4.03 Promotion and Review Board and Student Disciplinary Actions
PRB Review and Structured Academic Categories
The Promotion and Review Board (PRB) regularly reviews student grades, evaluations, and reports of academic and clinical performance. Performance issues that are raised as a result of the PRB’s review and/or referred to the PRB by the HMS Registrar or by the Academic Societies may trigger review at one of the PRB’s monthly meetings. In addition, unprofessional, inappropriate or irresponsible conduct by a student in connection with his or her academic, clinical, or extracurricular/enrichment activities will be considered by the PRB. Such conduct may include, but is not limited to, breaches of trust or confidence in personal actions including cheating, plagiarism, or unauthorized use of materials in academic exercises or examinations; misrepresentations, distortions or serious omissions in data or reports in research or clinical care; abuse, misrepresentation, or other improper conduct in relation to patients or colleagues in clinical or academic settings; repeated failures to meet assigned obligations in professional, clinical, or research training programs; and lapses in standards of professional conduct and responsibility. Evidence of student performance will be considered by the PRB in conjunction with the Master and Associate Master of the student’s Society in the context of the student’s special problems and/or needs.
Sharing Information about Student Performance with Course Directors
When a student is placed on Monitored Academic Status (MAS) or Academic Probation (AP) or is repeating an academic year, the PRB may inform one or more course, clerkship, or Principal Clinical Experience (PCE) director(s) of a student’s past performance in other courses before the student begins a course, clerkship, or PCE. This action is undertaken to ensure adequate observation and supervision of the student’s performance and to permit a comprehensive evaluation of the student’s progress at the conclusion of the prescribed course work.
Medical or Mental Health Issues
In appropriate circumstances, the PRB may require that a student receive a medical and/or psychiatric evaluation to assess whether a medical or mental health condition may be interfering with a student’s satisfactory academic performance or ability to meet standards of professional conduct. Among other things, such evaluation may inform the PRB’s thinking about whether reasonable accommodations might assist a student. If a student’s presence is deemed to be a potential threat to order, health, safety, or patient care, the Dean for Medical Education will take any action that is deemed appropriate, including placing the student on temporary leave of absence.
Structured Academic Categories
Based on its review of student performance, the PRB may place a student in any one of seven structured academic categories for remediation and/or sanction. Ordinarily, remedial and/or sanction programs will be implemented by the student’s Academic Society and monitored by the PRB. The seven structured academic categories include the following:
- Formal Notice
- Monitored Academic Status (MAS)
- Academic Probation (AP)
- Requirement to Repeat an Academic Year
- Voluntary or Involuntary Leave of Absence
- Requirement to Withdraw
1. Formal Notice
Ordinarily the PRB will send Formal Notice to a student after: a) two marginal satisfactory grades or one failure on initial taking of a final exam in a preclerkship course (regardless of whether the student passes the exam or improves the marginal grades on subsequent reexamination in the course); or b) a shelf exam failure in a core clerkship. Formal Notice will also be sent after documented failure to meet HMS standards of professional conduct and responsibility.
Any Formal Notice sent to the student will include a written explanation of the PRB’s concerns. A copy of the Formal Notice will be sent to the student’s Academic Society, the HMS Registrar, the Dean for Students, and the Dean for Medical Education.
2. Monitored Academic Status (MAS)
Monitored Academic Status indicates that a student requires closer monitoring by the School. MAS is designed primarily as a program for remediation tailored to an individual student’s special challenges and/or needs. Each student on MAS is strongly encouraged to work with his or her Academic Society to remediate academic difficulties and to employ all available resources of the School to address issues that may have contributed to his/her academic difficulties.
Ordinarily students will be automatically placed on Monitored Academic Status for one or more of the following reasons:
- One Unsatisfactory grade in a preclerkship course;
- Three or more marginal satisfactory grades in preclerkship courses;
- Two or more failures of shelf exams or other objective exams in core clerkships;
- One Unsatisfactory grade in a core clerkship or clinical elective;
- Three or more Formal Notices from the PRB;
- Failure to complete conditions specified by the PRB;
- Requirement to discontinue participation in the PCE for academic reasons; or
- Failure to meet HMS standards of professional conduct and responsibility.
Students on MAS may not serve on appointed committees at the School, are required to limit their extracurricular activities, and will not be granted a leave of absence for other than medical reasons.
Students are eligible to be taken off MAS when they have completed all conditions specified by the PRB. Any monitored period will be a minimum of one year, to allow sufficient time for close monitoring of student performance. Any monitored period may be extended past the original period if the PRB determines that the student requires continued monitoring. During this period, the student’s Academic Society will report to the PRB regularly concerning the student’s progress.
3. Academic Probation
Academic Probation is a formal action by the PRB that changes a student’s status in the School from “good standing” to “academic probation.” Academic Probation is noted permanently in the student’s official HMS recordand places a student on notice that his or her academic performance or behavior has created considerable cause for concern and is subject to critical and ongoing evaluation and monitoring.
Ordinarily students will be placed on Academic Probation for one or more of the following reasons:
- Requirement to repeat an academic year;
- Two or more Unsatisfactory grades in courses or clerkships;
- Two or more failures of USMLE Step exams;
- Failure of a course while on MAS;
- Failure to complete conditions specified by the PRB; or
- Serious or repeated failure to meet the HMS standards of professional conduct and responsibility.
Students on Academic Probation are not allowed to serve on appointed committees at the School, are required to discontinue their extracurricular activities, and are not granted a leave of absence for other than medical reasons. Students are eligible to be taken off Academic Probation when they have completed all conditions specified by the PRB. Any probation period will be a minimum of one year, to allow sufficient time for correction and close monitoring of student performance. See also: Section 1.05: Five-Year MD Program.
When the health, safety, or welfare of students, patients, or other members of the Medical School community are deemed to be at risk, the Dean for Medical Education, independently, or at the request of the PRB, will suspend the student from the Medical School or take any other protective action pending the outcome of PRB or other administrative review. Suspension may also be warranted when a student is accused of serious misconduct that requires further investigation.
5. Requirement to Repeat an Academic Year
Ordinarily students are required to repeat all or part of an academic year if they fail two or more courses or clerkships in one academic year. Students may also be required to repeat an academic year if they are noncompliant with PRB conditions or fail to meet HMS standards of professional conduct and responsibility. (See Section 2.19)
6. PRB-Imposed Leave of Absence (Voluntary or Involuntary)
In certain cases, the PRB may choose to offer a student the opportunity to go on voluntary Leave of Absence (LOA) or to place a student on Involuntary Leave of Absence (Involuntary LOA). Ordinarily this type of PRB-imposed LOA is indicated when remediation has been unsuccessful and time away for extensive academic remediation or medical help is deemed crucial to successful completion of the degree program. A student who has been placed on a PRB-imposed LOA (either voluntary or involuntary) and who subsequently petitions to return to the Medical School will be required to demonstrate to the PRB that the circumstances that led to the LOA have been addressed satisfactorily. If a leave was necessitated because of health concerns, prior to a student’s return, the student must obtain a medical or psychiatric clearance, as the case may be, from a physician selected by PRB, usually from Harvard University Health Services. At the end of the LOA, the student may request an extension. Extensions must be requested two or more months prior to the end of the LOA and will be considered on an individual basis. A LOA is granted for up to one year with the possibility of a one-year extension, granted on a case-by-case basis after review by the Council on Student Affairs (CSA) or the PRB, if a student submits the request before the first year of leave is over. Students who do not return to full-time status at the end of an approved leave and who have not reapplied for a second year of leave are considered to have withdrawn from Harvard Medical School. For more information about LOAs, see Section 2.09.
7. Requirement to Withdraw
Students may be required to withdraw in situations involving repeated failures, when attempts of academic remediation have been unsuccessful, or when students have failed to meet PRB requirements while subject to MAS, on Academic Probation, or during a PRB-imposed LOA. Thus, students who are repeating an academic year and fail one or more course(s) will be required to withdraw from the MD program. Students who fail to pass USMLE Step 1, Step 2CK, or Step 2CS after three attempts will be required to withdraw. Students may also be required to withdraw if found to have committed an act of academic dishonesty or for the repeated or gross failure to meet professional standards of conduct. Students who do not return to full-time status at the end of an approved leave and who have not reapplied for a second year of leave are considered to have withdrawn from Harvard Medical School.
Expulsion is triggered by serious misconduct or a continuing pattern of academic and/or behavioral failures that have not been successfully remediated. Expulsion requires support by a two-thirds vote of the HMS Faculty Council.
These Structured Academic Categories are summarized in the charts below.
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