4.08 Policy and Procedures for Consideration of Unprofessional Conduct

Office of the Registrar

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4.08 Policy and Procedures for Consideration of Unprofessional Conduct

Conduct inappropriate to the medical profession is behavior that raises serious doubts about the integrity, character, and faithfulness of a student in meeting the obligations of a medical career. Illegal, unethical, or other behavior inappropriate to the medical profession that is engaged in by a student outside of the Medical School community may also be considered and addressed under these procedures. It is the expectation of the Medical School that all students, whether or not they are on campus or are currently enrolled as degree candidates, will behave in a mature and responsible manner. This expectation for mature and responsible conduct also encompasses accountability for one’s own well-being, including responsible decision-making regarding physical and mental health. Further, the Medical School expects every student to be familiar with the regulations governing membership in the Harvard community. Because students are expected to show good judgment and use common sense at all times, not all kinds of misconduct or behavioral standards are codified here. See generally Section 4.01, Responsibilities of Teachers and Learners, and Section 7.21, University-Wide Statement on Rights and Responsibilities.

When information suggesting the possibility that a student has engaged in conduct inappropriate to the medical profession is brought to the attention of the Dean for Medical Education, the Dean for Students, the Academic Society Master, or the Promotion and Review Board (PRB), the PRB will take up the matter formally. Where the health, safety, or welfare of students, patients, or other members of the Medical School community is deemed to be at risk, the Dean for Medical Education will suspend the student from the Medical School or take any other protective action pending the outcome of these procedures.

When information suggesting the possibility of conduct inappropriate to the medical profession implicates both the rules and functions of the PRB and the Procedures for Resolving Complaints of Discrimination, Harassment, or Unprofessional Relationships and Abuse of Authority (http://hms.harvard.edu/content/procedures-resolving-complaints), the PRB, in consultation with the HMS Ombudsperson when appropriate, will determine which procedure will apply, but ordinarily the matter will be handled by the PRB. When a student’s behavior raises both academic and professional conduct concerns, ordinarily the matter will be handled under the Procedures for Consideration of Unprofessional Conduct. When both the Procedures for Consideration of Unprofessional Conduct and the Procedures for Resolving Complaints of Discrimination, Harassment, or Unprofessional Relationships and Abuse of Authority may apply, ordinarily the matter will be handled under the Procedures for Consideration of Unprofessional Conduct.

In all such cases, however, to the extent that the allegations implicate the University Policy on Sexual and Gender-Based Harassment, they shall be handled under the University Procedures for Handling Complaints Involving Students pursuant to the Sexual and Gender-Based Harassment Policy as set forth below.

When a student is simultaneously a candidate for a degree in another faculty, administrative leadership from the Medical School, ordinarily the Dean for Medical Education or the Dean for Students, will consult with that faculty to decide which faculty will take primary responsibility for resolving the question of unprofessional conduct and will determine a common action before advising the student. When further action by the Faculty of Medicine is required, the student and his/her Society Master will be notified in writing.

For allegations of sexual and gender-based harassment: 

When the information suggesting the possibility of conduct inappropriate to the medical profession involves allegations of sexual or gender-based harassment, then, as set forth in Section 7.16 of the Handbook, the University Policy on Sexual and Gender-Based Harassment (the “University Policy”) applies, as do the University’s Procedures for Handling Complaints Involving Students Pursuant to the Sexual and Gender-Based Harassment Policy (“University Procedures”), which can be found here. In such cases, under the University Procedures, the Harvard University Office for Sexual and Gender-Based Dispute Resolution (“ODR”) is responsible for determining whether a violation of the University Policy by a student took place. HMS remains responsible for student discipline through the PRB. All members of the PRB will receive appropriate training in the handling and resolution of allegations of sexual or gender-based harassment.

When the PRB learns that a formal complaint has been filed with ODR, a PRB representative will meet with the respondent to explain, among other things, the disciplinary process that may take place following the issuance of the ODR’s final report, the range of disciplinary sanctions, and the appeals process following the imposition of any discipline. The PRB representative will also be available to meet with the complainant.

Whenever a formal complaint of sexual or gender-based harassment against an HMS student results in the issuance of a final report from the ODR, the PRB must accept as final and non-reviewable the report’s findings of fact and its conclusions as to whether a violation of the University Policy has occurred. The PRB may interview the student and may undertake any other action it deems necessary to arrive at its conclusions, including consulting with senior faculty or administrators at the University when it feels additional expertise or advice would be useful. The complainant will have the option of meeting with the PRB, but is not required to do so. However, the PRB’s disciplinary proceedings against the student based on conduct addressed by the ODR’s final report will proceed with the understanding that the final report carries the same validity as a determination reached by the PRB itself. The role of the PRB is solely to determine the appropriate disciplinary response. The PRB may take a number of disciplinary actions, including probation, with or without requirements or restrictions; suspension; and requirement to withdraw, with or without a recommendation to dismiss or expel. When no violation of the University Policy has been found, the PRB will review the factual findings contained in the final report. Should the PRB conclude that the alleged conduct, while not a violation of the University Policy, might violate other HMS policies or expectations for conduct, then the PRB will take up the case as set forth below. Once an outcome has been reached, an appropriate representative of the Medical School will notify the student and the complainant of the disciplinary decision.

Any student who is required to withdraw or is expelled as a result of the PRB’s deliberations may request in writing that the PRB reconsider its decision. The request for reconsideration may not challenge the validity of the findings and conclusions contained in the ODR final report, nor may it introduce facts that could have been presented in the course of the ODR investigation or that conflict with any of the findings in the ODR final report. The request must be received by the PRB within 10 business days of the student’s receipt of notice of the decision on remedial action or sanction.

If it chooses to reconsider, the PRB may affirm, revise (make more or less severe), or revoke its decision. Written notification of the action on reconsideration will be sent to the student, to his or her Society Master, and to the HMS Registrar, ordinarily within 10 business days of the meeting at which the request was considered and the decision was rendered. Such notification will constitute the final action of the PRB.

Any student who is required to withdraw or is expelled may appeal the final action of the PRB to a three-member Appeals Panel designated by the Chair of the Standing Committee on Rights and Responsibilities (SCRR; Section 4.04) in consultation with the Chair of the PRB. All members of the Appeals Panel will receive appropriate training in the handling and resolution of allegations of sexual or gender-based harassment. The student’s appeal must be in writing and must contain a full statement of the reasons upon which an appeal is requested. The Appeals Panel must receive the appeal within 10 business days of the date of final action by the PRB. The Appeals Panel will hear the student in person and will review the documentary record. The complainant will have the option of meeting with the Appeals Panel, but is not required to do so. The only role of the Appeals Panel is to review the disciplinary actions taken by the PRB; the Appeals Panel will accept as true and non-reviewable the findings of fact and conclusions within the ODR final report. The Appeals Panel will submit a written report of its findings and recommendations to the Dean for Medical Education. In so doing, the Appeals Panel may affirm, revise (make more or less severe), or revoke the final action of the PRB.

Both the student and the complainant may bring a personal advisor to any interviews with the PRB or the Appeals Panel. A personal advisor should be an officer of the University who is affiliated with HMS but may not be related to anyone involved in the complaint or have any other involvement in the process. Personal advisors may view a redacted version of any documents provided to the parties and provide general advice. During interviews, personal advisors may not speak for their advisees, although they may ask to suspend the interviews briefly if they feel their advisees would benefit from a short break.

Finally, the student may request review of the decision of the Appeals Panel by the Dean of the Faculty of Medicine. The Dean of the Faculty of Medicine must receive any such request for review within 5 business days of the date of the decision of the Appeals Panel. The Dean of the Faculty of Medicine will review the matter, in consultation with the Dean for Medical Education, Academic Society Master, or others (e.g., the Faculty Council) if he wishes, and will provide written notice of his decision to the student, his/her Society Master, the Dean for Medical Education, the HMS Registrar, and the PRB. The Dean’s decision will be final and binding, except in cases of expulsion, in which a two-thirds vote of the Faculty Council is required. The complainant will be notified of the final disciplinary decision.

For all other allegations:

When, after an initial review of the information suggesting possible inappropriate conduct, further action is deemed necessary by the PRB, the PRB may appoint an independent fact-finder. The fact-finder will be a Harvard administrator or faculty member drawn from the Medical School or elsewhere. The fact finder may also be an independent contractor engaged by Harvard. The fact-finder will interview the student and may interview other individuals with relevant knowledge, solicit written statements, review the documentary record, and undertake whatever action is required to elucidate the relevant facts. At the conclusion of his/her inquiry, the fact-finder will prepare a written report describing the inquiry process and his/her findings of fact, identifying any disputed facts. Ordinarily, it is expected that fact-finding will be completed within thirty days, though this timeframe may be extended under extenuating circumstances, including but not limited to complex fact patterns, large numbers of witness interviews, and/or difficulty in scheduling witness interviews. The fact-finder’s report will be submitted to the PRB. The student will also be provided with a copy of the report for his/her written comments. Any comments must be submitted to the PRB within 10 days of receipt of the fact-finder’s report.

The PRB will review the student’s record and current situation in consultation with the student’s Academic Society Master and will determine a course of action that may include, but not be limited to, placement in any of the previously indicated structured academic categories (Section 4.03). In matters of consideration of unprofessional conduct, the PRB may also interview the student and may undertake any other action it deems necessary to arrive at its conclusions, including consulting with senior faculty or administrators at the University when it feels additional expertise or advice would be useful. The PRB may take a number of disciplinary actions, including probation, with or without requirements or restrictions; suspension; and requirement to withdraw with or without a recommendation to dismiss or expel.

The student will be notified in writing of the decision of the PRB. A copy of such notice will be sent to the student’s Academic Society Master, the Dean for Medical Education, the Dean for Students, and the HMS Registrar. The student and/or Society Master may be asked to respond to the stated concerns of the PRB.

Any student who is required to withdraw or is expelled as a result of the PRB’s deliberations may request that the PRB reconsider its decision. The request must be in writing and must be based on one or both of the following grounds: a procedural error occurred that may change the outcome of the decision; or the student has substantive and relevant new information that was not available at the time of investigation and that may change the outcome of the decision. Disagreement with the PRB’s findings or determination is not, by itself, a ground for appeal. The request must be received by the PRB within 10 business days of the student’s receipt of notice of the decision on remedial action or sanction.

If it chooses to reconsider, the PRB may affirm, revise (make more or less severe), or revoke its decision. Written notification of the action on reconsideration will be sent to the student, to his or her Society Master, and to the HMS Registrar, ordinarily within 10 business days of the meeting at which the request was considered and the decision was rendered. Such notification will constitute the final action of the PRB.

Any student who is required to withdraw or is expelled may appeal the final action of the PRB to a three-member Appeals Panel designated by the Chair of the Standing Committee on Rights and Responsibilities (SCRR; Section 4.04) in consultation with the Chair of the PRB. The student’s appeal must be in writing and must contain a full statement of the reasons upon which an appeal is requested. The Appeals Panel must receive the appeal within 10 business days of the date of final action by the PRB. The Appeals Panel will hear the student in person and will review the documentary record. The Appeals Panel may adduce and consider any other information it deems useful in reaching a decision. The Appeals Panel will submit a written report of its findings and recommendations to the Dean for Medical Education. In so doing, the Appeals Panel may affirm, revise (make more or less severe), or revoke the final action of the PRB.

The student may request review of the decision of the Appeals Panel by the Dean of the Faculty of Medicine. The Dean of the Faculty of Medicine must receive any such request for review within 5 business days of the date of the decision of the Appeals Panel. The Dean of the Faculty of Medicine will review the matter, in consultation with the Dean for Medical Education, Academic Society Master, or others (e.g., the Faculty Council) if he wishes, and will provide written notice of his decision to the student, his/her Society Master, the Dean for Medical Education, the HMS Registrar, and the PRB. The Dean’s decision will be final and binding, except in cases of expulsion in which a two-thirds vote of the Faculty Council is required.

Withdrawal or Leave of Absence during Pendency of a Disciplinary Proceeding

The transcripts of students who are withdrawn or placed on a leave of absence from the MD program pending the outcome of disciplinary proceedings will contain an appropriate notation.

Procedure on Unprofessional Student Comments in Course Surveys

Harvard Medical School regularly solicits student feedback on various aspects of the curriculum in order to improve the educational experience for all students. To that end, we ask that, for all core courses, students provide feedback that is candid, constructive, and critical. This is done via an electronic course survey process that ensures complete confidentiality, and all course surveys and accompanying comments are withheld from course directors until after the course grades have been submitted to the Registrar.

In certain rare cases, however, comments from students cross a clear line from critical to offensive, while possessing no redeeming constructive value. Because these comments are made available to the individual faculty member as well as to a number of educational professionals at HMS, including the chair of the instructor’s appointing department, unprofessional comments have the potential to inflict real harm on an individual faculty member, which violates a key tenet of the medical profession.

For this reason, the Curriculum Committee voted to establish a process that will ensure the continued integrity and confidentiality of the course survey process while providing an outlet to address the rare abuses that occur within the system.

In order to achieve this goal, a joint ad hoc committee comprised of three students and two academic society masters will be established to review any comment on a course survey deemed to be unprofessional by a course director, instructor, or official in the Center for Evaluation. To ensure that students on this committee represent the will of the student body, student members of this committee will be either elected student representatives to the Curriculum Committee or other curriculum governance committee or other students who hold elective office, e.g., the Student Council Executive Committee. If a majority of the ad hoc committee agrees that the comment does indeed constitute unprofessional conduct, the Center for Evaluation will authorize the HMS Information Technology department to override the confidentiality protections and identify the responsible student. This information will be provided exclusively to the student’s Society Master, who will determine the appropriate response. The comment will also be redacted from the course survey record.

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