Criteria for Academic Review and Advancement

A. Overview

Promotion from the FOM1 to the FOM2, and from FOM2 to the Core Clinical Experiences is determined by the Basic Science Academic Evaluation Board (BSAEB). Advancement within the CCE and AS years and recommendation for graduation are the province of the Clinical Science Academic Evaluation Board (CSAEB).

The BSAEB and CSAEB each meet approximately monthly during the academic year.  Additional electronic discussion/consultation and voting may occur as necessary. It is the responsibility of each Board to review a student’s entire record, taking into consideration the overall pattern and quality of a student’s academic performance. It should be emphasized that the recommendations of the Boards and actions of the Progress Board, ranging from unqualified promotion to dismissal, are based upon assessments of academic and technical competence and upon qualitative, ethical and behavioral criteria.

Any recommendation made by either Academic Evaluation Board that is considered an adverse recommendation; including requiring a student to (1) repeat a whole semester or an entire year; (2) enter a less than full-time or other program which will delay the student’s time of graduation, (3) take a Leave of Absence at the initiative of the Board rather than of the student, or (4) be dismissed must be presented to the Progress Board. Students may request to defer pre-clinical courses or clinical rotations and enter an extended course of study, without going before the Progress Board, as long as they are making satisfactory progress towards the MD degree.

A student will be considered to be making satisfactory progress towards the MD degree if the following percentage of the curriculum is met:

• End of first year of enrollment 10% of curriculum
• End of second year of enrollment 20% of curriculum
• End of third year of enrollment 30% of curriculum
• End of fourth year of enrollment 50% of curriculum
• End of fifth year of enrollment 75% of curriculum
• End of sixth year of enrollment 100% of curriculum

Percentage of curriculum completed will be calculated based on the percentage of the curriculum which would normally be completed in 4 years. Percentage of curriculum completed includes those mandatory curricular offerings and not supplementary elective courses.

Students failing to meet the above academic advancement criteria will be presented to the respective Academic Evaluation Board (BSAEB or CSAEB) and may be referred to a Progress Board for failure to make satisfactory progress within the curriculum.

Exceptions to the maximum number of years (6 enrollment/2 leave) can be made only in circumstances of extraordinary medical or person- al hardship, on appeal to the appropriate Academic Evaluation Board.

Approved by the Educational Policy Committee (EPC) 6/10.

In 2018, these criteria were changed for students in the Class of 2022 and later. Satisfactory progress for the Class of 2022 and later are:

• End of first year of enrollment 12.5% of curriculum
• End of second year of enrollment 25% of curriculum
• End of third year of enrollment 50% of curriculum
• End of fourth year of enrollment 70% of curriculum
• End of fifth year of enrollment 85% of curriculum
• End of sixth year of enrollment 100% of curriculum

Approved by the EPC April 2018

B. Academic Review and Advancement During the Pre-clerkship Years

In general, a student whose internal record shows no ratings of CREDIT/MARGINAL (CRM) or NO CREDIT (NCR) and less than two ratings of “Incomplete” does not require individual review. Specific requirements for advancement are:

Promotion from FOM1 to FOM2:

• Completion of all required courses for FOM1; no unremediated rating of Students who have received more than one rating of CRM will be reviewed by the BSAEB and Progress Board (if necessary) to determine whether or not they can progress for each course to FOM2
• Course coordinators for each course will establish prerequisites for progression to that course or block of a course. Students who have satisfied the prerequisites will be permitted to progress to that course or course block.
• Students who have not satisfied all requirements to go on to FOM2 may be permitted to take one or more blocks of FOM2 occurring in the first academic year. This promotion to FOM2 is on a provisional basis. In order to continue progression in FOM2, students must satisfy all requirements to move to FOM2 by the start of the second academic year.

Promotion from FOM2 to Core Clinical Experiences (CCE):

• Completion of all required courses in FOM1 and FOM2
• No unremediated ratings of NO CREDIT (NCR), no ratings of “Incomplete” and not more than one unremediated rating of CREDIT/MARGINAL (CRM).

Students meeting these requirements are eligible for advancement unless additional information brought to the attention of the Board (e.g., demonstration by the student of qualities of character or personality which are incompatible with a career as a physician) requires further deliberation and action.

• A student whose record shows an “Incomplete” rating shall be reviewed for the purpose of ensuring completion of the “Incomplete” rating.
• A student whose internal record shows one INTERNAL CREDIT/ MARGINAL (CRM) rating, shall be encouraged, but not required, to remediate that rating to CREDIT (CR) or better.
• A student whose record accrues two CREDIT/MARGINAL (CRM) ratings shall be reviewed for the purpose of prescribing remediation of at least one of the CREDIT/MARGINAL (CRM) ratings, or other appropriate action, including possible mandatory program extension.
• A student whose record accrues three CREDIT/MARGINAL (CRM) ratings may be required to remediate all three of them, and may, in addition, be placed on a mandatory program extension.
• A student whose record shows one rating of NO CREDIT (NCR), either alone OR in combination with one CREDIT/MARGINAL (CRM) rating shall be reviewed, required to remediate the NO CREDIT (NCR) rating(s) and considered for possible mandatory program extension.
• A student whose record shows one rating of NO CREDIT (NCR) and two ratings of CREDIT/MARGINAL (CRM) shall be reviewed and considered for:
  • remediation of all NO CREDIT (NCR) ratings and possible mandatory program extension
  • repetition of the entire academic year

• A student whose record accrues two or more NO CREDIT (NCR) ratings
  • or - one NO CREDIT (NCR) and three CREDIT/MARGINAL (CRM) ratings
  • or - four CREDIT/MARGINAL (CRM) ratings, shall be reviewed and considered for:
    • remediation of all CREDIT/MARGINAL (CRM) or NO CREDIT (NCR) ratings and possible mandatory program extension
    • repetition of the entire academic year
    • dismissal without an opportunity for further remediation

Program extension (please see “Extended Program” Section of the Handbook).

A medical student will be considered to be on “Extended Student” status (“ES”) when that student’s anticipated year of graduation is more than four academic years from the academic year of admission. The change in student status will be effective from the date at which the student begins the action which will extend the program (i.e. withdraws from a required course, begins a leave of absence to do research or other enrichment program, enrolls for fewer than the usual full load of courses). Program extension may include a period of academic leave, either to bring the student’s schedule back into synchrony with the curriculum or to require or allow specific support activities (e.g., counseling, tutoring, reading or other background courses, etc.).

C. Academic Review and Advancement During the Clinical Years

The Core Clinical Experience (CCE) and Advanced Studies (AS)* years constitute the clinical portion of the curriculum. Prior to the CCE year, the student is assigned by computerized lottery to thematic sections. Similarly, prior to the AS year, the student is assigned by computerized lottery to an approved subinternship, Emergency Clinical Problem Solver, Capstone month, and ABTS. As part of AS year planning, students work with their Learning Communities Mentor to select electives to enhance their educational experience and prepare them for residency training. Each student must complete 24 elective credits in order to meet graduation requirements. Details regarding these requirements can be found in Section 1 of the Student Handbook, MD Program Curriculum. (*Advanced Studies beginning in AY 2013/14 as part of the LInC curriculum).

Required Clinical Rotations

Clinical Grading Schema up to and including the 17-18 academic year:

• If a BELOW EXPECTED PERFORMANCE rating has been assigned in a required clerkship, the Clinical Science Academic Evaluation Board (CSAEB) shall review the student’s progress and require remediation which may include repetition of a portion of the clerkship, repetition of the entire clerkship or the taking of an additional clerkship in the appropriate area.
• If a FAILING rating has been assigned in a required clerkship, the CSAEB shall review the student’s progress and/or require remediation which will include repetition of the clerkship or the taking of an additional clerkship in the appropriate area.
• If a student is carrying two or more grades of INCOMPLETE, the student’s academic record will be reviewed by the CSAEB, which may recommend modifications in the student’s academic program.
• If more than one BELOW EXPECTED PERFORMANCE rating, or any combination of BELOW EXPECTED PERFORMANCE and FAILING ratings are assigned in required clerkships, the Board shall review the student’s progress and require repetition of the less than EXPECTED PERFORMANCE clerkships.
• If a student is carrying more than one grade of BELOW EXPECTED PERFORMANCE or FAIL, in a required clinical rotation the CSAEB may recommend modifications in a student’s academic progress.

Clinical Grading Schema beginning with the 18-19 academic year:

• If a FAILING rating has been assigned in a required clerkship, the CSAEB shall review the student’s progress and/or require remediation which will include repetition of the clerkship or the taking of an additional clerkship in the appropriate area.
• If a student is carrying two or more grades of INCOMPLETE, the student’s academic record will be reviewed by the CSAEB, which may recommend modifications in the student’s academic program.
• If a student is carrying more than one grade of FAIL in a required clinical rotation the CSAEB may recommend modifications in a student’s academic progress.

Comprehensive Core Clinical Assessment (CCCA)

Any student who does not fulfill competency performance standards on the CCCA, will be required to complete a self-assessment as directed by CCCA faculty, meet with CCCA faculty to review their performance and must take the (CCCA Retest) to meet competency performance standards. Students will be notified of their CCCA performance results and the need to rake the CCCA Retest by mid-August of each year. The CCCA Retest will be conducted no later than November of the CCCA year.

A CCCA Committee will be formed as a standing subcommittee of the CSAEB to determine and oversee the planning and assessment for any student who does not fulfill competency performance standards on the CCCA. Any such student will be notified no later than August of their CCCA year. They will be required to meet with a faculty member on the CCCA committee to review their individual performance and will be offered individualized assistance. All such students must complete the CCCA Retest. The CCCA Retest will be developed under the oversight of the Committee and will be administered no later than November of the CCCA year. Students’ performance outcomes from the CCCA Retest will be reviewed by the CCCA Committee.

For the student who does not demonstrate “competency” standards on the CCCA Retest, performance of “not meeting competence” on the CCCA will be reported to the student and the CSAEB. Any such student will be required to undergo individualized remediation of their clinical skills with the Center for Academic Achievement. As it is a graduation requirement to pass the CCCA, additional testing for any such student will be overseen by the CCCA Committee.

The student may submit a written appeal regarding the CCCA and the CCCA Retest grade to the Committee within 2 weeks of the grades being sent to the students. All appeals will be managed by the CCCA Committee.

Advanced Studies Electives

Clinical Grading Schema up to and including the 17-18 academic year:

• If one BELOW EXPECTED PERFORMANCE rating is assigned in an elective, the Board shall recommend, but not require, remediation.
• If more than one BELOW EXPECTED PERFORMANCE rating or any FAILING rating is assigned in elective courses, the Board shall require repetition of the less than EXPECTED PERFORMANCE electives or substitution of other appropriate electives to meet the 24 week minimum.
• If a BELOW EXPECTED or FAILING rating is assigned in an elective and the 24 week minimum is fulfilled by substitution of another appropriate elective rather than by direct remediation of the original elective, the grade of BEP or F in that elective will remain on the student’s permanent transcript.

Clinical Grading Schema beginning with the 18-19 academic year:

• If any FAILING rating is assigned in an elective course, the Board shall require repetition (remediation) of the elective if it is required to meet the 24 week Remediation of the FAILING grade will be noted on the permanent transcript with an asterisk.
• If a FAILING rating is assigned in an elective and the 24 week minimum is fulfilled by addition of another appropriate elective rather than by direct remediation of the original elective, the grade of F in that elective will remain on the student’s permanent transcript.

The Clinical Science Academic Evaluation Board shall recommend students to the Dean of the T.H. Chan School of Medicine for receipt of the MD degree based on completion of all of the requirements for the MD degree as found in “Section ONE: Academic Programs.”