School Policies

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• SOM Catalog
• 30 Learning Objectives
• Clinical Students
• Course Evaluation Policy
• Duty Hours
• Faculty Advisors
• Grading
• Honor Code
• Standards of Behavior
• Student Leave
• USMLE (United States Medical Licensing Examination)

Clinical Students

Clinical Electives - Students can take no more than three clinical elective units in one specialty, unless they are taken as ninth or tenth units in the fourth year.

Clinical Rotations with Relatives - Students will not be permitted to take clinical rotations under the supervision of a parent or other relative.

Excused Absences from Clinical Rotations - Students may take up to three excused absence days from a clinical rotation with proper documentation. If more than three days away are required for any purpose, arrangements for make-up time must be made with the Assistant Dean for Students and the course director.

Course Evaluation Policy

We at Vanderbilt believe that medical education is a lifelong process. Learning may occur in solitary, thoughtful reflection, in patient-doctor interactions, in interactions with peers and with those more experienced than oneself, and in a host of other settings.

In the classrooms, laboratories, and patient care areas of the School of Medicine and the Hospital, we believe the most effective learning is a team endeavor in which teachers are learners and vice versa. This mutuality is reflected, for example, in the obligation of faculty members to provide grades and other constructive commentary on student performance and how it can be enhanced. And it is reflected in the expectation that students will provide evaluative feedback and commentary on each course in order to improve the quality of instruction at Vanderbilt. Both processes of evaluation are essential to the Vanderbilt educational experience.

The student curriculum committee and the undergraduate medical education committee endorse the following guidelines in order to elicit the meaningful participation of every student in the evaluation process.

1. Every required course/clerkship will be evaluated by students.
2. The evaluation instrument (e.g., questionnaire) should be the product of student-faculty collaboration and of reasonable length.
3. Every student is expected to respond in a professional manner to each item which she/he feels qualified to answer.
4. Strict anonymity of responses must be assured.
5. Failure to respond will result in withholding the grade for the course. Further, repeated failure to respond in a timely and reasonable fashion will be brought to the attention of the appropriate Promotion Committee.

Duty Hours

In order to encourage a well-rounded, balanced journey through the clinical years of medical school, it is the policy of Vanderbilt University School of Medicine that all third and fourth year students will be expected to take at least one day off in seven. It is also expected that supervising house staff and attending physicians will be sensitive to student fatigue and total number of hours spent on clinical and educational activities.

Grading

The Vanderbilt University School of Medicine has established a series of learning objectives for its educational program that can be clustered into the following categories: (1) knowledge, (2) skills in accessing information, (3) skills for the diagnosis and management of patient problems, (4) clinical reasoning skills, (5) skills in communication and interpersonal relations, (6) professional development and (7) professional values. The achievement of these educational objectives defines the successful development of the physician-in-training and occurs during the course of a student's progress in medical school.

All Years

Students will be evaluated on both acquisition of knowledge and skills as well as professional development and values. Appropriate professional values are expected of medical students throughout all stages of professional training. In the category of professional values, students will be evaluated in each course as meeting standards, cause for some concern, or cause for major concern. Any student causing any level of concern should be promptly identified and brought to the attention of the Associate Dean for Students so that counseling can be initiated. A student for whom major concern persists will be given a failing grade (F) for the course without regard to performance in other categories. Such students are subject to dismissal. If some concern is noted in more than one course and persists after counseling, this student will be automatically reviewed by the promotions committee and will be subject to dismissal.

A grade of Incomplete is to be used only to reflect that work has not been completed and should not be used when work has been completed, but at an unsatisfactory level and requiring remediation.

VMS 1

	Final grades for all courses in VMS1 will be Pass (P), Pass* (P*), or Fail (F).
	A P grade is to be given to students for performance that is completely satisfactory in all aspects of course work.
	A grade of P* will be given to students whose performance is marginal because of important deficiencies in some aspects of course work. A student with two or more P* grades will receive special review by the Promotion Committee, which may recommend that the student undertake remedial activities. The P* grade may be applicable for academic credit in an individual course only after approval by the student's Promotion Committee and endorsement by the Executive Faculty as reviewed in light of the student's complete record for the year. Upon receiving such approval, the P* grade will be recorded on the official transcript as a P. In the absence of such approval, the P* grade will be recorded on the official transcript as an F.
	An F grade is given for unsatisfactory work resulting in failure. A student with one or more F grades will receive special review by the Promotion Committee. Such a student will be required to undertake remedial activities or be subject to dismissal. An F grade will remain on the student's official transcript along with the grade achieved in remediation.

VMS 2

	Final grades for all courses in VMS2 will be Honors (H), Pass (P), Pass* (P*), or Fail (F).
	An H grade for a course is to be given to students for superior performance in all aspects of the course. A student must meet standards in all categories of professional values to be given an H grade. Honors grades will be awarded according to criteria established by individual course directors, such that approximately 25% of a class would receive an honors grade.
	Other grades are defined as for VMS1.

VMS 3 & 4

Faculty and House Staff Assessments of Students. Faculty and house staff providing primary evaluations of students will not recommend letter grades. The evaluation provided by faculty and house staff will provide (1) assessments of the frequency with which each student demonstrates behavior in the various categories subject to evaluation, (2) narrative comments, and (3) an evaluation of suitability for appointment to residency on the service.

Determining Clerkship Grades. Students will receive a grade for each category of learning objectives and a final course grade. For the categories other than Values, discussed above, and for the final grade, each student will be graded Honors (H), High Pass (HP), Pass (P), Pass* (P*), or Fail (F).

Determining Grades for Categories:

	An H grade will be given to students demonstrating superior achievement in a category.
	A HP grade will be given to students demonstrating better than average, but not superior achievement in a category.
	A P grade will be given to students demonstrating completely satisfactory performance in a category.
	A grade of P* will be given to students whose achievement in a category is marginal.
	An F grade will be given for unsatisfactory achievement in a category. A student receiving an F in any category must receive an F for the clerkship.

Determining Clerkship Grades:

	An H grade will be given to students for superior or outstanding achievement in all of the categories. Ordinarily, honors grades will be given to no more than 25% of a class.
	A HP grade will be given to students with superior achievement in several, but not all categories.
	A P grade will be given to students who demonstrate satisfactory achievement in all categories.
	A grade of P* will be given to students whose performance is marginal because of important deficiencies in some aspects of course work. The P* grade may be applicable for academic credit in an individual course only after approval by the student's Promotion Committee and endorsement by the Executive Faculty as reviewed in light of the student's complete record for the year. Upon receiving such approval, the P* grade will be recorded on the official transcript as a P. In the absence of such approval, the P* grade will be recorded on the official transcript as an F.
	An F grade is given for unsatisfactory work resulting in failure. A student receiving an F in any individual category must receive an F for the clerkship. Similarly, a student with concerns in the area of Professional Values is subject to receiving an F grade based on the criteria defined above.

Requirements for Satisfactory Progress in the Clinical Years. Promotion in the clinical years requires not only satisfactory performance in each clerkship, but also satisfactory achievement in each of the six categories of learning objectives and in the area of professional values. An F or P* grade in a course will lead to special review by the Promotions Committee. A P* grade in the same category in more than two courses will also lead to special review by the Promotions Committee. Promotion Committees may require students with F or P* grades in categories or courses to undertake special remedial activities. Students with an F in one clerkship, P* s in two clerkships, or P* s in the same category in three clerkships are subject to dismissal after review by the Promotion Committee. The criteria for professional values described above are also applicable in the clinical years.

Honor Code

All students pledge to conduct themselves honorably, professionally, and respectfully in all realms of the medical center and in all aspects of medical education and patient care. Under the Honor System, the student pledges that he or she neither gives nor receives unauthorized aid nor leaves unreported any knowledge of such aid given or received by any other student. This pledge applies to all tests, themes, term papers, examinations or any other activities required for the awarding of the M.D. degree. This pledge encompasses all clinical work involving patient care and representations of patient care information. All students are under the jurisdiction of the Honor System and are expected to abide by the Honor Code during their studies at Vanderbilt University School of Medicine (VUSM). Any student taking a course in the School of Medicine, regardless of where registered, is under the jurisdiction of the Honor Council of VUSM and subject to the penalties it may impose.

Standards of Behavior

Statement of Standards¹
In practice, physicians are held to high standards of professionalism and patient care. The medical learning environment is expected to facilitate students' acquisition of the professional and collegial attitudes necessary for effective, caring and compassionate health care. The development and nurturing of these attitudes requires mutual respect between teachers (including faculty, residents and staff) and students, and between each student and his or her fellow students². Mutual respect between student and teacher, and between fellow students, may be expressed in many ways but all interactions shall include honesty, fairness and evenhanded treatment. Behavior which is inimical to the development of mutual respect shall be prohibited. Such behavior may include but is not limited to:

(1) Harassment of a sexual nature;
(2) Discrimination or harassment based on race, sex, religion, color, national or ethnic origin, age, disability, military service or being or being perceived as homosexual, heterosexual, or bisexual;
(3) Grading, promoting or otherwise evaluating any student on any basis other than that student's performance or merit.

¹ All Vanderbilt University policies concerning medical student interactions with faculty and staff as set forth in the Vanderbilt University Student Handbook, the Faculty Manual and the Staff Manual remain in full force and effect.
² By their express terms, these Standards apply only to interactions which involve one or more medical students; however, it is hoped that these Standards will serve as a guide to all members of the Vanderbilt University Medical Center community. The reporting procedure outlined herein shall apply only to allegations of the violation of these Standards in interactions involving medical student(s).

Comments
The following delineates more clearly the behavior enumerated above which may be inimical to the development of mutual respect between students and teacher and between fellow students. For purposes of these Comments, the term "person" shall refer to a student in interactions between fellow students or, in student-teacher interactions, to the student or teacher, as appropriate.

(1) Harassment of a sexual nature may include:

a. Denying the opportunity for training or rewards because of a student's gender;
b. Requesting sexual favors in exchange for grades or other awards;
c. Making unwanted sexual advances;
d. Unreasonable and inappropriate sexual or sexist conduct directed towards any person;
e. Displaying in an unreasonable and inappropriate manner sexually suggestive or pornographic materials; or
f. Grading or evaluating a student based upon gender rather than performance and merit.

(2) Discrimination and harassment may include:

a. Denying the opportunity for training or rewards because of a student's age, race, religious affiliation or any other attribute of the student other than merit or performance;
b. Unreasonable and inappropriate conduct directed towards any person which is intended to insult or stigmatize that person,
c. Exclusion of a student from any usual and reasonable expected educational opportunity for any reason other than as a reasonable response to that student's performance or merit;
d. Requiring a student to perform personal services such as shopping or babysitting; e. Showing favoritism among students based upon any attribute of the student(s) other than performance or merit and thereby reducing educational opportunities available to the non-favored student(s); or
f. Grading or evaluating a student based upon any attribute of a student other than that student's performance and merit.
g. Any physical mistreatment, such as hitting, slapping or kicking, or threatening such physical mistreatment;
h. Requiring a student to perform menial tasks with the intent to humiliate the student.

Any perceived violation of these Standards of Behavior ("Standards") may be reported in accordance with the following procedure. Violations of these Standards may subject the offender to disciplinary action. These Standards may be amended at any time by the Executive Faculty. The Standards Committee shall be composed of such members as the Dean shall appoint from time to time.

Reporting Procedure
Prior to filing a formal report as outlined below, the individual considering making a report should first, if at all possible, attempt to resolve the matter directly with the alleged offender. In addition, the reporting individual may consult informally with any member of the Standards Committee for information and assistance. Any such informal consultation will be confidential if so requested. The only written record of any such confidential consultation shall consist of a confidential memorandum retained in the files of the Chair of the Standards Committee.

To make a formal report of an alleged violation of these Standards, a written description of the alleged violation, signed by the individual making the report, shall be delivered to any individual on the Standards Committee. The Standards Committee shall conduct a preliminary investigation, giving the reporting individual, the alleged offender and any other persons as the Standards Committee shall determine a fair opportunity to express their views on the matter. Further, the Standards Committee shall make, in accordance with commonly held standards of conduct, any necessary preliminary determination of what does or does not constitute reasonable or appropriate conduct and behavior. Thereafter, the Standards Committee shall issue a written statement of their preliminary findings to the individual making the report, the alleged offender and to the Dean. The Dean shall then take such further action on the matter as the Dean shall deem appropriate, consistent with Vanderbilt University policy on disciplinary actions as set forth in the Vanderbilt University Faculty Manual, Student Handbook or Staff Policies, as applicable.

Alternatively, a student alleging sexual harassment or unlawful discrimination may make a complaint to Vanderbilt¡¯s Opportunity Development Center in accordance with the procedure outlined in the Student Handbook. If the complaint to the Opportunity Development Center does not resolve the matter to the satisfaction of the individual making the complaint, a formal grievance may be filed with the Office of the Chancellor in accordance with the procedure in the Student Handbook.

Proposed by a joint student faculty committee and approved by Executive Faculty, School of Medicine, May 5, 1993.

Student Leave

Students in the third and fourth year on clinical rotations may have reason to be away from their rotations. A student leave pass must be used in a situation where the student is the initiator of a leave involving leaving town or an overnight stay. Examples of reasons for which a Student Leave Pass may be granted are significant personal life events such as the marriage of a sibling or the birth of a child and significant professional events such as the presentation of a paper at a national or international meeting. A Student Leave Pass obtained from the Student Records Office in 203 Light Hall. Information required includes the date, time and reason for the leave. The signatures of both the clerkship director and the Associate Dean of Students are also needed. Students must also notify their team in advance of the request. These passes should be used on all third year clerkships and required clerkships of the fourth year.

At the discretion of the senior resident and attending physician on the ward team, students may occasionally be given time off when working conditions permit. These excuses are not to be used for more than 24 hours in lieu of a signed Student Leave Pass.

USMLE (United States Medical Licensing Examination)

It is the place of Vanderbilt University School of Medicine that all medical students will take Step 1 and Step 2 (both Clinical Knowledge and Clinical Skills) of the United State Medical Licensing Examination (USMLE) prior to graduation, although passage of these examinations will not be a degree requirement.