4.03 Policies and Procedures on Student Rights and Responsibilities
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 Board’s review and/or referred to the Board by the HMS Registrar or by the Academic Societies may trigger review at one of the Board’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 Board 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 Board’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:
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Formal Notice
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Monitored Academic Status (MAS)
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Academic Probation (AP)
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Suspension
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Requirement to Repeat an Academic Year
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Voluntary or Involuntary Leave of Absence
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Requirement to Withdraw
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Expulsion
1. Formal Notice
Ordinarily the Board 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 preclinical course (regardless of whether the student passes the exam or improves the marginal grades on subsequent reexamination in the course); b) two satisfactory grades in core or elective clerkships; or c) 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 Board’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:
- Failure of a course or clerkship;
- Three or more marginal satisfactory grades in preclinical courses;
- Two or more failures of shelf exams or other objective exams in core clerkships;
- Three or more satisfactory grades in core clerkships or clinical electives;
- Three or more Formal Notices from the Board;
- 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 Board determines that the student requires continued monitoring. During this period, the student’s Academic Society will report to the Board regularly concerning the student’s progress.
3. 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)
4. Suspension
Where 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. 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.
6. Academic Probation
Academic Probation is a formal action by the Board 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 record. Academic Probation places a student on notice that his or her academic performance or behavior has created considerable cause for concern and is subject to critical evaluation.
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 course or clerkship failures;
- Two or more failures on a National Board (USMLE) Step exam;
- 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.
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, for example, 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.
8. Expulsion
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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Causal Event(s) or triggers |
Remedial Action and Requirements of Category |
Communication Documentation |
Duration |
|---|---|---|---|
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FORMAL NOTICE |
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Ordinarily one or more of the following:
· 1 primary failure (on initial exam)
· 2 marginal satisfactory grades in preclinical courses
· 2 Satisfactory grades in core or elective clerkships
· Shelf exam failure in a core clerkship
· Serious comments of concern either in narrative evaluation from a course or clerkship or as reported by the Academic Society, course/clerkship/PCE director or other official
· Failure to meet HMS standards of professional conduct and responsibility |
NA |
Student receives written notice regarding PRB concerns, including written notice cc’d to Society, Registrar, the Dean for Students and the Dean for Medical Education. |
NA |
|
MONITORED ACADEMIC STATUS (MAS) |
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|
Causal Event(s) or triggers |
Remedial Action and Requirements of Category |
Communication Documentation |
Duration |
|
Ordinarily one or more of the following:
· 1 course or clerkship failure
· 3 marginal satisfactory grades in preclinical courses or 3 or more Satisfactory grades during the clinical phase of education
· 2 or more shelf exam or other objective exam failures
· Noncompliance with PRB conditions
· Continuing pattern of formal notice (3 or more)
· Failure to meet HMS standards of professional conduct and responsibility
· Requirement to discontinue participation in PCE for academic reasons
·Failure of either USMLE Step 1 or Step 2 (CK and/or CS) |
Remedial program* for student created by Society and/or the Office of Advising Resources and approved by PRB.
Students on MAS may not serve on appointed committees at the School, are required to limit* their extracurricular activities, and are ordinarily not granted a leave of absence for other than medical reasons.
* Remedial program must include a statement of degree to which activities are to be limited and must be approved by the PRB.
When appropriate, the PRB will be responsible for working with the Society and/or the student to ensure that the student has reflected on and learned from the experience.
At an appropriate time during the period of MAS the student must work with the Society to prepare a written account for PRB review about what has been learned from the experience.
Society reports back to PRB at regularly scheduled meetings about student progress, with particular focus on what she/he has learned from the experience. |
Student receives written notice regarding PRB concerns and placement of student on MAS. Written notice cc’d to Society, Registrar, the Dean for Students and the Dean for Medical Education.
The Board may inform one or more course director(s) of a student’s past performance in other courses prior to the student’s starting a course.
MAS is not reported in the student’s permanent academic record. |
Ordinarily for period of one year with extension if necessary. |
|
ACADEMIC PROBATION (AP) |
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|
Causal Event(s) or triggers |
Remedial Action |
Communication Documentation |
Duration |
|
Ordinarily one or more of the following:
·2 or more failures of courses and/or clerkships (remediated failures will be taken into consideration)
● Failure of a course while on MAS
· Noncompliance with PRB conditions
· Serious or repeated failure to meet HMS standards of professional conduct and responsibility
· 2nd failure of either USMLE Step 1 or Step 2 (CK or CS)
· Requirement to repeat an academic year |
Remedial program for student created by Society and/or the Office of Advising Resources and approved by PRB. Program must provide for structured support in areas of academic weakness and must be constructed to promote professional development.
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.
When appropriate, the PRB will be responsible for working with the Society and/or the student to ensure that the student has reflected on, and learned from, the experience.
At an appropriate time during the period of AP, the student must work with the Society to prepare a written account for PRB review about what has been learned from the experience. This account should be organized according to developmental areas.
Society reports back to PRB at regularly scheduled meetings about student progress, with particular focus on what she/he has learned from the experience. |
Student receives written notice regarding PRB concerns and placement on Academic Probation. Notice includes statement that student is no longer “in good standing.” Written notice cc’d to Registrar, Society, Dean for Students, Dean for Medical Education. The Board may inform one or more course director(s) of a student’s past performance in other courses prior to the student’s starting a course. AP is recorded in the student’s permanent academic record.
Dates, reasons for AP, and resolution specified in the student’s MSPE/Dean’s letter to be reviewed by the PRB.
|
Ordinarily for period of one year with extension if necessary. |
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REQUIREMENT TO REPEAT ACADEMIC YEAR |
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Causal Event(s) or triggers |
Remedial Action |
Communication Documentation |
Duration |
|
Ordinarily one or more of the following:
· 2 or more unremediated course or clerkship failures
· Noncompliance with PRB conditions
· Failure to meet HMS standards of professional conduct and responsibility
|
Student is placed on Academic Probation.
Remedial program for student created by Society and/or the Office of Advising Resources and approved by PRB. Program must provide for structured support in areas of academic weakness and must be constructed to achieve learning in structured developmental categories.
Students repeating an academic year are not allowed to serve on appointed committees at the school, are required to limit their extracurricular activities, and are ordinarily not granted a leave of absence for other than medical reasons.
When appropriate, the PRB will be responsible for working with the Society and/or the student to ensure that the student has reflected on, and learned from, the experience.
At an appropriate time during the period of repeat, the student must work with his/her Society to prepare a written account for PRB review about what has been learned from the experience. This account should be organized according to developmental areas.
Society reports back to PRB at regularly scheduled meetings about student progress, with particular focus on the outcome of the student’s reflection on what she/he has learned from the experience. |
Student receives written notice regarding PRB concerns and requirement to repeat academic year and placement on AP. Written notice cc’d to Society, Registrar, Dean of Students, Dean for Medical Education. AP is recorded in the student’s permanent academic record.
The Board may inform one or more course director(s) of a student’s past performance in other courses prior to the student’s starting a course.
Dates, reasons for Repeat Academic Year and resolution specified in the student’s MSPE/Dean’s letter to be reviewed by the PRB.
Student may appear before the PRB to present a personal account of the case. |
Ordinarily for a period of one year. |
|
Suspension |
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|
Causal Event(s) or triggers |
Actions/ Requirements |
Communication Documentation |
Duration |
|
Ordinarily one or more of the following:
Where the health, safety, or welfare of students, patients, or other members of the Medical School community are deemed to be at risk due to the behavior or presence of the student.
Suspension may also be warranted when a student is accused of serious misconduct that requires further investigation.
|
Student must discontinue all HMS activities both academic and extracurricular.
Student may be asked to surrender ID and, while suspended, may not be permitted access to the resources or facilities of the School
Significant concerns regarding a student’s suitability for a career in medicine |
Student receives written notice regarding PRB concerns and Suspension.
Written notice cc’d to Society, Registrar, Dean for Students, Dean for Medical Education.
Dates, reasons for Suspension and resolution specified in the student’s MSPE/Dean’s letter to be reviewed by the PRB.
|
To be determined |
|
TEMPORARY WITHDRAWAL; INVOLUNTARY LEAVE OF ABSENCE (LOA) |
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|
Causal Event(s) or triggers |
Remedial Action |
Communication Documentation |
Duration |
|
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 |
Remedial program created by Society and/or the Office of Advising Resources and approved by PRB. Remedial program must make explicit the School’s expectations for the student’s activities during the leave, expected duration of the leave, and conditions of return and reentry into the MD program. One criterion for the plan is its implication for progress in the developmental categories.
At appropriate times during the LOA, the student must work with the Society to prepare a written account for PRB review about what has been learned from the experience. This account should be organized according to developmental areas.
Society reports back to PRB at regularly scheduled meetings about student progress, with particular focus on the outcome of the student’s reflection on what she/he has learned from the experience.
A LOA triggered in whole or in part by medical or mental health concerns may require medical or psychiatric clearance before a return to School. The PRB will make this determination at the outset when placing a student on leave. Clearance is usually determined by Harvard University Health Services. |
Student receives written notice regarding PRB concerns and requirement for leave of absence. Written notice cc’d to Society, Registrar, Dean for Students, Dean for Medical Education.
Dates, reasons for LOA and resolution specified in the student’s MSPE/ Dean’s letter to be reviewed by the PRB.
Student may appear before the PRB to present his/her account of the case. |
LOA status is granted for one year at a time with the possibility for a second year’s LOA if the application is submitted before the first year ends.
Student remains on AP if applicable upon return for one year or a period determined by the PRB. |
|
REQUIREMENT TO WITHDRAW |
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|
Casual Event(s) or triggers |
Remedial Action and Requirements of Category |
Communication Documentation |
Duration |
|
One or more of the following:
· Repeated failure when attempts of academic remediation have been unsuccessful
·Academic dishonesty such as acts of plagiarism, cheating, or falsification of research results.
· Noncompliance with PRB conditions and/or requirements while on MAS, Academic Probation or on a PRB-imposed LOA
· 1 or more failure during a repeat academic year
· Failure to return from LOA after two consecutive years
· Failure to adhere to time to degree policies
· Failure to meet HMS standards of professional conduct and responsibility
· Failure to pass a USMLE Step I or Step II exam after three attempts |
N/A |
Student receives written notice regarding PRB concerns and decision to impose a requirement to withdraw. Written notice cc’d to Society, Registrar, Dean for Students, Dean for Medical Education.
Student may appear before the PRB to present his/her account of the case. |
NA |
|
EXPULSION |
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|
Causal Event(s) or triggers |
Remedial Action and Requirements of Category |
Communication Documentation |
Duration |
|
The Board determines that no further action on the part of the School or the student can reasonably assure the student’s eventual successful completion of degree program |
Requires 2/3 vote of the Faculty Council |
Student receives written notice regarding requirement to withdraw or expulsion. Written notice cc’d to Society, Registrar, Dean for Students, Dean for Medical Education.
Student may appear before the PRB to present his/her account of the case. |
NA |
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