Grading, Promotion, and Academic Standing (GPAS)

https://elpaso.ttuhsc.edu/som/ome/CEPC/_documents/secure/GPAS_Policy_11-22-2022.pdf

1. Policy Statement: This document defines the school’s expectations and practices related to the determination of student grades, promotion, and academic standing.
2. Reason for Policy: The purpose of this policy is to guide the faculty and its relevant committees in their administration of student grades, promotion, and academic standing.
3. Who Should Read this Policy: All PLFSOM educational program leaders, including the dean, the vice president for academic affairs, all academic officers of the Office of Medical Education and Office of Student Affairs, all course/clerkship directors and assistant directors, and all members of the following standing faculty committees: the Committee on Curriculum and Educational Policy CEPC), the Committee on Student Grading and Promotion (GPC), the SubCommittee on Evaluation of Educational Programs, and the Committee on Student Affairs. This policy is included in the student handbook and should be read by all students
4. Resources: This policy is administratively maintained by the PLFSOM Office of Medical Education, and further supported by the Office of Student Affairs. As described below, the Committee on Student Grading and Promotion has especially extensive responsibility for adherence to and application of this policy.
5. The Policy (Introduction):
   1. Grading: Every student has a right to a course grade that represents the faculty’s good faith judgment of the student’s academic performance. A student’s grade in every course is based upon performance, professional behavior, and/or participation in any activities as may be applicable to that course as described in its syllabus. Responsibility for student assessment and grading rests with the course faculty. Faculty members have an obligation to the students, the school, and the public to award passing grades only to those students who have demonstrated the knowledge, skills, attitudes, and conduct defined by the MD degree program’s educational goals and objectives, the PLFSOM technical standards for admission, retention, and graduation (‘Technical Standards’) and by other school and institutional policies related to attendance, participation, assessment, and conduct.
   2. Promotion/Student Advancement (referring to LCME accreditation element 9.9): Every student achieving all of the academic, technical non-academic, and professional standards of the courses and curricular phase in which they are enrolled is entitled to be promoted according to the MD degree plan as outlined in the school’s academic catalog. Responsibility for monitoring and recommending students for promotion and graduation based on their academic and professional progress rests with the Committee on Student Grading and Promotion (GPC). The GPC has an obligation to the students, the school, and the public to allow a student to be promoted, and to graduate, only when they have demonstrated the knowledge, skills, attitudes, and conduct defined by the MD degree program’s educational goals and objectives, the PLFSOM standards for curricular completion (‘Technical Standards’) and by other school and institutional policies related to attendance, participation, assessment, and conduct. This obligation specifically includes preventing the promotion and graduation of students who demonstrate unacceptable behavior or conduct in the care of patients, in relationships with faculty, residents, staff, and peers, and/or in their public life. A student may be dismissed if the GPC determines that the student’s academic and/or professional performance is unsatisfactory or that the student is otherwise unfit to continue the study of medicine with information from the physician and student wellbeing committee along with the Paul L Foster School of Medicine technical standards for admission, retention, and graduation.
   3. Good academic standing: Students on academic probation as defined below in Sections 9 (pre-clerkship phase) and 11 (clerkship phase) are not in good academic standing. Students on academic warning as defined in Sections 9 (preclerkship) and 11 (Clerkship) are still considered to be in good academic standing unless otherwise specified by the GPC.
      1. Students on probation are not permitted to enroll in any additional or supplemental elective courses or programs, or to serve as an officer for a school-sponsored student committee or organization. Students on probation are required to withdraw from any additional or supplemental elective courses or programs, and to resign from any ongoing service as an officer for any school sponsored student committees, organizations or leadership roles.
      2. Students on academic warning are required to critically review and reduce their extracurricular activities (leadership roles, supplemental curricula, and/or volunteerism), and required to seek approval of their plans in this regard from the associate dean for student affairs or their designee. This review is to be documented and retained by the associate dean of student affairs’ or their designee. Non-adherence to an approved plan may result in referral of the student to the GPC for a review of their academic status based on a professionalism concern.
   4. Leave of Absence: Students on leave of absence with interruption of enrollment are required to resign from any ongoing service as an officer for any school sponsored student committees, organizations or leadership roles. Participation in volunteer activities must be approved by the associate dean for student affairs or their designee. For more information regarding LOA with and without interruption of enrollment, please refer to the Student Leave of Absence and Suspensions Policy HSCEO OP 77.05 Policy.
6. Responsibilities for the operational/day-to-day monitoring of student progress ​The associate dean for student affairs in conjunction with the college mentors, the associate dean for medical education, the assistant dean for the pre-clerkship phase, and the assistant dean for the clerkship phase are responsible for the operational/day-to-day monitoring of the medical students and will refer students to appropriate academic or personal counseling services when indicated.
7. Responsibilities of the Committee on Student Grading and Promotion (GPC) The GPC is a standing committee of the PLFSOM Faculty Council, defined and governed by the PLFSOM Faculty Bylaws, and with fundamental responsibilities as outlined in Section 5 above. The GPC is not a policy making body, but it applies policies related to grading and promotion as approved by the Committee on Curriculum and Educational Policy (another standing committee of the PLFSOM Faculty Council). The Office of Student Affairs provides administrative support to the GPC and maintains the committee’s meeting minutes and other records. Students are notified from the Office of Student Affairs in writing if they are expected to meet with the GPC to discuss their performance in relation to the school’s academic, non-academic (technical), and professional standards. Students are required to meet with the associate dean of student affairs and/or the assistant dean of student affairs to prepare for the GPC meeting. The chair of the GPC composes the committee’s recommendation(s) letter that individually notifies affected students of any decisions by the committee related to their academic status, and the student’s college mentors, the director of academic support, the associate dean for student affairs, the assistant dean for students affairs, the associate dean for medical education, the respective assistant deans for pre-clerkship or clerkship phase, and the dean (or their designee) receive a copy. In addition, a copy of this document shall be retained in the student’s permanent record. The proceedings of the GPC are confidential, in accordance with the Family Educational Rights and Privacy Act of 1974 (FERPA).
   1. Guidelines for GPC deliberations and determinations regarding a student’s academic status
      1. Five members of the committee constitute a quorum at a regular or called meeting.
      2. All committee decisions requiring a vote are determined by a simple majority vote with the chair included as a voting member.
      3. In conducting individual student reviews, the committee is expected to review the relevant academic outcomes, including professionalism concerns, to consider a student’s responses to the specific outcomes and concerns, and act on the committee’s findings according to the rules outlined in this policy whenever applicable. In circumstances for which a rule is not specified, the GPC is empowered to make determinations regarding a student’s academic status within the institution’s general academic policies.
8. Responsibilities of the Dean Initial recommendations and associated actions for each student are delegated to the GPC. The dean or their designee acting as the chief academic officer is responsible for administering the appeals process and rendering final decisions
9. Review of pre-clerkship phase coursework The GPC reviews pre-clerkship student progress at the end of the fall semester and at the end of each academic year. Completed courses in the pre-clerkship phase of the curriculum use a Pass/Fail grade mode according to HSCEP OP 59.05 (Grading Procedures and Academic Regulations). Other transcript notations may apply to courses not completed (per HSCEP OP 59.05). Students passing all courses with no professionalism concerns or exceptional circumstances adversely affecting their academic progress are promoted as a cohort according to the MD degree plan (per PLFSOM academic catalog). All other students are designated as either on academic warning or academic probation (see also paragraph 5.c above):
   1. Academic Warning: Students designated as on academic warning have specifically identified academic and/or professional challenges that are potentially remediable within the current academic year or prior to progression to the next academic phase. Unless specifically modified by the GPC, this status persists until all associated academic and/or professional performance deficiencies are satisfactorily resolved, at which point the student is no longer designated as on academic warning.
   2. Academic Probation: Academic probation is a formal designation and is recorded on the Medical Student Performance Evaluation (MSPE) at the discretion of the Grading and Promotions Committee. Students on academic probation have specifically identified academic and/or professional deficits that are not remediable within the current academic year or prior to progression to the next academic phase. In most instances of academic probation students will be required to repeat a year or complete a revised curriculum plan that is less than one year in duration. This needs to be considered in conjunction with the Leaves of Absence and Suspensions Policy HSCEP OP: 77.05. Unless specifically modified by the GPC, the designation of academic probation persists until satisfactory completion of the repeat year, at which point the student is on academic warning until satisfactory completion of the pre-clerkship phase of the curriculum. At the discretion of the GPC, a student placed on academic probation for professionalism concerns may be permitted to progress without repeating the year. The designation of probation will remain until the GPC determines that the professionalism issue has been satisfactorily addressed and remediated.

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All students referred to the GPC are subject to individualized GPC reviews that incorporate the student’s current and accumulated academic performance since matriculation, any professionalism notations/concerns, compliance with educational program expectations (per program policies and as may be individually specified by the GPC), and any exceptional circumstances affecting the student’s academic performance. In most cases a student’s academic warning or probation status is automatically determined by their circumstances as outlined below. However, students initially designated as on academic warning shall be re-designated as on academic probation if the GPC determines that repeat of the year or a revised curriculum plan is necessary.

Note regarding pre-clerkship phase deferred/temporary grade resolution and course remediation plans: Standard plans for the resolution of deferred/temporary course grades are specified by course syllabi. When individualized course (or course component) remediation is a consideration, the course director shall propose a plan for GPC review and approval.

1. Fall Semester Review

   Table 9.a Pre-Clerkship Phase Fall Semester Review Rules
   The GPC will consider all pre-clerkship phase students after the end of the fall semester. Students will be placed on academic warning or academic probation and reviewed by the GPC according to the following rules:
   If:	Then:
   Deferred/temporary grade in one course:
   SPM
   One SPM unit failed on the first attempt	Academic warning, referral to the GPC at the discretion of the SPM course director, the assistant dean for the pre-clerkship phase, and/or the associate dean for medical education (for consideration of individual remediation or repeat of the year).
   Two SPM units failed on the first attempt	Academic warning with required referral to the GPC for individualized review, including academic performance issues that may not be adequately identified or addressed at the course level (see sections 5.b and 9 above)
   SCI or Medical Skills or Colloquium	Academic warning, referral to the GPC at the discretion of the course director and/or associate dean for medical education (for consideration of individual remediation or repeat of the year)
   Deferred/temporary grade in two courses:
   One SPM unit and one of the following: SCI, Medical Skills, or Colloquium	Academic warning and referral to the GPC at the discretion of the relevant course directors, the assistant dean for the pre-clerkship phase and/or the associate dean for medical education (for consideration of individual remediation, repeat of the year, or dismissal)
   Two SPM units and one of the following: SCI, Medical Skills, or Colloquium	Academic probation and referral to the GPC for consideration of repeat of the year or dismissal
   Any two of the following: SCI, Medical Skills, or Colloquium	Referral to the GPC for determination of at-risk status (academic warning or academic probation) and for consideration of individual remediation, repeat of the year, or dismissal
   Deferred/temporary grade in three or more courses:
   Any combination of three or four of the following: SPM, SCI, Medical Skills, or Colloquium	Academic probation and referral to the GPC for consideration of repeat of the year or dismissal
   Failure of one course:
   SPM, SCI, Medical Skills or Colloquium	Academic probation and referral to the GPC for consideration of individual remediation, repeat of the year or dismissal
   Failure of multiple courses:
   Any combination of two or more courses (SPM, SCI, Medical Skills, and/or Colloquium)	Academic probation and referral to the GPC for consideration of repeat of the year or dismissal
   vi. Professionalism concerns	A student referred to the GPC based on a professionalism concern may be placed on academic warning or probation based on the GPC’s review of the specific concern(s) and the student’s overall academic record. GPC considerations may include individual remediation, repeat of the year, or dismissal, and possible referral to the Physician and Student Well Being Committee (PSWBC). As professionalism is an essential component of the school’s academic program (see the PLFSOM medical education program goals and objectives and the PLFSOM technical standards), the GPC may issue directives solely based on professionalism concerns (regardless of the student’s performance related to other educational program goals and objectives). Refer to policy HSCEP OP 10.20 for requirements regarding criminal record information/updates available at: https://elpaso.ttuhsc.edu/opp/_documents/10/op1020.pdf

    

2. Year End Review

   Table 9.b Pre-Clerkship Year End Review Rules
   The committee will consider all pre-clerkship phase students after the end of the academic year. Students will be placed on academic warning or academic probation and reviewed by the GPC according to the following rules:
   If:	Then:
   Not already on academic warning or academic probation based on prior performance	Criteria per Section 9.a (see above) applies
   Already on academic warning based on prior performance:
   Already on academic warning based on Fall semester performance in SCI, MS, or Colloquium plus failure of one SPM unit in the Spring semester	Continuation of academic warning, referral to the GPC at the discretion of the SPM course director, the assistant dean for the pre-clerkship phase, and/or associate dean for medical education
   Already on academic warning based on one SPM unit failure in the Fall semester plus failure of one SPM unit in the spring semester	Continuation of academic warning with required referral to the GPC for individualized review, including academic performance issues that may not be adequately identified or addressed at the course level (see sections 5.b and 9 above)
   c. Already on academic warning based on one SPM unit failure in the Fall semester plus: Failure of two SPM units in the spring semester or Failure of one SPM unit in the spring semester and a deferred/temporary grade in one spring semester course including Medical Skills, SCI or Colloquium	Academic probation, and referral to the GPC for consideration of repeat of the year or dismissal
   Already on academic warning based on performance in the fall semester of either SCI, MS, or Colloquium plus a deferred/temporary grade in one spring semester course of either SCI, MS, Colloquium	Continuation of academic warning, referral to the GPC. For consideration of individual remediation, repeat of the year, or dismissal
   Failure of any spring semester course	Academic probation, and referral to the GPC for consideration of repeat of the year or dismissal
   Failure to resolve any deferred/temporary grades from the fall semester	Academic probation, and referral to the GPC for consideration of repeat of the year or dismissal
   Professionalism concerns	Rules as per Section 9.a.vi apply (see above)
   Timelines for the resolution of deferred/temporary course grades and/or course remediation:
   Year 1 students	To advance to year 2, all year 1 academic expectations, including passing of the Comprehensive End-of-Year Exam (CEYE), must be fulfilled a minimum of 2 weeks before the start of orientation for Year 1 of the next academic cycle Unsuccessful, incomplete, or unattempted resolutions of deferred/temporary grades two weeks before orientation of the 2nd year (timeline as above) will result in a grade of FA (failure) for the associated course or requirement, with no opportunities for remediation other than repeat of the year, if eligible, or dismissal
   Year 2 students	See Section iv.b below
   Review based on cumulative end-ofyear requirements (Students are also subject to review based on cumulative end-of-year requirements)
   Year 1 students:
   Failure of first attempt of the CEYE	Academic warning, referral to the GPC at the discretion of the assistant dean for the preclerkship phase, the associate dean for medical education or their designee
   Failure of a second attempt of the CEYE	Academic probation and referral to the GPC for consideration of repeat of the year, if eligible, or dismissal
   Year 2 students: (* see footnote below for stipulations governing AY 2022-2023)	Students will be eligible to take Step 1 when the following criteria are met: student has completed all year 2 coursework with no unresolved temporary/deferred grades AND they have achieved a minimum score of 63 on the end of year or most recent CBSE For on-time promotion to the clerkship phase according to the standard degree plan, students completing year 2 must take and pass the USMLE Step 1 exam prior to the first day of orientation for the next year 3.
   Student passes (routinely or through remediation) all pre-clerkship phase courses and is not designated as on academic warning or probation.	If student achieves a score of 63 or greater on the CBSE, then student is designated as eligible to take the USMLE Step 1 examination. If student does not achieve a minimum score of 63 on the end of year or most recent CBSE, then they would be placed on academic warning, be ineligible to take Step 1, ineligible to enroll in year 3. Referred to GPC for review of their progression plan
   Student passes (routinely or through remediation) all pre-clerkship phase courses and is designated as on academic warning or probation	Student’s eligibility to take the USMLE Step 1 examination is subject to GPC review and approval (with GPC discretion to require advancement under academic warning and an individual remediation plan, repeat of the year, or dismissal). Same requirements for CBSE as noted above.
   Student completes Year 2 but does not take and PASS USMLE Step 1 prior to the first day of orientation for the next year 3	Academic warning, ineligible to enroll in year 3, referral to GPC to explain rationale for delaying USMLE Step 1 and progression into the clerkship phase, GPC discretion to direct student to engage with academic counseling/support resources, and the student is required to pass USMLE Step 1 before re-enrolling in the curriculum. Upon passing USMLE Step 1, the student will enter the clerkship phase either with block 2 of the same academic year, or with block 1 of the next academic year (as determined by the GPC in consultation with the associate dean for medical education or their designee and based on educational program considerations such as block capacity and the comparability of student cohorts and experiences). If a student in this situation does not pass Step 1 prior to block 2 of the same academic year, then their final opportunity to enter year 3 shall be with block 1 of the next academic year
   *During AY 2022-2023, requirements for Step 1 outlined in the GPAS adopted on March 11, 2019 will remain in effect. At the start of AY 2023-3024 for third year, on May 22, 2023, the new rules outlined in this updated policy regarding Step 1 will take effect and this footnote will be deleted.
   Failure of first attempt of USMLE Step 1	Academic warning: If failing grade is received prior to the start of clerkship block 1: student is ineligible to enroll in year 3, Mentors notified, student required to meet with the associate dean for student affairs (or their designee), student may be referred to the GPC at the discretion of the associate dean for student affairs, and the student is required to pass USMLE Step 1 before re-enrolling in the curriculum. Upon passing USMLE Step 1, the student will enter the clerkship phase either with block 2 of the same academic year, or with block 1 of the next academic year (as determined by the associate dean for medical education or their designee and based on educational program considerations such as block capacity and the comparability of student cohorts and experiences). If a student in this situation does not pass Step 1 prior to block 2 of the same academic year, then their final opportunity to enter year 3 shall be with block 1 of the next academic year
   Failure of second attempt of USMLE Step 1	Academic probation, student to meet with associate dean for student affairs (or their designee) to review circumstances, options (as discussed in section above), and recommendations. Student will be referred to the GPC to review their progress plan and make further recommendations.
   Failure of third attempt of USMLE Step 1	Referral to the GPC for consideration of dismissal

    

3. Additional expectations related to repeat years

   Table 10 Additional Rules Related to Repeat of a Pre-Clerkship Year (see also Section 12.b below)
   Students on academic probation and repeating a pre-clerkship year will be subject to the following rules that apply to both fall semester and end-of-year reviews and must go to tutoring as a condition from the GPC. The students may avail themselves of the TTUHSC EP tutors or they may seek out outside tutors and demonstrate that they are working with them on a regular basis.
   If:	Then:
   Deferred/temporary grade in any semester course	Referral to GPC for discussion of progression plan or consideration of dismissal*
   Failure of any semester course (includes SPM, SCI, MS or Colloquium)	Referral to the GPC for consideration of dismissal*
   iii. Professionalism concerns	Rules as per Sections 9.a.vi apply (see above)*
   *Repeat of the year is not a possibility in these circumstances because it would violate the 6-year rule as outlined in Section 13.

    

4. Review of clerkship phase coursework The GPC reviews year 3/core clerkship block student progress at the end of each block and at the end of the academic year. The GPC reviews year 4 student progress on a rolling basis as indicated based on input from the associate dean for medical education, assistant dean for clinical instruction and/or the associate dean for student affairs. Except for the intersessions, Emergency Medicine and Family Medicine longitudinal clerkships and the boot camp (which apply the Pass/Fail grading mode), all completed courses of the clerkship phase apply the Honors/Pass/Fail grading mode. Other transcript notations may apply to courses/clerkships not completed (per HSCEP OP 59.05 Grading Procedures and Academic Regulations). Students passing all courses/clerkships with no professionalism concerns or exceptional circumstances adversely affecting their academic progress are promoted as a cohort according to the MD degree plan (per PLFSOM academic catalog). All other students are designated as either on academic/professional warning or academic/professional probation (see also paragraph 5.c above):
   1. Academic warning:Students on academic warning have specifically identified academic and/or professionalism challenges that are potentially remediable within the current academic year or prior to graduation. Unless specifically modified by the GPC, this status persists until all associated academic performance deficiencies are satisfactorily resolved, at which point the student is no longer on academic warning.
   2. Academic probation: Academic probation is a formal designation and is recorded on the Medical Student Performance Evaluation (MSPE) at the discretion of the Grading and Promotions Committee. Students on academic probation have specifically identified academic deficits that require repeat of a year or a revised curriculum plan that is less than one year in duration. This needs to be considered in conjunction with the Leaves of Absence and Suspensions Policy HSCEP OP: 77.05. Unless specifically modified by the GPC, this status persists until satisfactory completion of the repeat year or revised curriculum plan, at which point the student is placed on academic warning until the student’s satisfactory completion of the clerkship phase of the curriculum, at which point the student is no longer on academic warning. At the discretion of the GPC, a student placed on academic probation for professionalism concerns may be permitted to progress without repeating the year. The designation of probation will remain until the GPC determines that the professionalism issue has been satisfactorily addressed and remediated.

All students are subject to individualized GPC reviews that incorporate the student’s current and accumulated academic performance since matriculation, any professionalism notations/concerns, compliance with educational program expectations (per program policies and as may be individually specified by the GPC), and any exceptional circumstances adversely affecting the student’s academic performance.

Note regarding clerkship phase remediation plans: Standard remediation plans may be specified by course/clerkship/block syllabi. When individualized course/clerkship/block (or component) remediation is a consideration, the relevant course/clerkship/block director(s) shall propose a plan for GPC review and approval.

1. Year 3 end-of-clerkship block review rules

   Table 11.a Year 3 End-of-Clerkship Block and End of Year Review Rules
   The committee will consider all Year 3 students after the end of each 3rd year clerkship block. Students will be placed on academic warning or probation and reviewed by the GPC according to the following rules:
   If:	Then:
   Failure of one or two clerkships:	Referral to GPC for consideration of: one-month remediation* in year 4 for each failure (student placed on academic warning), repeat of the associated clerkship block(s), repeat of year 3 (student placed on probation), or dismissal based on the student’s prior academic and professional performance.
   Failure of three clerkships	Academic probation and referral to GPC for consideration of: repeat of the relevant block (if the three failures are contained in one block), repeat of year 3 or dismissal
   Rating of needs improvement in 3 or more competencies cumulative across all clerkship final assessments	Referral to GPC for consideration of: individualized remediation* (student placed on academic warning), repeat of the relevant block or repeat of year 3 (student placed on academic probation), or dismissal based on the student’s prior academic and professional performance
   Failure of 1st attempt of NBME in 3 or more different clerkships	Referral to GPC for consideration of: repeat of the relevant clerkship block(s) or repeat of year 3 (student placed on academic probation), or dismissal based on the student’s prior academic and professional performance.
   Professionalism concern	A student referred to the GPC based on a professionalism concern may be placed on academic warning or academic probation based on the GPC’s review of the specific concern(s) and the student’s overall academic record. As professionalism is an essential component of the school’s academic program (seethe PLFSOM medical education policy on program goals and objectives), the GPC may issue directives solely based on professionalism concerns (regardless of the student’s performance related to other educational program goals and objectives). GPC recommendations may include individual remediation*, delayed progression to year 4, repeat of year 3, delay of graduation, or dismissal GPC may recommend a formal notation in the professionalism sections on the MSPE Refer to policy HSCEP OP 10.20 for requirements regarding criminal record information/updates available at:https://elpaso.ttuhsc.edu/opp/_documents/10/op1020.pdf
   *Students cannot earn clerkship phase elective credit for GPC-required remediation(s)

2. Year 4 review rules

   Table 11.b Year 4 Review Rules
   The committee will consider all year 4 students on a rolling basis following each 4th year block. Students will be placed on academic warning or probation and reviewed by the GPC according to the following rules:
   If:	Then:
   Failure of one or two required or elective courses/clerkships in the fourth year	Referral to GPC for consideration of: individualized remediation* (student placed on academic warning), delay in graduation, repeat of year 4 (student placed on academic probation), or dismissal based on the student’s prior academic and professional performance.
   Failure of three or more required or elective courses/clerkships in the fourth year	Academic probation and referral to GPC for consideration of individualized remediation and delay in graduation, or repeat of year 4, or dismissal based on the student’s prior academic and professional performance.
   Rating of Needs Improvement in 2 or more competencies cumulative across all final assessments (regardless of final grade) in required clerkships and/or elective courses.	Referral to GPC for consideration of: individualized remediation*and delay in graduation (student placed on academic warning), or, repeat of year 4 (student placed on academic probation), or dismissal based on the student’s prior academic and professional performance.
   Scholarly Activity and Research Program (SARP) requirements:
   Failure to submit final report by the Fall deadline for year 4 (SARP II)	Academic warning and referral to GPC by a SARP course director
   Failure to complete all SARP requirements by May 1st of year 4	Academic probation and referral to the GPC for Consideration of delay in graduation, repeat of year 4, or dismissal
   Professionalism concern	A student referred to the GPC based on a professionalism concern may be placed on academic warning or academic probation based on the GPC’s review of the specific concern(s) and the student’s overall academic record. As professionalism is an essential component of the school’s academic program (see the PLFSOM medical education policy on program goals and objectives), the GPC may issue directives solely based on professionalism concerns (regardless of the student’s performance related to other educational program goals and objectives). GPC recommendations may include individual remediation*, repeat of year 4, delay of graduation, or dismissal GPC may recommend a formal notation in the professionalism sections on the MSPE If the MSPE has already been uploaded, an addendum regarding the professionalism concern may be added. If this occurs after Match Day, then the student’s residency program director may be contacted
   Failure to take Step 2 CK prior to October 31st of 4th year	Student will be removed from rotations and placed on academic warning, required to meet with the associate dean for student affairs (or their designee), student’s college mentors notified, GPC review not required unless graduation timeline is affected. Student can return to the curriculum once the Step 2 CK exam has been taken.
   Failure of Step 2 CK on the first attempt	Academic warning, student required to meet with the associate dean for student affairs (or their designee), student’s college mentors notified, GPC review not required but student must submit a passing score for Step 2 CK by May 1st in order to graduate in May of the same academic year (non-fulfillment of this requirement may result in delay of graduation)
   Failure of Step 2 CK on the second attempt	Academic probation and referral to the GPC for discussion of their progression plan and consideration for delay in graduation. Student required to meet with the associate dean for student affairs (or their designee), student’s college mentors notified. Student must submit a passing score for Step 2 CK by May 1st in order to graduate in May of the same academic year (non-fulfillment of this requirement may result in delay of graduation)
   ix. Failure of Step 2 CK on the third attempt	Referral to the GPC for consideration of dismissal
   *Students cannot earn clerkship phase elective credit for GPC-required remediation(s)

12.  Failure to remediate
    1. If a student fails to successfully complete a GPC-approved remediation plan (as per the framework outlined above), then the student shall be automatically referred back to the GPC for consideration of repeat of the year, if eligible, or dismissal
    2. If a student on academic probation fails one or more courses/clerkships during a repeat year, then the student shall be automatically referred back to the GPC for consideration of dismissal (see also table 10 above)
13. Promotion and graduation timeline
    1. Students are expected to complete the MD degree program and graduate within 4 years of initial matriculation
    2. A student’s timeline for completion of the MD degree may be extended due to:
       1. A school-approved leave of absence (Refer to the Student Leaves of Absence and Suspensions Policy HSCEP OP 77.05)
       2. Academic difficulty requiring repetition of an academic year as per this policy
    3. Non-completion of years 1 and 2 of the MD degree program within 3 years will result in dismissal, regardless of cause
    4. Non-completion of the MD degree program within 6 years will result in dismissal, regardless of cause. Exceptions to this policy can only be made after consideration of exceptional circumstances with a unique and compelling justification. Extension of the MD degree program beyond 6-years is subject to approval by the dean and the TTUHSCEP chief academic officer.
    5. Extension of the timeline for students in dual degree programs will be considered on a case- by-case basis. As noted in 13.d, a unique and compelling justification will be required, and the decision will be subject to approval by the dean and the TTUHSCEP chief academic officer.
14. Appeals
    1. A student may appeal the decision of the GPC. This appeal must be made to the dean or their designee of the school of medicine within five business days, in writing, and must cite grounds for the appeal. An appeal may only be based on a claim that due process of GPC policies and procedures was not followed
    2. The dean or their designee may issue the decision alone or may appoint an Appeals Committee comprised of three members of the faculty representing both the clerkship and pre-clerkship phases of the curriculum to determine whether a basis for appeal exists.
    3. If an Appeals Committee is appointed:
       1. The associate dean for student affairs (or their designee) and the chair of the GPC (or their designee from among the regular members of the GPC) shall serve as ex officio members of the Appeals Committee.
       2. The Appeals Committee will be convened by the chief academic officer within five business days after appointment to consider the student’s appeal.
       3. The student shall notify the associate dean for student affairs in advance if they are to be accompanied by an attorney or other representative. An attorney or representative may appear only in an advisory capacity and may not address the Appeals Committee. Should the student be accompanied by an attorney or representative, the school of medicine shall be represented by the Office of General Counsel. If necessary, the appeal hearing may be delayed up to five business days of the scheduled date if needed to allow personnel from the Office of General Counsel to attend.
       4. The student may present a statement to the Appeals Committee regarding their appeal. Both the Appeals Committee and the student may call witnesses and present evidence relevant to resolution of the appeal. At the conclusion of the hearing, the Appeals Committee shall forward its recommendation to the dean or their designee. If the recommendation is not unanimous, a minority view shall be appended.
       5. Unless suspended for justifiable cause, the student may continue to participate in the curriculum as enrolled until the appeal is resolved.
       6. After review of the Appeals Committee recommendation, the dean or their designee will make a final decision.
    4. The decision of the dean or their designee is final. The student and the chair of the GPC will be notified in writing by the dean or their designee.
15. Notifications related to repeat of a year or dismissal
    1. Following a final decision to require a student to repeat a year, or to dismiss a student from the Paul L. Foster School of Medicine, the Office of Student Affairs shall notify in writing Accounting Services, Financial Aid, the Registrar, and other pertinent offices and entities
16. Review and revision of grading and promotions policies
    1. Consistent with Section 7 above, grading and promotion policies are developed, reviewed, and approved by the Committee on Curriculum and Educational Policy, which is a standing committee of the PLFSOM Faculty Council as defined in the PLFSOM Faculty Bylaws.

Policies are subject to revision. Refer to the Office of Medical Education website or contact the Office of Medical Education to ensure that you are working with the current version.