a culturally diverse patient population. Students are expected to attend and participate in medical education opportunities. Student evaluation may be partially based upon participation if stated in the course syllabus and approved by the Curriculum Committee. The school makes every effort to provide reasonable accommodations to access health services. Students with three (3) unexcused absences from mandatory classes or activities will be viewed as demonstrating unprofessional behavior, triggering the School of Medicine's Policy on Professional Behavior (Approved by SOM Executive Faculty September 23, 2004).

The full policy (E-SOM-OME-GEN-PO-00009) can be found online in the UMMC Document Center.

Grade Appeals

• The course director shall be presumed to have assigned the proper grade until proven otherwise. The burden of proof to the contrary rests with the student, and students have the right to appeal an incorrectly assigned final grade or content of an evaluation following the process below.
• Appeals for courses sponsored by individual departments are made to the chair of the department; those for conjoint courses are made to the assistant dean for academic affairs. Such appeals must be filed in writing within fourteen (14) days of the posting of the grade. The respondent will then have fourteen (14) days to respond to the student's dispute. It is recommended that the student notify the Office of Medical Education when making any appeal.
• If the student feels the matter has not been appropriately resolved, a written appeal may be made to the executive faculty through the Office for Medical Education. Failure to file an appeal within fourteen (14) days constitutes a waiver of the right to appeal. The details for an appeal are outlined in the UMMC Bulletin and the Student Handbook.
• Students have the right to appeal, on procedural grounds only, to the associate vice chancellor of academic affairs within five (5) days of the decision being appealed. (Document E-AA-SA-ARG-PO-00001 in the UMMC Document Center).

Non-Involvement of Providers of Student Health Services in Student Assessment

The health professionals who provide health services, including psychiatric/psychological counseling, to a medical student must not be involved in the academic assessment or promotion of the medical student receiving those services. In cases where they are asked to serve in an evaluator capacity or decision affecting promotion, progression, or retention, they must recuse themselves as having a conflict of interest by emailing the Course Administrator and informing them that a conflict exists. The reason for the conflict should not be disclosed. Students are also empowered to make this disclosure through the Office of Student Affairs.

The full student policy is available in the SOM Student Handbook.

Professional Behavior

Policy

Medical students will encounter a number of people who will note their behaviors. These observers may report compliments or concerns related to the professional behavior of a student through verbal, written, or other reporting mechanisms. Examples of report sources include faculty members, residents, nurses, other health care providers, other medical center employees, medical school peers, patients, or patient's family members. Reports of exemplary professional or unprofessional behaviors or concerns should be made to the assistant or associate dean for student affairs, the assistant dean for academic affairs, or the vice dean for medical education.

Procedure

When a student receives a report of a concern related to unprofessional behavior, the assistant or associate dean for student affairs, the assistant dean for academic affairs, or the vice dean for medical education shall meet with the student to discuss the incident. Following the initial meeting with the assistant or associate dean for student affairs, the assistant dean for academic affairs, or the vice dean for medical education, the following actions will be taken:

1. If the incident is considered minor:
   1. The initial interview and counseling session, as well as further monitoring of a student's performance in the area of concern, may suffice.
   2. Other assistant or associate deans in the School of Medicine may be asked to participate in counseling
      and meeting with the students. The counseling session will be documented in the student's file in the office of the assistant or associate dean for student affairs or the office of the assistant or associate dean for medical education, but the report will not carry forth to future evaluations if the behavior does not recur and if there are no other reports of unprofessional behavior.
   3. If the reported incident, upon investigation, is found to be frivolous and not valid, this fact will be clearly documented in the student's file.
2. If the incident is of serious concern or if there has been a pattern (greater than two) of minor incidents, the assistant or associate dean for student affairs or the assistant or associate dean for medical education, or other assistant or associate deans in the School of Medicine will interview and counsel the student as above and may:
   1. Discuss the incident with the Dean's Council and recommend that the student be placed on a leave of absence;
   2. Discuss the incident with the Dean's Council and recommend that the student be placed on probation for unprofessional behavior;
   3. Discuss the incident with the Dean's Council and recommend that the student repeat the course;
   4. Discuss the incident with the Dean's Council and recommend the student repeat the academic year; or
   5. Discuss the incident with the Dean's Council and recommend the student be dismissed from the School of Medicine. These recommendations will be presented to the dean of the School of Medicine for approval. A student who returns after a suspension, dismissal, or withdrawal for unprofessional behavior will automatically be on academic probation for at least one academic quarter. A student dismissed from the School of Medicine for unprofessional behavior may appeal for readmission to advanced standing.

Mechanism for Appeal

Following a decision for remediation or dismissal rendered by deliberation of both the dean and executive faculty, the vice dean for medical education or the assistant dean for academic affairs shall notify the student within five (5) working days of the decision. From the time of sending the notice, the student shall have an additional ten (10) working days to notify the vice dean for medical education of his/her intent to appeal the decision. If no response is received from the student after this ten (10)-day time period has passed, the decision will be final, and the right to appeal shall have been waived. Only an email or letter shall represent the decision of the dean and executive faculty.

An appeal committee shall be assembled by the Office of Medical Education and composed of five (5) faculty members who currently serve as program directors or associate program directors of physician residency programs at the medical center. The student shall have the right to appear before this committee and present any statements, evidence, or witnesses of their choosing. Legal counsel on behalf of the student may be present, at the student's own expense, but may serve only in an advisory capacity and may not address the appeal committee, present evidence, or make any statements. Decisions shall be rendered by majority vote. The appeal committee shall have the right to uphold or revoke the previous decision, apply a harsher or gentler sanction, or set certain criteria for the student to meet to continue with the educational program.

The full policy and procedure are being updated and will be available in the UMMC Document Center.

Religious Diversity

Medical students are not required to participate in, and procedure or medical service for which they have a religious objection but must attend all required educational sessions, regardless of any objection to the content. Students must communicate any procedures to which they have an objection with clerkship directors at the beginning of each rotation. Care must be provided to all patients, regardless of personal characteristics, such as diagnosis, gender, race, religion, or sexual orientation.

The full procedure can be found online in the UMMC Document Center.

Student Complaints

Policy

Students have the right to complain without fear of retribution or retaliation. Students have the right to expect a timely response. Per the University of Mississippi Medical Center (UMMC) Student Complaints policy, a student seeking to resolve an academic or misconduct complaint may seek resolution through the school's published administrative channels, entering at the appropriate level and proceeding in the order stated

Procedure

1. A student seeking to resolve a non-academic or non-misconduct complaint should seek resolution through the appropriate office on campus designated to address the student concern. Issues involving such matters as sexual harassment, discrimination, disability, employment, or mistreatment fall under the institutional policies handled by specific offices, such as the Office of Human Resources or the Equal Employment Opportunity Office. If the issue is not satisfactorily resolved, the student should submit the complaint in writing to the School of Medicine associate dean of student affairs. The complaint should contain, at a minimum, the date and time of the alleged conflict or action and a summary of the complaint.
2. If a student believes the non-academic or non-misconduct complaint has not been resolved satisfactorily, he or she may file a written grievance with the associate/assistant dean for student affairs. In such cases, the associate/assistant dean for student affairs will work to ensure a fair and equitable process and solicit a written response to the grievance from the appropriate institutional representative within 10 working days.
3. If the student continues to believe the non-academic or non-misconduct complaint has not been resolved
   satisfactorily, an ad hoc grievance review committee will be convened to review the complaint and to make a recommendation. The ad hoc grievance review committee may:
   1. Recommend rejection of the grievance and deny the requested outcome.
   2. Support the grievance and recommend approval of the requested outcome, or
   3. Support the grievance and recommend approval of a revised outcome.

The associate/assistant dean for student affairs shall communicate in writing the recommendation of the ad hoc grievance review committee to the associate vice chancellor for academic affairs. The decision of the associate vice chancellor for academic affairs is final and completes the grievance review process. All parties will be notified in writing of the final decision within 10 working days.

4. The Office of Student Affairs for UMMC provides a Web-based version of a student comment/complaint box allowing anonymous or identified complaints at https://umc.edu/Office of Academic Affairs/For- Students/Student Affairs/Student Comments and Complaints.html. This email account is used to collect and track student issues and concerns for the entire institution. Best efforts will be made to respond within 48 hours, unless the student wishes to remain anonymous.
5. The Student Affairs Council will maintain a protected record of all non-academic and non-misconduct student complaints in a proactive effort to identify institutional opportunities for improvement. The associate dean/director of student affairs from each school will report all non-academic and non-misconduct complaints that rise to the level of the individual school dean's office to the Student Affairs Council on a quarterly basis. The director of student services will report all student complaints that rise to the institutional level to the Student Affairs Council monthly.

The entire policy and procedure can be found online in the UMMC Document Center.

Student Mistreatment

Policy

The School of Medicine seeks to ensure a safe and professional learning environment for medical students that is free of mistreatment. All mistreatment is serious and is strictly prohibited. The School of Medicine provides well- defined mechanisms for medical students to report violations, for the School of Medicine to address violations, and for the education of standards of conduct for faculty, students and those with whom medical students interact during the medical education program. Reports of mistreatment are encouraged, and the School of Medicine does not tolerate retaliation of any kind for reports of mistreatment.

Procedure

UMMC maintains an educational environmental and workplace free from any type of mistreatment. Whatever the circumstance, students who believe they were mistreated are strongly encouraged to bring it to the attention of appropriate institutional officials. Categories of mistreatment include general mistreatment, discrimination and sexual misconduct. The procedure for reporting mistreatment applies to students, faculty, staff, and residents. Individuals may consult the director of student services at any time for assistance. Such informal consultation will always be confidential, unless precluded by safety of the student or institutional policy. All complaints of mistreatment are responded to within a maximum of 48 hours. Additionally, the office of student affairs provides a web-based mechanism for students to report negative behaviors and mistreatment anonymously (https://www.umc.edu/Office%20of%20Academic%20Affairs/For-Students/Student%20Affairs/Student-Complaints.html).

General Mistreatment

General mistreatment comes in many forms, including but not limited to verbal abuse, public humiliation, intentional neglect, assignment of tasks in retaliation, belittlement, and unreasonable/intentional exclusion from an educational opportunity. Formal complaints of general mistreatment regarding faculty, residents, or staff are made through the student affairs officer for the school to the chief human resources officer or the assistant director of equal employment opportunity when appropriate. Formal complaints of general mistreatment regarding other students are made to the student affairs officer for the school. All reported incidents will be investigated thoroughly. All complaints of mistreatment are responded to in a maximum of 48 hours.

Discrimination

Under Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act and their implementing regulations, no individual may be discriminated against solely on the basis of age, race, gender, religion, national or ethnic origin, disability or veteran status. Allegations of discrimination (in any category) against a student must be reported immediately through the student affairs officer for the school and to the chief human resources officer or the assistant director for equal employment opportunity when appropriate. The institution responds and investigates all reported incidents in a timely fashion.

Sexual Misconduct

UMMC prohibits sexual misconduct in any form, including sexual assault or sexual abuse, sexual harassment, and other forms of nonconsensual sexual conduct. Title IX of the Education Amendments of 1972 prohibits discrimination based on sex in education programs and activities. It is the position of UMMC that sexual misconduct in any form will not be excused or tolerated. Criminal, civil and university disciplinary processes are available to a student or employee with a complaint. UMMC is committed to prompt, effective and fair procedures to investigate and adjudicate reports of sexual misconduct and to the education of the university community about the importance of responding to all forms of sexual misconduct. Special emphasis is placed on the rights, needs, and privacy of the student. Students who believe they have been a victim of sexual misconduct are encouraged to contact the student affairs officer for their school and/or the Title IX Coordinator. Students also are encouraged to immediately contact the UMMC Police Department if they have been sexually assaulted and to seek immediate medical attention.

The associate dean for student affairs, with the assistance of the appropriate Medical Center officials, will investigate the incident(s) including statements by witnesses to the alleged incidents(s) and evidence about the relative credibility of the allegedly harassed student and the alleged harasser. If it is determined that there is sufficient cause to believe that incident(s) of peer sexual harassment has occurred, a written report will be given to the dean with recommendations for appropriate steps to be taken to end the harassment. The associate dean for student affairs will take steps to ensure that there are no negative consequences to either the student making the report, or the student alleged to have been harassing the former. UMMC will not tolerate retaliation in the investigation of a complaint. A person bringing a frivolous allegation of sexual harassment may be subject to disciplinary action, up to and including termination.

Additionally, the UMMC Office of Student Affairs provides a web-based version of a student comment box, located on the Student Affairs website in the Helpful Links section. This email account is used to collect and track student issues and concerns. Students will receive a response within 48 working hours if contact information is provided.

The full policy and procedure (E-SOMOAA-GEN-PR-00012) can be found online in the UMMC Document Center.

Student Progression, Retention, and Dismissal

Policy

Decisions regarding progress through the educational program at the University of Mississippi School of Medicine are based upon academic criteria and professional norms, not upon arbitrary, capricious, or irrelevant standards. Professionalism, one of the six core competencies for all physicians, is considered as an academic matter at this institution.

The School of Medicine Medical Student Promotions Executive Committee and its subcommittees are empowered to review student performance and recommend to the dean and executive faculty whether a student should be promoted, participate in remediation, or be dismissed from the program.

Procedure

Committee Composition: The School of Medicine Medical Student Promotions Executive Committee oversees the student promotion process and comprises a chair, three (3) foundational science representatives, and six (6) clinical science representatives. Ex officio, non-voting members consist of the vice dean for medical education, assistant dean for academic affairs, associate dean for student affairs, and a representative appointed by the Office of the General Counsel.

A quorum of the committee or subcommittees shall consist of at least 50% plus one of voting members, with decisions being rendered by majority vote. Should a tie occur, then the vice dean for medical education or designee shall cast the deciding vote.

Membership: Members are appointed by the dean of the School of Medicine upon the recommendation of the School of Medicine Deans Council, Curriculum Committee, department chairs, or by self-nomination. One foundational science member shall be appointed for an initial term of one (1) year. Two clinical science members shall be appointed for an initial term of one (1) year. One foundational science member shall be appointed for an initial term of two (2) years. Two clinical science members shall be appointed for an initial term of (2) years. The remaining group shall serve an initial term of three (3) years. At the expiration of the initial terms, members shall be appointed to serve a term of three (3) years. In the event of a vacancy, members may be appointed to a shorter term as may be appropriate to maintain the balance of staggered terms. All members shall serve a 3-year term, with one (1) foundational science and two (2) clinical science faculty members replaced annually. Upon completion of a 3-year term, a member is not eligible for reappointment for three years. A current course director cannot serve as a committee member.

The chair shall be appointed by the dean of the School of Medicine for a four (4)-year term, with a chair-elect being appointed by the beginning of the chair's second year. If the chair elect is a current member of the curriculum committee, an additional representative for either the foundational sciences or clinical sciences faculty will be appointed to fill their vacant position for the remainder of their term. Upon completion of a four (4)-year term, a chair will not be eligible for appointment to the committee in any capacity for at least three years.

Subcommittees: Membership of the foundational science and clinical science subcommittees and their chairs shall be appointed by the chair of the School of Medicine Medical Student Promotions Executive Committee. The chairs of these subcommittees shall come from the membership of the Promotions Executive Committee, with the remaining members coming from the faculty at-large. Each subcommittee shall consist of nine (9) members (including the chair), of which at least five will be clinical faculty members.

Additionally, the following shall be invited to each subcommittee meeting, vice dean for medical education, assistant dean for academic affairs, and legal counsel representative as non-voting members to provide information.

Process: Students eligible for progression through the program who meet a set of automatic criteria (defined below), do not have to be reviewed by the subcommittees. These students will be presented by the Promotions Executive Committee for progression to the executive faculty and dean. Students who fail to meet any one of these criteria will be considered by the subcommittee for the student's current phase of training, which shall issue a written recommendation to the School of Medicine Medical Student Promotions Executive Committee. In the case of a student who is considered for remediation of all or part of an academic year or dismissal from the program, the student shall have the right to appear before the Promotions Executive Committee and present such statements, testimony, and witnesses as they choose. If the student prefers, they may submit this information as a written statement instead. Legal counsel may not be present with the student for these academic reviews.

Student Advocate and Support: Upon request by the student, the associate dean for student affairs, assistant dean for student affairs, or a designee shall serve as a support mechanism for the student(s) and provide guidance on the promotion review and appeals processes and such advice as they deem appropriate.

Non-Binding Precedent: Each case considered by a subcommittee, or the School of Medicine Medical Student Promotions Executive Committee shall be considered on its own merits and shall not be subject to the precedent set by previous decisions.

Appeals: Following a decision for remediation or dismissal rendered by deliberation of both the dean and executive faculty, the vice dean for medical education or the assistant dean for academic affairs shall notify the student within five working days of the decision. From the time of sending the notice, the student shall have an additional ten (10) working days to notify the vice dean for medical education of his/her intent to appeal the decision. If no response is received from the student after this ten (10)-day period has passed, the decision will be final, and the right to appeal shall have been waived. Only an email or letter shall represent the decision of the dean and executive faculty.

An appeal committee shall be assembled by the Office of Medical Education and composed of five faculty members who currently serve as program directors or associate program directors of physician residency programs at the medical center. The student shall have the right to appear before this committee and present any statements, evidence, or witnesses of their choosing. Legal counsel on behalf of the student may be present, at the student's own expense, but may serve only in an advisory capacity and may not address the appeal committee, present evidence, or make any statements. Decisions shall be rendered by majority vote. The appeal committee shall have the right to uphold or revoke the previous decision, apply a harsher or gentler sanction, or set certain criteria for the student to meet to continue with the educational program.

Automatic Promotions

First Year
Automatic Promotion Criteria: The following is the list of automatic promotion criteria to move from the first year to the second year of the medical education program: (1) passing grades (>70%) in all courses; (2) cumulative weighted average of at least 75%, not including Introduction to the Medical Profession I; (3) no professionalism concerns noted on faculty or peer evaluations and no professionalism reports made to the Offices of Medical Education or Student Affairs; (4) and no other concerns regarding academic and professional performance inconsistent with the practice of medicine. For a student to be promoted without additional review, students must meet all four (4) of the criteria.

Second Year
Automatic Promotion Criteria: The following is the list of automatic promotion criteria to move from the second year to the third year of the medical education program: (1) passing grades (>70%) in all courses; (2) cumulative weighted average of at least 75%, not including Introduction to the Medical Profession II; (3) no professionalism concerns noted on faculty or peer evaluations and no professionalism reports made to the Offices of Medical Education or Student Affairs; and (4) no other concerns regarding academic and professional performance inconsistent with the practice of medicine. For a student to be promoted without additional review, students must meet all four of the criteria.

Third Year
Automatic Promotion Criteria: The following is the list of automatic promotion criteria to move from the third year to the fourth year of the medical education program: (1) passing grades (>70%) in all clerkships; (2) cumulative weighted average of at least 75% in all required clerkships and all attempted electives; (3) no professionalism concerns noted on faculty or peer evaluations, no professionalism reports made to the Offices of Medical Education or Student Affairs; (4) no other concerns regarding academic and professional performance inconsistent with the practice of medicine; and (5) passage of USMLE Step 1. For a student to be promoted without additional review, students must meet all five of the criteria.

Fourth Year
Automatic Graduation Criteria: The following is the list of automatic promotion criteria for graduation: (1) passing grades (>70%) in all rotations and courses; (2) cumulative weighted average of at least 75% in all courses, including both the core requirements and the required 14 weeks of electives; (3) no professionalism concerns noted on faculty or peer evaluations, no professionalism reports made to the Offices of Medical Education or Student Affairs, (4) no other concerns regarding academic and professional performance inconsistent with the practice of medicine; and (5) passage of Step 2 CK and Step 2 CS. For a student to be promoted without additional review, students must meet all five of the criteria.

Professionalism Issues: Professionalism is an academic standard at the University of Mississippi School of Medicine, and as such, may form the sole basis for recommendations for remediation or dismissal of a student by the School of Medicine Medical Student Promotions Executive Committee to both the dean and executive faculty.

Professionalism issues may also be considered by the School of Medicine Deans Council, and recommendations made following its own procedures. Students may not be evaluated or sanctioned by both groups for the same unprofessional behaviors at the same time. However, previous infractions and/or decision from either group may be used to establish a pattern of behavior should additional concerns be reported to either group.

Records: Records of committee and subcommittee proceedings and recommendations shall be maintained by the Office of Medical Education in written or electronic format and documented in the student management system. These records shall be available as needed to the dean, executive faculty, appeals committees, promotions committee or subcommittees, or the SOM Deans Council, if needed for future decisions. Additionally, notation of negative sanctions shall be made in the Medical Student Performance Evaluation as indicated by American Association of Medical College standards for the letters. Students may access their own records according to the provision of institutional policy and the Family Educational Rights Protection Act.

The full policy and procedure (E-SOM-OME-GEN-PO-00012) can be found online in the UMMC Document Center.

Policies for Clinical Clerkships

Absences for Third Year Core Clerkships

Clerkship directors should make all reasonable efforts to excuse students from classes or clinical activities in order to access health services. Other absences should be approved on a case-by-case basis. If additional days beyond those required in the Student Duty Hours Policy above are required for school or other professional functions, these days must be approved by the clerkship director for that rotation. No more than one half (1⁄2) day per week of the clerkship should be approved. Further, students must adequately complete all subcomponents of each clerkship, even if their number of absences is otherwise acceptable.

Student absences should be reported to the course director and administrator and, if appropriate, to the supervising faculty member. Student should also make reports through MedHub for each day of absence. The full [process for reporting absences in MedHub is available in the SOM Student Handbook.

Board Examination Failures

Students failing one of the National Board of Medical Examiners Subject or Customized Examinations in the clinical sciences must schedule a repeat administration of the examination with the Office of Student Affairs within one (1) month of the date of the initial failure. Such repeat administration must take place within three (3) months of the date of the original failure. Students who fail a second attempt on a National Board of Medical Examiners examination will be required to repeat the clerkship and pass a third attempt at the examination before progressing to the next stage of training. Students who fail on the third attempt will be referred to the Promotions Committee for potential dismissal from the School of Medicine program.

The full policy (E-SOM-OME-GEN-PO-00015) can be found online in the UMMC Document Center.

Clinical Skills Assessments

• Failing students will be contacted by the Medical Director and will be required to complete a performance improvement report within (five) 5 days of initial contact.
• Fifty percent (50%) of the score is determined by the standardized patient evaluations and the remainder (50%) is determined by the progress note. Students who score in the bottom five (5) percentile will be considered to have failed the examination unless they have scored 70% of the total possible points.

Medical Student Evaluation Process

Each evaluation type is assigned and completed within MedHub. The course administrator usually assigns all evaluations, except as noted below. It is possible, however, to require students or faculty to initiate various types of evaluations without the need for clerkship administrator intervention. If this method is used, please contact the Office of Medical Education for assistance and ensure students are notified of this requirement. Additionally, notify students of any effects on their grades and evaluations in both the syllabus and at clerkship orientation.

Medical Student Patient Care Documentation

The University of Mississippi School of Medicine is committed to a quality educational experience for all
students. Part of the educational experience is learning how to appropriately document health care information for a patient's medical record. To be prepared for residency, every medical student needs to learn how to gather, organize and synthesize information. Here at the University of Mississippi School of Medicine, students must incorporate the use of the electronic health record into patient care.

All clinical (M3 and M4) students are expected to document their evaluations of patients within the electronic health record. The junior clinical students (M3) will document within the current student tab. The senior clinical students (M4) will document within the patient's medical record.

To ensure compliance with federal regulations and payer requirements, attending physicians may only refer to the medical student's documentation of the Review of Systems (ROS) and Past Medical, Family Medical, and Social History (PMFSH) for billing purposes. The Centers for Medicare and Medicaid Services (CMS) does not allow any documentation by any type of student to be used to support a billable service except as noted above. Any contribution and participation of a student to the performance of a billable service must be performed in the physical presence of a teaching physician or the physical presence of a resident in a service meeting the requirements for teaching physician billing. See http://www.cms.gov/Regulations-and- Guidance/Guidance/Transmittals/downloads/R2303CP.pdf for specific language.

Students will receive training in communication and appropriate use of electronic health records during the preclinical curriculum. Within the syllabus, each clinical clerkship will include the required documentation by students. This documentation will be reviewed by the teaching faculty, and the students will receive formative feedback regarding the documentation effort. Students will need to be reminded to time and date all documents. In addition, all students should be instructed in the appropriate manner to correct errors in writing.

The final use of the documentation will be communicated to the students at the beginning of each rotation and will be noted in the course syllabus. The intent is that documentation by M3 students will be used for teaching purposes and that documentation by M4 students will be like that done by interns and be used for the care of patients. Each Course Director will be responsible for communicating this information to the teaching faculty and residents of their respective departments.

The full policy is available online in the UMMC Document Center.

Supervision of Medical Students

The University of Mississippi Medical Center is dedicated to medical education and to providing excellent care for
our patients. To fulfill this mission, it is recognized that students must participate in rendering services to patients. Students will always be supervised to protect the students and the safety of the patients. This document outlines the guidelines whereby the attending staff or their designee will provide supervision of students in the various settings of this institution.

Types of Supervison

Supervision will consist of two specific levels: Direct Supervision and Indirect Supervision.
Direct supervision is defined as the supervising physician is physically present with the student and the patient during the encounter or procedure. Indirect supervision with direct supervision immediately available occurs when the supervising physician and/or his designee is physically within the hospital or other site of patient care and is immediately available to provide direct supervision if needed.

Faculty Supervision

Medical students are learners and are not licensed to provide independent patient care. At all times, the supervising attending physician retains medical and legal responsibility for the patient's care and is ultimately responsible for the evaluation and management of the patient. It is the responsibility of the supervising faculty to ensure all their designees, residents, fellows, and other licensed practitioners are appropriately prepared for their roles for teaching and supervision of medical students within their scope of practice. Some of the day-to-day supervision of medical students may be delegated to the appropriately prepared designee at the discretion of the supervising faculty. However, the supervising attending physician retains full responsibility for the supervision of the medical students assigned to them during their clinical rotation.

Clinical Supervision

Students will be supervised at all times by qualified faculty members or their designees. Students must be provided with easily accessible, reliable, effective systems of communication with faculty and/or their designee at all times.

Student supervision will foster progressive responsibility and autonomy as appropriate throughout medical school education. Levels of responsibility will be determined by a student's level of training and clinical skills.
Supervision will include formative constructive feedback at the midpoint and summative feedback at the end of a rotation/assignment.

Students may take histories, perform physical exams, and synthesize data. They must clearly identify themselves to patients as medical students. They are allowed access to the medical record. Senior M4 students can document the medical record of patients in designated settings. All documentation will be clearly labeled as a medical student note. Student documentation must be reviewed by an attending physician or their designee. The students must then be provided with feedback. Clinical decisions and orders can never be formulated or enacted by a medical student without an attending or their designee's input. All on-call experiences are subject to the above rules.

Procedural Supervision

Medical students may participate in the care and management of a patient, including invasive and non-invasive procedures, under the supervision of an attending physician or their designee. The degree of supervision should consider the complexity of the procedure, the potential for adverse effects, and the competency of the student to ensure the safety and comfort of the patient. The physician and or their designee must have privileges to perform the procedure being supervised.

The full policy (E-SOM-OME-GEN-PO-00003) can be found online in the UMMC Document Center.

Student Duty Hours

Duty hours are defined as all scheduled clinical and academic activities related to the training program, i.e., patient care (both inpatient and ambulatory), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled educational activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

Duty hour restrictions include:

• A limitation of eighty (80) hours per week, averaged over a four-week period, inclusive of all in-house
  activities.
• One (1) day in seven (7) free from responsibilities to the program, averaged over a four (4) week period, inclusive of call and free from all clinical, educational, and administrative activities (other than reading and preparation time).
• Eight (8) hour breaks between work periods
• Fourteen (14) hour breaks after a twenty-four (24)-hour scheduled call.
• Single work periods no longer than twenty-four (24) hours, with a four (4) hour extension if necessary to transition patient care.

The full policy (E-SOM-OME-GEN-PO-00006) can be found online in the UMMC Document Center.

Student/Preceptor Assignments on Community-Based Rotations

Clerkships that include a community-based portion must have a process in place for students to request a change in preceptor should there be a mismatch or if the student's housing options are inadequate. Medical students must be made aware of this process during the orientation for the clerkship and in the syllabus for the course.