Curriculum Policies

USMLE Requirements

 

Effective with the Class Entering in 2009

 

This policy is a change and is effective starting with all students in the first year curriculum in 2009-2010. All students will be required to take and record a passing score for the USMLE Step 1 and Step 2 CK and CS exams in order to graduate from the MD program. 

 

Approved by Curriculum Committee April 2009

Approved by Faculty Council May 2009

 

Procedures

Students are required to take and record a passing score for USMLE Step 1 prior to entering the third year.  All students must take the exam prior to starting the Transition to Clerkship course.  MD/PHD and MD/MPH students are required to take and pass the USMLE Step 1 prior to being eligible to enter graduate studies or clinical curriculum.

Students who receive a non-passing score may complete their current clerkship rotation or take an incomplete grade.  These students will be given an automatic one year leave of absence to achieve a passing score on Step 1 and must pass the exam before they can re-enter the clinical curriculum. During this leave year, students can decide to be registered for the Clinical Review Course for a maximum of two terms to remediate USMLE Step 1 or Step 2 CK/CS.  Students must seek approval from the Associate Dean for Student Affairs prior to registration.  If they do not pass USMLE Step 1 within that year, they will be subject to a dismissal hearing by the Medical Student Progress Board.  If a student wishes to re-enter the curriculum before the one year leave of absence is completed, the student must request this in writing 6 weeks prior to the start of the next clerkship. 

The only exception will be for students selected by the Associate Deans to be at significant risk for not passing.  They will be identified based on overall academic performance and MOCK board scores.  See Administrative Deferrals Policy for detail. Any student that does not sit for the exam by July 30 will be required to take an automatic one year leave of absence from the third year.  Students who delay the USMLE Step 1 beyond the August rotation will no longer be able to meet the graduation requirements with their class and therefore automatically extend their curriculum by one year.  During this leave year, students can decide to be registered for the Clinical Review Course for a maximum of two terms to remediate USMLE Step 1 or Step 2 CK/CS.  Students must seek approval from the Associate Dean for Student Affairs prior to registration.

Students are required to take and record a passing score on both USMLE Step 2 clinical knowledge (CK) and clinical skills (CS) prior to graduation.  They must complete both exams with a passing score received by the Dean’s Office no later than May 15 of their graduation year in order to be able to participate in the commencement ceremony. They will be given a one year automatic leave of absence to achieve a passing score on Step 2 CK and CS and must pass the exam before they can re-enter the clinical curriculum.   If they do not pass USMLE Step 2 CK and CS within that year, they will be subject to a dismissal hearing by the Student Progress Board.

 

Approved by the Clinical Sciences Subcommittee March 9, 2009

Approved by the Basic Science Subcommittee March 16, 2009

Approved by the Curriculum Committee April 9, 2009

 

Deferral of USMLE Examinations

School of Medicine policy requires students to take USMLE Step 1 prior to beginning the Transition to Clerkship and/or a clerkship. 

 

A deferral of USMLE Step 1 is only granted for documented illness or injury. 

 

Failure to Comply with the USMLE Step 1 Policy

If a student does not take the USMLE Step 1 exam prior to the Transition to Clerkship and clinical curriculum:

·         A student will not be permitted to begin clerkships until the USMLE Step 1 has been taken and passed.  Student is subject to policies and procedures regarding the USMLE Policy (refer to the policy for specifics).   

·         A student must contact the clerkship director for the July rotation at least 1 week in advance to arrange for dropping the course.  Likewise, the student must contact the Office of Education and Student Affairs.

·         A student will not have priority as a fourth year student to reschedule this third year rotation.

·         A Professional Development Evaluation may be submitted for non-compliance with the USMLE Step 1 policy.

 

Administrative Deferrals Policy

Administrative deferrals can be granted by the Associate Dean for Undergraduate Medical Education.  The following criteria will be used, but is not limited to:

 

A group of students can be identified by the Associate Deans to have demonstrated academic performances in years one and two which may put them at risk for not passing Step 1.  These identified students must meet the following performance criteria to be considered at risk:

              

               Mock Board score of 40 or less

               OR

               Mock Board score of 50 or less and a course class average of 77% or less

 

If a student falls into one of these categories, they might be identified as needing additional time to prepare for Step 1 and may be required to participate in preparation programs. 

The following are some of the components that might be outlined for participation in this program.

-          Required participation in any identified preparation program

-          Attendance at all sessions is required

-          The course will be held prior to Transition to Clerkship so students will have an additional 4 weeks of study time for the exam.

-          Permitted to drop the July clerkship

-          Required to take the Transition to Clerkship course

-          Requested to take Step 1 exam at least one week prior to the start of the second rotation period.  Must be completed by July 30.

-          Cannot begin clerkships until Step 1 exam has been taken. (Please refer to the USMLE policies and procedures for details)

 

USMLE Policy for Students Prior to Entering Class of 2009

Students are required to sit for USMLE Step 1 at the end of the second year curriculum prior to starting the Transition to Clerkship course and clerkships. If a student is unable to meet this requirement or fails Step 1, they are required to take or repeat the exam in the November/December elective block.  USMLE Step 2 CK and CS should be completed by March prior to graduation in June.

Attendance Policy for MS1 and MS2

Satisfactory achievement of the educational goals and the objectives of each course requires regular class attendance and participation in all curricular activities. All educational experiences which involve patient contact, clinical demonstration and direct care are required. Students are excused from classes on approved OHSU holidays.Students are expected to adhere to the OHSU Inclement Weather policy as stated in the Administrative Policies section. Students are expected, as a component of their professional responsibility, to complete a course evaluation for each course within one week of the end of the course.

In accordance with the "Guiding Principles" of the undergraduate medical education program, all medical students are expected to participate fully in all aspects of the medical curriculum. The SOM Curriculum Committee expects all students to attend lectures, and to fully participate in small group and laboratory learning experiences unless otherwise indicated by the course director.Active participation by both students and faculty in small groups is an excellent method of learning which strengthens group interactions and professional development skills.

1. Attendance in small groups and laboratories is required in all courses unless specified by the course director.

2. Each course will assign exam questions from the small group content areas apportioned to the value of the small group time.

3. Students are expected to be present in their assigned group, and sign-in, to receive credit for attending the session.Students are expected to come to the small group session having read the assigned materials and prepared to participate in the small group discussions.

4. The small group sessions will comprise at least 5% of the overall grade in a course.

Approval of the Basic Sciences Course Directors July 2005

Revised& Approved FSYC-SC March 14, 2011

Revised& Approved FSYC-SC May 16, 2011

 

Attendance Policy Regarding Clinical Clerkships

Students are expected to attend all activities in a required clinical clerkship.  If a student is granted an approved absence that exceeds two days, then the student is expected to make up the time as outlined by the clerkship director.  For absences that can be anticipated, approval must be obtained at least 6 weeks prior to the start of the clerkship.  A student requesting time off must notify the clerkship director and attending physician by using the Request for Time Off Form.  Finalized Request for Time Off forms will be submitted to the Dean's Office for tracking.

 

There are three categories regarding absences from a clerkship:

1. Student or immediate family illness or emergency. Student should contact the clerkship director or designee immediately and request time off. Student should submit the Request for Time Off form to the clerkship director within 24 hours. Clerkship director can require this time to be made up if it exceeds two days.
   
   
2. Request to attend as a OHSU representative or present at a professional conference.  This category also includes interviewing or taking the USMLE exams.  These events are known well in advance and the student should submit a Request for Time Off Form to the clerkship director at least 6 weeks prior to the start of the clerkship to seek approval. Students are permitted to have a total of 2 days during the third year and 2 days off during the 4th year to pursue these kinds of events. If the request conflicts with required activities in the clerkship (e.g. exams, etc) the request can be denied.  Clerkship director can require this time to be made up if it exceeds two days.
   
   
3. Request for Time Off for non urgent personal reasons such as wedding, reunions, etc. are usually not approved by the clerkship director but can be reviewed if you submit a Request for Time Off form. The clerkship director requires all this time to be made up.
   

Steps for Requesting Time Off  

• Time Off Request Form

1. A student submits to the Clerkship Director the Request for Time Off form at least 6 weeks prior to the start of that clerkship.
   
   
2. Clerkship Director will review the request to determine if this time off will compromise the clinical service or the academic experience for this student.   3)    Clerkship Director reviews the request and will approve with conditions or deny. 4)    Clerkship Director forwards the final decision and the Request for Time Off form to the Dean's Office where the attendance records will be maintained for all clerkships.  

If a student has a sudden illness and must be out for a day then the student will seek approval per telephone with the clerkship director and submit the Request for Time Off upon their return. 

Policy for Examination Schedule Change

1.If a student defers an examination due to illness, the student must contact Teaching Services staff (494-8428) who will forward the deferral request to the course Director and Student Affairs Office.Subsequently, the student is responsible for arranging to sit for the deferred examination as outlined below (refer to item 4.)

Health care in the Student Health Service is available to all students who are ill.

2.A student may postpone exams for health reasons no more than once during the academic year.Need for a second examination deferral for health reasons requires meeting with the Associate Dean for Student Affairs and a signed release for health information from SHS.

3.Changing the scheduled time of an examination for non-health reasons is generally not permitted.Exceptions include emergencies and unique academic opportunities. In the case of academic opportunities, students must submit an e-mail request (which includes the phone number of the course director) to the Associate Dean for Student Affairs and the Course Director at least two weeks prior to the examination.Students must be in satisfactory academic standing to be considered for an examination schedule change for non-health reasons.

The Associate Dean for Student Affairs is responsible for reviewing non-health related examination schedule change requests from students, discussing the issues with the Course Director, and conveying the final written decision to the student, Course Director and Teaching Services office.

4.Students deferring exams must take the examination within one week of the original examination date.Failure to do so will be cause for assigning a grade of "incomplete."Students who are approved for examination deferral must reschedule the examination through Teaching Services.

5.Students who defer examinations shall sign the following affirmation prior to taking a deferred examination: "I affirm that I have not received any knowledge of the content of the exam that is to be made-up or discussed its contents with my classmates or others who may have knowledge of its contents."

6.Students who receive permission to take an examination early, shall sign the following affirmation prior to taking the exam:"I affirm that I will not disclose any knowledge of the content of the exam or discuss its contents with my classmates or others who may take this examination later."

Revised and Approved

March 10, 1999

August 8, 1999

February 9, 2009

Amended FSYC-SC 1/24/11

 

Passing Grade Expectations for

MS1 and MS2 Courses

Students in the MS-1 and MS-2 required curriculum must achieve an average of 70% (75% in Gross Anatomy, Imaging & Embryology) on the cumulative examination scores in order to receive a passing grade for any course.

Allother components of the course, includingquizzes, labs small group attendance etc., may change the final grade as long as the minimum 70% (75% in Gross Anatomy, Imaging & Embryology) has been achieved on the exams.

Students receiving less than 70% average score (75% in Gross Anatomy, Imaging & Embryology) in any course will receive a marginal or failing grade for that course.

Students in the MS1 and MS2 PCM course must achieve a summative score of 70% or higher on all graded course criteria over the duration of three terms in each academic year, to receive a passing grade for the course.

Grades considered less than satisfactory will be reviewed by the School of Medicine Student Progress Board.

The Student Progress Board in conjunction with the Course Director will determine remediation of the course if warranted.

Approved by Basic Science Subcommittee (aka:FSYC-SC) September 20, 2010

Approved by Curriculum Committee, October 2010

Amended FSYC-SC, March 14, 2011

 

Clerkship Expectations

The overall objective of the third year is to integrate all that you have learned into the basic skills needed to be a successful physician. Physicians are lifelong learners who must always reach for the next level. In order to reach that goal, the clerkship directors are providing you with a list of expectations to assist you during this next year.

• You are expected to be present and participate fully in all activities involved in the clerkship, including orientation, seminars, and the final exam.
• You are expected to make decisions, defend them, and understand the consequences of a poor decision.
• You are expected to give 100% effort while on a clerkship and you should expect the same from your classmates.
• You are expected to be respectful of your classmates, residents, faculty and other staff at all times. Do not undermine your colleagues.
• You are expected to be current with all your patients and you are encouraged to do advanced reading on those patients. You should feel free to bring relevant articles to the team.
• You should expect the residents and attendings to provide constructive criticism, so that you can improve throughout the clerkship. A formal midterm feedback session is required at week 3 of the rotation and week 5 of the Medicine rotation.
• You are expected to be present daily unless you are ill or have a family emergency. You must seek approval for this time off by contacting the clerkship director for permission. There are no scheduled holidays during required third year clerkships.
• You will be assigned to specific sites and team by the Clerkship Director.
• You should expect that you will receive your final evaluation within 6 weeks of completing your rotation.
• You are expected to submit your procedural logs electronically on the last day of the clerkship.
• You are expected to complete your course evaluation for the clerkship within one week of the end of the clerkship.
• Remember that patient is the focus of the patient care experience, not you.

Required Clerkship Principles of Evaluation

• The process must include evaluation of students, faculty, curricular content, and curricular methodology
• All required rotations must submit a final grade and comments to the Dean’s Office no later than 6 weeks after the completion of a clerkship.
• Accountability to the standards for distribution of feedback must be monitored.
• Midterm formative feedback of students must be completed in week 3 of a 5 week rotation and week 5 of a 10 week rotation.
• The midterm formative feedback form will be common for all 3rd year required clerkships and be in a checklist format.
• A common set of skills and attitudes pertaining to professionalism will be assessed by each clerkship director for 3rd and 4th year required clerkships. If a student receives an overall evaluation of below expectation, they will be required to remediate. The clerkship director will recommend a remediation plan that is submitted to the Student Progress Board for implementation. A clerkship director can also determine if to use professionalism as part of overall final assessment.
• The class grade distribution expectation will be 20-25% Honors, 40-45% Near Honors, 30-35% Satisfactory. The grade distribution will be reviewed annually by the clerkship directors.
• The students must be evaluated based on the instructional objectives that have been developed by each clerkship director.
• Evaluation of students must include direct monitoring by faculty of patient care skills, including history taking, physical examination, and procedural skills, appropriate for each clerkship.
• Summative feedback must be obtained regarding student performance, faculty teaching effectiveness, and effectiveness of educational methodology at the end of each rotation.
• The ACGME Core Competencies should serve as a guide to general areas of evaluation of students.

• The Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
• Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.
• Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care.
• Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals.
• Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
• Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.

Approved by Clinical Sciences Subcommittee May 17, 2004
Approved by the Curriculum Committee on June 10, 2004

University Holidays

Third and fourth year students are expected to be available for clerkship duties on all university holidays except the following:

• Thanksgiving Day
• Winter Break

Third & fourth year students will not have the five one day holidays observed by the University unless specified by the attending physician or the clerkship director.

Inclement Weather Policy

OHSU, as a health care system, must always remain open during inclement weather. However, adverse weather conditions may present travel problems or other unsafe situations, causing classes to be delayed or canceled, as well as alterations in some office, clinic and lab schedules. Outlined below are guidelines for medical students concerning inclement weather.

First and Second Year Students

Announcements and decisions regarding OHSU class schedules will be made by the OHSU President's Office. Classes may be on a normal schedule, delayed or canceled. Please contact the Weather Hot Line at 494-9021 or listen to the local radio and television stations for the status of classes at OHSU. Decisions are to be made by 6:00AM.

If classes are to be held or delayed you are expected to make a reasonable effort to attend class. If conditions make it impossible for you to travel safely to the OHSU for a scheduled activity requiring attendance (e.g. examination), please contact TSO at 494-8428 or by email (lehmannd@ohsu.edu) and indicate your absence.

If you are scheduled for a preceptorship, follow the procedures above for classes. You are responsible for contacting your preceptor regarding your attendance for that day.

Third and Fourth year Students

If you are assigned to a ward/inpatient clerkship, then you are expected to meet your clinical responsibilities since OHSU Hospital remains open in inclement weather. Students should contact their attending physician or resident in the morning regarding your clinical responsibilities. If conditions make it impossible for you to travel safely, contact your attending or resident regarding your circumstance.

If you are assigned to an outpatient clerkship, then follow the OHSU announcements regarding the status of your clinic. Clinics may be on a normal schedule, delayed or canceled. Contact the Weather Hot Line at 494-9021 or listen to the local radio and television stations for the status report from the OHSU. The report should be given by 6:00AM.

If clinics are to be open or delayed in opening you are expected to make a reasonable effort to meet your clinic responsibilities. However, if conditions make it impossible for you to travel safely, contact your attending or resident regarding your absence.

If you are scheduled to participate in clerkship orientation and/or the Continuity Curriculum, then follow the OHSU announcements regarding the status for classes. See policy above for first and second year students.

Elective Courses Not Taken on a Medical School Campus

• Name of person(s) or institution offering the elective
• Subject matter of the elective and course content
• Duration
• Immediate supervision
• Justification for the elective
• Must be in good academic standing

This information must be submitted in writing to the appropriate OHSU department chairman together with the Away Elective Form, to be endorsed by the chairman’s signature. These documents are then to be submitted to the Education and Student Affairs office at least six (6) weeks prior to the experience.

• Policy on Requesting to do required 4th year rotations or more than 8 weeks/12 elective credits away from OHSU
• SUBI/ICU Evaluation Form

 

Policy on International Educational Experiences

Forms

• International Away Elective Form

 

There are three methods for students to seek an international educational experience as specified below:

1. Authorized by the School of Medicine to receive academic credit and scholarship support
   
   
2. Authorized by the School of Medicine to receive academic credit
   
   
3. Non sponsored by the School of Medicine and receive no academic credit.

Scholarship Support for International Education Experiences Earning Academic Credit

The School of Medicine Committee for International Medical Education provides endowed scholarship support for students to pursue opportunities for international clinical experiences. Eligibility for funding requires that the student must meet the criteria and follow the procedures outlined below. Prior to submission of the application, the student should contact Dr. Jay Kravitz, Assistant Professor of Public Health, for assistance in identifying international educational opportunities. 

1. Students requesting scholarship funds in support of an international experience are required to submit an application for funding during the next academic year commencing in July. The SOM Committee for International Medical Education will review applications, interview applicants, and make final recommendations for funding to the Associate Dean for Medical Education who will make a final decision regarding the awarding of funds. The Committee meets in April and makes awards in early May.
   
   
2. Eligibility criteria for a competitive scholarship application are as follows:

a. Successful completion of the required first, second and the third year curriculum.

b. Passed USMLE Step 1.

c. Previous preparation for international experience will make an application more competitive. (Examples: International health coursework such as JCON 705A, previous international healthcare, education or service experience, foreign language course, etc)

d. Submit the following information by the deadline to Office of Education and Student Affairs:

i. Indicate the name and location of a person or agency that is supervising/responsible for your experience at each site.
ii. Submit a letter from the supervisor at the site indicating the objectives you plan to accomplish during this visit.
iii. Indicate the length of stay (dates) for each experience.
iv. Describe the learning experience expected to be achieved during these experiences.
v. Explain basis by which this experience will enhance your medical education.

e. Experiences of at least 2 months and preferably 3 or more months.

3. Upon completion of the international experience, students receiving funding are required to submit a written report (limited to 5 pages double spaced) about their experience(s) and to make a presentation on the experience(s) to the SOM Committee for International Medical Education and other interested faculty and students. Upon completion of the written report and presentation the student will receive the final one third portion of approved funding.
   
   
4. Students approved for an international education experience, are required to be registered and pay University tuition ( if due) and fees while away on an international experience. Students can earn up to a total of 9 clinical elective academic credits which apply to graduation requirements. The remaining academic credits may be applied to qualify as a full time student for financial aid purposes and will be represented on the academic transcript. Students are required to meet with the Financial Aid staff prior to departure regarding financial aid regulations. Students need to meet with the Administrative Director for Education and Student Affairs to arrange for academic credits.
   
   
5. Students are responsible for requesting a final grade from their sponsor, who submits it to Office of the Dean.
   
   
6. Prior to departure, students are required to obtain consultation from a travel clinic regarding appropriate immunization and prophylactic medications.
   
   
7. Students are required to secure medical insurance as well as emergency medical assistance insurance prior to departure and this coverage should be in place for the duration of the international experience. It is suggested that students contact AEA-SOS International or a comparable organization to purchase insurance. AEA-SOS, Inc. can be reached at P.O. Box 11568, Philadelphia, PA 19116 or 1-800-767-1403.

 

Authorized International Education Experience for Earning Academic Credit

The following are the guidelines for medical students wishing to earn academic credit, receive financial aid or be granted an extension of their curriculum in order to pursue an international educational experience(s). Eligibility for an international educational experience requires that the following criteria must be met at least 12 weeks prior to departure.

1. Successful completion of the required first, second and third year curriculum. Passed USMLE Step 1.

2. Submission of an application to the SOM Committee for International Medical Education by the deadline. The following is the required information to be submitted in writing for approval:

          a. Indicate the name and location of a person or agency that is supervising/ responsible for your experience at each site.
          b. Indicate the length of stay (dates) for each experience.
          c. Describe the learning experience expected to be achieved during these experiences.
          d. If this experience extends your medical curriculum beyond four years, explain why this experience will enhance your education
          e. Meet with the Administrative Director for Education and Student Affairs to arrange academic credits and financial aid for the period you are away.
          f. Meet with the University Financial Aid Office staff prior to departure regarding financial aid regulations.

3. Students approved for an international education experience, are required to register and pay University tuition (if due) and fees while away on an international experience. Students can earn up to a total of 9 clinical elective academic credits which apply to graduation. The remaining academic credits may be applied to qualify as a full time student for financial aid purposes and will be represented on the academic transcript.

4. Students are responsible for requesting a final grade from their sponsor, who submits it to Office of the Dean.

5. Prior to departure, students are required to obtain consultation from a travel clinic regarding appropriate immunization and prophylactic medications.

6. Students are required to secure medical insurance as well as emergency medical assistance insurance prior to departure and this coverage should be in place for the duration of the international experience. It is suggested that students contact AEA-SOS International or a comparable organization to purchase insurance. AEA-SOS, Inc. can be reached at P.O. Box 11568, Philadelphia, PA 19116 or 1-800-767-1403 or online at www.internationalsos.com
   
   

Non Sponsored International Education Experiences without Academic Credit

Medical students may also pursue international experience(s) during the summer term between years one and two. Successful completion of the year one curriculum is required. Students earn no academic credit toward graduation requirements and are considered not sponsored by the School of Medicine. Non sponsored students pursuing education experiences are encouraged to obtain medical insurance as well as emergency medical assistance insurance in this circumstance. In this regard, students should contact AEA-SOS International or a comparable organization. AEA-SOS, Inc. can be reached at P.O.Box 11568, Philadelphia, PA 19116 or 1-800-767-1403 or online at www.internationalsos.com