Student Progress Committee Policies, Principles and Guidelines

Section 1. Operating Guidelines Overview

Role of SPC

The Student Progress Committee (SPC) exists to monitor medical students’ progress toward graduation and to determine if the standards of the University of Washington School of Medicine (UWSOM) are being met in individual cases. All areas of student progress are monitored, including promotion, remediation, probation, leave of absence, expansion, reprimand, suspension, dismissal, licensing exam performance, compliance, and graduation. SPC also recommends students for awards including Graduation with Honors, Graduation with High Honors, and Graduation Awards.

SPC considers each case on an individual basis within the context of UWSOM’s standards. SPC may allow latitude within its guidelines for managing a student’s progression in the medical school program when SPC members agree that the circumstances of the case support it.

SPC reviews a student’s record when there is concern about academic performance and/or conduct. UWSOM’s grading and evaluation system, SPC’s review process, and the process for addressing and managing allegations of unacceptable conduct provide for due process. This includes notifying the student of inadequacies, an opportunity for the student to respond to concerns about academic performance or unacceptable conduct, and careful and deliberate decision-making. When a student’s record, when viewed as a whole, does not show satisfactory progress, and/or there are reports of unacceptable conduct, SPC determines the appropriate course of action, with the advice of block, course, and clerkship directors, administration, and/or other requested consultants.

In order to graduate, students must:

  • Successfully complete all curricular requirements
  • Pass Foundations-2 and Patient Care Objective Standardized Clinical Evaluations (OSCEs)
  • Pass USMLE Step 1 and Step 2-CK
  • Demonstrate conduct in accordance with UWSOM’s academic and professionalism standards.

A pattern of evaluator concerns about a student’s performance or conduct may constitute a failure to meet graduation requirements, even if all curricular elements and exams are passed.

The UWSOM’s policies may differ from the University’s policies. This is due to the unique structure of the medical school, dispersed over academic and clinical sites in a five-state region. Due to the standards required for patient interactions, SPC’s guidelines for managing students’ academic progress and professional development may differ from the University’s policies.

Grades and evaluations are submitted by course, block, thread, and clerkship directors; these form the basis on which SPC makes decisions about individual students. SPC is not responsible for the UWSOM’s grading system and is not involved with grade appeals. These are the purview of Curriculum.

SPC does not investigate allegations of unacceptable conduct. When there is an allegation that UWSOM’s academic or professionalism standards have been violated, the inquiry is completed by a designated UWSOM or University process. Once this process is complete, SPC reviews confirmed violations and determines actions.

Composition of SPC and Voting Process

10-12 members of the UWSOM faculty serve as voting members of SPC. They are chosen by the Vice Dean for Academic, Rural and Regional Affairs and are approved by the Dean of the School of Medicine. One member serves as Chair. Quorum is reached when 51% of the voting members are present. Votes are determined by a simple majority of those present. The Chair votes when needed to achieve quorum, to break a tie, or to create a tie in order to allow more discussion.

  • Ex-officio (non-voting) members of SPC are present at meetings to provide SPC with relevant information about individual students and/or perspective on UWSOM’s curriculum. Current ex-officio members are:
  • Associate Dean for Student Affairs (serves as Administrative Dean to SPC)
  • Assistant Deans for Student Affairs
  • Associate Deans for Admissions, Colleges, and Curriculum
  • Regional Assistant Foundations Phase Deans
  • Regional Assistant Clinical Deans
  • Assistant Deans for Student Development, Student Support, Basic Sciences and Clinical Education
  • Representative from the Office of Healthcare Equity
  • Representative from the Department of Biomedical Informatics
  • Registrar
  • Director of Proactive Advising

Decisions Made on Behalf of SPC

The SPC Chair may decide individual cases on behalf of SPC or may convene a subcommittee of 3 or more SPC members plus the Chair to review cases urgently. A scheduled SPC meeting that does not reach quorum may also function as a subcommittee.

If a student accepts a decision made by the Chair or subcommittee on behalf of SPC, the decision is presented to SPC at the next scheduled meeting as “information only.” A student who does not accept a decision made by the Chair or subcommittee on behalf of SPC may request that SPC review their case and determine actions at the next SPC meeting. Such students remain in their current status, i.e., do not begin the recommended program or remediation, until their case is reviewed by SPC.

Suspension or dismissal may not be recommended by the SPC Chair or subcommittees. These actions can only result from a vote of the full SPC.

Confidentiality

SPC maintains strict confidentiality surrounding students’ academic performance and progress in the medical school program. The following individuals have knowledge of the student’s status and/or are informed when appropriate to facilitate the student’s successful progress:

  • SPC chair and SPC
  • Faculty and staff who serve as ex-officio members of
  • The student’s college mentor. College mentors are informed of any action taken by SPC regarding one of their
  • Relevant staff members who schedule appointments with deans, schedule students in courses and clerkships, write letters of good standing, maintain academic files,
  • Block, thread, course, and clerkship directors (or designees) who present or provide information to SPC about students having difficulty in their curricular component, and who need to manage remediation
  • Academic faculty of affiliated degree programs (e.g., Medical Scientist Training Program).
  • Director of Academic Support.
  • Anyone with legitimate need to know as defined by the federal Family Educational Rights and Privacy Act (FERPA).

Conflict of Interest

Voting and ex-officio members of SPC may have relationships with students reviewed at SPC.  To prevent conflicts of interest, SPC members are required to disclose that they have a conflict of interest and recuse themselves from student reviews, interviews, discussions, and voting when the student being discussed is:

  • A direct mentee, including students in the SPC’s member’s College Faculty group
  • A friend or family member
  • Related to a colleague or friend (child, spouse, etc.)
  • A current or former patient of the SPC member
  • In any other relationship with the SPC member, past or present, that creates a conflict of interest

A faculty member recusing themselves will physically leave the meeting room during the review, interview, discussion, and vote portions of the SPC process for the student with whom the faculty member has a conflict of interest.

Course, block, thread, and clerkship directors and leaders may serve on SPC. When a student is under discussion because of a deficiency in that SPC’s member’s course at that SPC member’s site, that SPC member is required to recuse themselves from the interview, discussion, and vote. However, that faculty member may inform SPC about that student’s performance in their course before leaving the meeting. This faculty member does not need to recuse themselves from future meetings if the same student is reviewed for different deficiencies.

When students are being interviewed by SPC, they are given a list of SPC members in advance. The student may request that specific members of SPC recuse themselves, based on a direct relationship with those SPC members. If the faculty member disagrees with the student’s request for recusal, the SPC Chair will make the final decision.

Section 2. Curricular Requirements and Expected Timeline

School of Medicine Curricular Requirements are the purview of Curriculum, not SPC. Included here are timeline issues that are relevant to SPC actions.

Foundations Phase 

The Foundations Phase Curriculum is intended to be completed in 18 months. The curricular requirements must be completed as a full-time, intact, contiguous curricular schedule unless a student requests or is mandated to take leave of absence. Students returning from leave of absence must re-enter the curriculum at the point they stopped and continue contiguously from there.

All Foundations Phase curricular requirements must be successfully completed before entering the Patient Care Phase.

Students are assigned to one of the UWSOM’s six regional campuses at enrollment and are expected to complete all Foundations Phase curricular requirements at that campus. Students who need to repeat curricular requirements may be assigned to a different regional campus by SPC.

Patient Care Phase

The six required clerkships must be completed as a full-time, intact, contiguous curricular schedule unless a student requests or is mandated to take leave of absence. Only under exceptional circumstances will permission be granted to delay a required clerkship into the final year or to take a required clerkship at another Liaison Committee on Medical Education (LCME) approved medical school.

Explore & Focus Phase 

All Explore & Focus Phase curricular requirements must be successfully completed before the Physician’s Oath & Hooding Ceremony.

Objective Structured Clinical Examination (OSCE)

Passing Foundations-2 and Patient Care OSCEs is a graduation requirement. The Foundations-2 OSCE must be passed before entering the Patient Care Phase. The Patient Care OSCE must be passed at the end of the Patient Care Phase and before the Explore & Focus Phase, even for students planning to expand. A Student Affairs Dean may make exceptions to the timing of the OSCE in individual circumstances.

United States Medical Licensing Examination (USMLE) 

Passing USMLE Step 1 and Step 2-CK are graduation requirements.

Step 1  

  • Students must complete all Foundations Phase requirements except Consolidation & Transition and Transition to Clerkships before taking Step 1, including any remediations.
  • For Step 1 deadline information, see UWSOM Policy Regarding USMLE Step 1 Exam.
  • Students must take Step 1 within 1 year of completing Foundations Phase.

Step 2-CK  

  • Students must pass all Patient Care Phase clerkships, including any remediation, before taking Step 2-CK.
  • Students must take Step 2-CK no later than June 30 of the year prior to expected graduation year.
  • For students completing their Patient Care Phase off-cycle from the projected timeline, Step 2-CK must be taken within 12 weeks of completing the Patient Care Phase.
  • If a passing score is not recorded by the deadline for National Residency Matching Program certification, a delay of graduation may be necessary.

Voluntary Leave of Absence  

Students may request leave of absence for personal reasons, academic reasons, or to participate in curricular programs such as research fellowships or concurrent degrees. Students may request personal leave to manage pregnancy, parental leave, personal illness, caregiving for family members, or other reasons. Going on leave to avoid failing a block, course, or clerkship is not allowed. Students who take leave may need to extend their graduation date.

Requests for leave go to Student Affairs Deans. A Student Affairs Dean may approve leave on behalf of SPC for up to 4 quarters. These leaves are reported to SPC as information-only. For additional leave beyond 4 quarters, students must petition SPC by submitting a letter explaining why they need extended leave and what actions they are taking to prepare for their return to the curriculum. Students who need more than 8 quarters to resolve an issue must withdraw from the curriculum, except in the most extenuating circumstances, as determined by SPC.

If a leave of absence follows Foundations Phase, the student must pass Step 1 before starting a fellowship or concurrent degree. If a leave of absence follows Patient Care Phase, the student must pass Step 2-CK before starting a fellowship or concurrent degree. Students taking personal leave are encouraged to complete Step exams before going on leave when feasible.

Expanded Curriculums (Expansions)  

An expansion means that a student extends their graduation date beyond the usual 4 years. Leaves of absence, additional quarters of coursework, and concurrent degrees are common reasons for expansions. Students choosing to expand should plan their time away from the curriculum to fall between phases, i.e., not during Foundations or Patient Care phase. These phases are intended to be taken as full-time, intact, contiguous curricular schedules. Expanding during Explore and Focus phase is allowed.

Blocks and clerkships must be taken in a full-time capacity, e.g., a 6-week clerkship cannot be expanded and taken over 10 weeks.

Section 3. Events that Result in Review by SPC

“SPC Review” means that the student’s entire record, including academic performance, evaluator concerns, and findings from any UW or UWSOM misconduct processes are presented to SPC for discussion and determination of actions.

Fail Grades 

Students receiving fail grades in blocks, courses, clerkships, and clerkship exams are reviewed by SPC.

Competency Not Achieved 

Students receiving this designation in a thread are reviewed by SPC.

USMLE Step Exam Fails

Students who fail Step 1 or Step 2-CK are reviewed by SPC.

Failure to Take Step 1 

Students who have not taken Step 1 within 1 year of completing Foundations Phase will be reviewed.

Failure to Complete Objective Structured Clinical Examination (OSCE) 

Students who fail to successfully complete Foundations 2 or Patient Care OSCE are reviewed by SPC.

Evaluator Concerns 

Evaluator concerns are internal designations, meaning they do not appear in the Medical Student Performance Evaluation unless further action occurs. Evaluator concerns are submitted by faculty within student evaluations or may take the form of written statements from any faculty member describing a performance concern. Evaluator concerns are received and reviewed by Student Affairs Deans. Students with evaluator concerns are reviewed by SPC at the discretion of a Student Affairs Dean when the student has additional academic and/or conduct concerns, or if there is a pattern of evaluator concerns.

Incompletes 

A student who must leave a block, course, or clerkship due to illness or a personal emergency may be granted an “incomplete” by a Student Affairs Dean. If the student does not complete the work by the deadline set by Curriculum, the incomplete will convert to a Fail and will therefore be reviewed by SPC.

Registrar Drop

Students who must leave a block, course, or clerkship due to illness, personal emergency, or because they have been placed on a leave of absence, will receive a grade designation of “Registrar Drop” (previously referred to as a withdrawal) when permitted by the appropriate Foundations Dean or clerkship director in consultation with a Student Affairs dean. Students are not allowed to take a Registrar Drop to avoid failing a block, course, or clerkship. A student who does not complete a course and does not have permission to take a Registrar Drop will be assigned a grade of fail. All Registrar Drops are reported to SPC.

Former Quarter Drop

Students may consult with a Student Affairs Dean to begin the process of receiving a grade designation of Former Quarter Drop, previously referred to as Hardship Withdrawal Petition.

Failure to Complete UWSOM Compliance Requirements

Non-compliance with essential compliance requirements may be considered by the Student Progress Committee at the discretion of Student Affairs Deans.

Violations of UWSOM’s Academic or Professionalism Standards 

SPC defines academic and professionalism standards of conduct by referring to UW Medicine Policy on Professional Conduct, UWSOM Standards of Conduct and Professional Behavior, and UW Student Conduct Code.  These standards together are referred to as “UWSOM’s academic and professionalism standards.” Violations of these standards, whether within the educational environment or in the community, may be reviewed by SPC for discussion and determination of actions. This is part of SPC’s academic review process.

When an alleged violation of UWSOM’s academic and professionalism standards occurs, a Student Affairs Dean manages the process in accordance with the UWSOM Guidelines for Managing Alleged Violations of Academic and Professionalism Standards (Section 6.) When a formal or informal hearing occurs, the Chair of SPC may receive the report as “information only” or the full SPC may interview the student and determine actions.

Section 4. Actions and Sanctions for Managing Students in Difficulty

When an “SPC review” occurs, SPC reviews an individual student’s deficiencies and their entire record, deciding on a course of action that considers academic performance, conduct, and evaluator concerns. More than one action and/or alternatives not listed may be used as individual cases warrant. SPC may set a timeline for actions to be completed and criteria for subsequent performance. The student will be informed of the plan in writing within 10 days and will work with Student Affairs to implement it.

SPC Actions may include but are not limited to:

  • Allow Remediation
  • Disciplinary Warning/Letter of Reprimand
  • Requirement for Work to be Re-done
  • Academic Probation
  • Disciplinary Probation
  • Mandatory Leave of Absence
  • Advanced Information
  • Referral to WPHP
  • Suspension
  • Dismissal

Actions that the National Residency Matching Program requires UWSOM to report in the Medical Student Performance Evaluation are requirement for work to be re-done, disciplinary probation, mandatory leave of absence, and suspension. Remediations will be reflected in the student’s official transcript.

Each action is described in further detail below.

Allow Remediation

Remediation of Courses and Clerkships 

SPC decides whether a student may remediate. Block, course, thread, and clerkship directors may not remediate a student’s deficiency until SPC meets and determines an appropriate course of action based on the student’s overall performance. The student may have difficulty in more than one area and a coordinated plan may be needed for the student’s benefit.

SPC’s remediation plan is based on multiple factors, including but not limited to recommendations of the block, thread, course, or clerkship director, input from ex-officio members of the SPC, input from the student’s College Mentor, and the student’s overall medical school progress.

SPC may require that the remediation be completed before the student may continue in other coursework.

Typical remediation plans for students with a single deficiency are listed here:

  • Fail grade in a block: SPC usually accepts the block director’s recommendation for re- examination or repeat of the
  • Competency not achieved in a thread: SPC usually accepts the thread director’s recommendation for taking the thread remediation
  • Fail grade in a course that is not part of a block: SPC usually accepts the course director’s or clinical skills director’s recommendation for
  • Fail grade in a clerkship: SPC usually accepts the clerkship director’s recommendation for repeat of the clerkship.
  • Fail grade on a clerkship exam without having failed the clerkship: SPC usually allows re-take of the exam.

For multiple deficiencies, SPC determines an appropriate course of action considering the student’s entire record and any extenuating circumstances presented. SPC may require repeat of certain curricular requirements, even those previously passed. For example, SPC may require a student who has failed 2 blocks in Term 1 to re-start the curriculum, including courses already passed such as Foundations of Clinical Medicine.

A student who does not remediate on the timeline set by SPC, or who fails a remediation, will be reviewed again by SPC for further action.

Remediation of Step Exams: Step 1 Re-takes and Deadlines 

When a student fails Step 1 on their first attempt and has no other deficiencies, SPC typically permits re-take. When a student fails Step 1 on their second attempt, SPC may permit re-take and/or take other actions, in light of the student’s entire record and any extenuating circumstances presented. A student who fails Step 1 a third time may be considered for dismissal.

When SPC permits re-take of Step 1, a deadline may be set by SPC. Typically, this deadline will be the end of the quarter following the one when the student received the failing score. For example, if a student receives a Step 1 fail during Summer quarter, SPC would assign the last day of Autumn quarter as their re-take deadline. Individual circumstances may warrant different deadlines.

Students who fail Step 1 are allowed to finish the current quarter’s clerkships. They are required to work with Student Affairs and Registration to adjust their clerkship schedule to allow adequate time to study for and re-take the exam. Dropping scheduled clerkships may be necessary.

A student who has not taken Step 1 within 1 year of completing Foundations Phase will be reviewed by SPC. SPC may require an interview with the student to understand the barriers. SPC may set a Step 1 deadline for that student and review the student again if the deadline is not met.

SPC may require that a student achieve a passing score on Step 1 before any clerkships are scheduled. This requirement is typical after a student has failed Step 1 or has been out of the curriculum for a year or more before attempting Step 1.

Remediation of Step Exams: Step 2-CK Re-takes and Deadlines 

Students who fail Step 2-CK are allowed to finish any clerkships or clinical electives they have begun. If the student has no other deficiencies, SPC typically permits re-take. When a student fails their second attempt of Step 2-CK, SPC may permit re-take and/or take other actions, in light of the student’s entire record and any extenuating circumstances presented. A student who fails Step 2-CK a third time may be considered for dismissal.

Students who fail Step 2-CK are required to work with Student Affairs and Registration to adjust their schedule to allow adequate time to study for and re-take the exam. Delay of graduation may be necessary. Step 2-CK must be retaken and passed prior to the deadline for National Resident Matching Program Match certification. SPC may set a different deadline in specific cases.

Disciplinary Warning

A disciplinary warning is used for minor breaches in conduct, particularly when there is evidence that the student did not intend to deceive or abuse a right or privilege. The intent is to help the student understand and correct the deficiency. Example: a student accessed a family member’s medical record believing that this was reasonable to help their relative navigate their medical care. The warning may include specified assignments or activities for the student to complete. A disciplinary warning is documented with a Letter of Reprimand and is only reported in the student’s Medical Student Performance Evaluation at the discretion of Student Affairs Deans.

Requirement for Work to be Re-Done

SPC may require that coursework or other graduation requirements be redone to remediate serious but not egregious breaches in conduct. The intent is to have the student understand the consequences of behavior which the student knew was in violation of UWSOM’s academic and professionalism standards. Example 1: a student was found to have committed plagiarism in their Scholarly Project. The student was required to start over and complete a new project fulfilling the requirement. Example 2: a student deliberately and without attribution used another provider’s clinical note as if it reflected their own work with that patient. The student was required to repeat the clerkship. The National Resident Matching Program Match requires that the reason for work to be re-done appears in the student’s Medical Student Performance Evaluation.

Academic Probation 

Academic probation serves to notify a student that dismissal will be considered if the student has additional deficiencies. SPC may put a student on academic probation for the following:

  • 2 or more block fails
  • 2 or more step exam fails
  • 2 or more clerkship fails

Thread deficiencies and fails other than those above will be considered in the totality of the student’s record when determining if the student should be placed on probation.

The above deficiencies do not require that a student be placed on probation. SPC uses discretion in the use of probation designations so that being placed on probation serves as a warning to the student that dismissal may be the next action. Unsatisfactory progress in any area that falls under SPC’s purview may result in academic probation.

Students on academic probation due to Foundations fail(s) and/or Step 1 fail(s) will typically be removed from probation when they achieve a passing score on Step 1. Students on academic probation due to clerkship fails will typically be removed from probation when the fail grade(s) have been remediated and the student has completed 4 quarters of coursework without additional fail grades. SPC may make the probation period longer or shorter depending on individual circumstances.

A student placed on academic probation during the Foundations Phase, then removed after passing Step 1, may be placed back on probation after a single additional deficiency at the discretion of SPC.

Students on academic probation may not take non-clinical electives, serve in leadership roles in student activities, pursue paid employment, work toward a concurrent degree, or any other activity that might interfere with their medical school performance without prior permission from a Student Affairs Dean.

Academic Probation is an internal designation and is not reported in the Medical Student Performance Evaluation.

Disciplinary Probation 

Students may be placed on disciplinary probation when a violation of UWSOM’s academic and professionalism standards has occurred. If there are additional conduct issues while a student is on disciplinary probation, dismissal may be considered. The duration of disciplinary probation is determined at the time that it is imposed.

The National Resident Matching Program Match requires that disciplinary probation be reported in the Medical Student Performance Evaluation.

SPC votes to approve students’ removal from academic and disciplinary probation. Students must be removed from probation before they graduate.

Mandatory Leave of Absence 

Students with academic or conduct issues may have leave mandated by SPC. SPC may stipulate what the student must do before returning. If no stipulations are made, the student may return from leave and register for courses without involvement of SPC. If stipulations are made, the student must petition SPC to return, demonstrating that they have met those stipulations. If stipulations are made and not met, SPC may recommend that the student remain on leave or may consider dismissal.

In cases where SPC approves a return from leave, SPC may set requirements for continuing in the curriculum and may place the student on academic and/or disciplinary probation. SPC may require an interview with the student before approving a return from leave.

Students who are placed on leave may need to extend their graduation date.

The National Resident Matching Program Match requires UWSOM to report mandatory leaves of absence in the student’s Medical Student Performance Evaluation.

Advance Information 

In rare circumstances, SPC may place students on “Advance Information” status. This is used when a student has had certain types of academic or conduct difficulty. When on Advance Information status, course and/or clerkship directors receive formal, confidential notification of the difficulty before the student begins the course or clerkship. The objectives for using advanced information are to provide the student with additional support in the area(s) of deficiency, to ensure that there is adequate feedback to the student, and to ensure that there is adequate evaluation of the area(s) of concern. Example: a student had several evaluator concerns around ineffective communication styles. Advanced information status was put in place so that subsequent supervisors could closely observe for progress in this domain.

Advanced information status is not reported in the Medical Student Performance Evaluation.

Communications regarding students on Advanced Information status are managed by Student Affairs Deans. Further information is in the Advanced Information Procedure.

Fitness for Clinical Contact

Academic, Rural and Regional Affairs deans and/or SPC have the right to prohibit a student’s continuation in the clinical setting if there are concerns related to patient care or patient safety, the ability to practice with reasonable skill and safety due to a mental or physical condition, the potential for compromising compatibility and effective functioning of the healthcare team, and/or evidence of substance abuse. Further information is in the Fitness for Clinical Contact Policy.

Referral to Washington Physicians Health Program (WPHP) 

The opportunity for students to participate in direct patient care places responsibility on the UWSOM to ensure that patients are not placed at risk due to a student’s mental illness, physical illness, or impairment from drugs or alcohol. A variety of situations may lead to a student being referred to WPHP. Once referred to WPHP, the student must be endorsed by WPHP before being considered for re-entry into the curriculum.

SPC may require a student be referred to and endorsed by WPHP before continuing in the curriculum when circumstances suggest that physical illness, mental illness, impairment from drugs or alcohol, or other circumstances may be contributing to the student’s deficiencies. WPHP protects the student’s privacy while considering the possible underlying causes for changes in performance and/or problematic behavior.

If a student who is being reviewed by SPC has already been referred to WPHP, Student Affairs Deans may report that information to SPC as part of the student’s overall record. Students referred to WPHP by any UWSOM official other than SPC who feel the referral is unwarranted may request that SPC review their case. See Section 5 for details of this process.

Referral to WPHP is not reported in the Medical Student Performance Evaluation.

Suspension

Suspension is an institutional action separating a student from continuing in the UWSOM program for a specified period of time. SPC may issue a suspension when there is clear evidence of a serious violation of UWSOM, UW, or UW Medicine’s guidelines and/or policies for personal or professional conduct, including but not limited to:

  • Documented cheating in coursework
  • Intentional misrepresentation of patient information
  • Placing patients’ care or safety at risk
  • Unacceptable conduct in the community
  • Violating the University’s student conduct code
  • Violating local, state, or federal laws

After completing the suspension, the student will be interviewed by SPC and present documentation supporting their readiness to return. The student must demonstrate understanding and growth in the domain of personal or professional conduct that was violated. If the conduct is egregious, the student does not show insight into their conduct as being inappropriate for a physician-in-training, and/or the student does not demonstrate satisfactory progress in the conduct area of concern, SPC may consider dismissal.

If the student is permitted to re-enter the curriculum, SPC may place them on disciplinary probation with the expectation that their conduct will be at an acceptable level for the remainder of their tenure in the medical school. If there is another violation of UWSOM, UW, or UW Medicine’s guidelines and/or policies for personal or professional conduct, SPC may consider dismissal.

The suspension is part of the student’s academic record and is included in administrative letters written about their performance, including the Medical Student Performance Evaluation. While suspended, the student may not be involved in any medical school programs or activities and should be absent from the medical school setting.

Dismissal 

A student may be dismissed if they do not meet the academic and/or conduct standards for graduation set by UWSOM. If a student’s record, when viewed as a whole, does not meet UWSOM’s expected level of performance, SPC may recommend dismissal even though passing grades are recorded in individual courses. A dismissal recommendation may be made at any time during a student’s medical school enrollment. A student does not have to be placed on probation prior to being recommended for dismissal.

Dismissal may be considered for one or more of the following:

  • 3 or more block fails
  • 3 or more clerkship fails
  • Failure on repeated block, course, or clerkship
  • Additional fail grade while on probation
  • 3 or more step exam fails (same step or combination or steps)
  • Combination of 3 fails or deficiencies in 2 or more areas, which may include blocks, threads, courses, step exams, and/or clerkships
  • Major or persistent violations of UWSOM’s academic and professionalism standards
  • Failure to complete UWSOM compliance requirements

If SPC votes to consider dismissal, an interview with the student is planned for the next scheduled SPC meeting. The student is informed that they are under consideration for dismissal and is provided a detailed description of the concerns leading to SPC’s decision. The student is given at least 14 days’ notice that they are required to appear at the next SPC meeting for their dismissal consideration interview. The SPC Chair has discretion to delay the interview under extenuating circumstances.

At the interview, the student may be accompanied by one advocate who is a member to the medical school faculty. The student must give their advocate’s name to the Student Affairs Office at least 10 days before the meeting. The presence or appearance of a student’s legal counsel is not permitted.

The student must provide a written statement addressing the concerns leading to the dismissal consideration. The student may additionally request letters of support and other relevant documentation from outside parties. All written materials must be submitted to the Student Affairs Office at least 7 days before the dismissal consideration interview.

Before the interview, SPC reads the student’s written statement, letters of support, and their entire academic record including Step exams, evaluations, evaluator concerns, reports resulting from UWSOM informal or formal hearings, and reports from UW Community Standards and Student Conduct Office.

At the dismissal consideration interview, the student presents their perspective on their difficulties and their plans to address those difficulties, and then takes questions from SPC members. The student’s advocate, if present, may also share information and answer questions.

After the interview, SPC votes to either recommend dismissal or some other remedy that allows the student to continue in the curriculum.

If the decision is a dismissal recommendation, the student may request an appeal. The student must submit the request for appeal, in writing, to the Chair of SPC within 10 days of the dismissal recommendation. Appeals are heard by the Dismissal Appeal Committee (DAC). The sole purpose and responsibility of DAC is to provide a fair and formal review of dismissal recommendations made by SPC. It is composed of 3 neutral faculty members, appointed by the Vice Dean for Academic, Rural and Regional Affairs, who do not participate in regular SPC meetings and have adequate knowledge of UWSOM’s standards to independently assess whether a student is meeting those standards. DAC convenes as soon as possible whenever a student requests a dismissal appeal.

DAC will consider the case at a meeting which includes the student, their faculty advocate, a Student Affairs Dean, and the Chair of SPC, all of whom present information about the events leading to the dismissal recommendation. DAC does not re-consider whether the student’s stated deficiencies are appropriate grounds for dismissal. The purpose of DAC’s review is to (1) consider new information that was not reasonably available during the initial SPC deliberation, (2) consider any evidence that discrimination or bias impacted the students’ academic participation or evaluation, and (3) consider any evidence that SPC’s decision-making was arbitrary or capricious.

A DAC member who has a relationship with the student that presents a conflict of interest, as described above for SPC members, will recuse themselves as soon as they know the identity of the student to be discussed. Students will be informed in advance of who is on DAC and may request that a DAC member recuse themselves, based on a direct relationship with that member. If the faculty disagrees with the student’s request for recusal, the Vice dean for Academic, Rural, and Regional Affairs will make the final decision. When there is a recusal, the Vice Dean for Academic, Rural and Regional Affairs will select an alternative faculty member to serve for that meeting.

At the end of the meeting the three DAC members vote to affirm or overturn the dismissal recommendation. The decision is by simple majority. The decision is communicated in writing to the student within 7 days.

If DAC affirms the dismissal, the Faculty Council on Academic Affairs (FCAA) reviews the case to ensure proper procedures have been followed. If FCAA finds that process was followed correctly, the dismissal recommendation is forwarded to the Dean. The student has up to 10 days after FCAA’s decision to contact the Dean to set a meeting to discuss the dismissal. The Dean’s decision is final and may not be appealed.

Students may withdraw from UWSOM at any point up until the Dean sustains the dismissal.

Students are usually allowed to continue in the curriculum during the dismissal review process. However, deans for Academic Affairs, including Student Affairs and Curriculum, as well as SPC, may at times seek to limit the student’s presence in the curriculum. Need for mandatory Leave of Absence and/or concerns about Fitness for Clinical Contact may apply to students in the dismissal review process as they do to other students.

If a student continues in the curriculum while under dismissal review, SPC will have oversight over what blocks, courses, or clerkships may be scheduled.

If the dismissal consideration or recommendation is based on fail grades, the student is not permitted to remediate those blocks, courses, or clerkships until the dismissal consideration is resolved by SPC or the dismissal recommendation is overturned through the academic review process.

If SPC’s dismissal recommendation is overturned by DAC, FCAA, or the Dean, SPC will determine the appropriate academic program and curricular schedule. This may include requiring a student to retake blocks, courses, or clerkships which were previously passed. SPC may place the student on probation, elect to provide Advance Information to block, course, or clerkship directors, require the student be endorsed by WPHP, and/or other requirements that SPC deems necessary to allow the student to make satisfactory progress toward graduation. 

Withdrawal from the MD Program

Students typically withdraw from UWSOM if they decide that medicine is not the best career path, they are unable to complete the program for academic or personal reasons, or they are being considered for dismissal. Students choosing to withdraw notify a Student Affairs Dean. SPC reviews withdrawals as “information only.”

Section 5. SPC Review Processes

Review of Dismissal Recommendations 

Dismissal recommendations may be appealed to the DAC and are automatically reviewed by FCAA and the Dean by the process described in Section 4.

Review of SPC Actions Other Than Dismissal

Students who disagree with any SPC decision other than dismissal may request a review. The student informs the SPC Chair that they are requesting a review within 10 days of receiving SPC’s decision. After that, SPC decisions are final. The student must prepare a written petition and submit it at least 7 days prior to the next SPC meeting. The petition explains why SPC’s decision is wrong and what alternative plan the student proposes to better allow success in the curriculum. SPC will consider the written petition at the next SPC meeting and decide if the student’s proposal is acceptable or not. This decision will be communicated in writing within 10 days after the SPC meeting.

When SPC does not accept the student’s proposal, the student may accept the original decision or may request to appear in person to explain their plan further. When a student requests to appear in person, an interview is planned for the next scheduled SPC meeting. The SPC Chair has discretion to delay the interview under extenuating circumstances.

At the interview, the student may be accompanied by one advocate who is a member to the medical school faculty. The student must give their advocate’s name to the Student Affairs Office at least 10 days before the meeting. The presence or appearance of a student’s legal counsel is not permitted.

In addition to their written petition, the student may present letters of support and other relevant documentation from outside parties for SPC to review. All written materials must be submitted to the Student Affairs Office at least 10 days before the interview.

Before the interview, SPC reviews the student’s written petition, letters of support, and their entire academic record including Step exams, evaluations, evaluator concerns, reports resulting from UWSOM informal or formal hearings, and reports from UW Community Standards and Student Conduct Office.

At the interview, the student presents their perspective on their difficulties and their plans to address those difficulties, and then takes questions from SPC members. The student’s advocate, if present, may also share information and answer questions.

After the interview, SPC determines the plan that the student must follow to continue in the curriculum. Based on all the information reviewed and the student’s presentation of their appeal, SPC may take any appropriate action described in Section 4 other than dismissal; SPC is not limited to the actions initially taken in response to the student’s deficiencies. This decision is final with no further review within UWSOM or the University. The student may withdraw from the curriculum if they do not agree with the decision.

Review of WPHP Referrals Not Issued by SPC

Students may be referred to WPHP by UWSOM officials other than SPC. A student who believes the referral is not warranted may appeal the referral to SPC. In this situation, the student petitions SPC in writing explaining why the referral is unwarranted. An interview is planned for the next SPC meeting. These interviews follow the same structure as other non-dismissal interviews.

If the student is disputing the factual basis of their referral to WPHP, a formal or informal hearing process should be pursued instead, not a review by SPC.

Before the interview, SPC reviews the student’s written statement describing why WPHP referral is unwarranted, letters of support, and their entire academic record including Step exams, evaluations, evaluator concerns, reports resulting from any informal and/or formal hearings, and reports resulting from a UW Community Standards and Student Conduct Office investigation.

After the interview, SPC votes to uphold or reverse the referral to WPHP. This decision is final without further opportunity for appeal. Based on all the information reviewed and after hearing the student’s perspective, SPC may take any action described in Section 4 instead of or in addition to WPHP referral, except dismissal. Students may appeal those actions following the same process as any other SPC action.

Section 6. Guidelines for Managing Alleged Violations of Academic and Professionalism Standards

The UWSOM is committed to maintaining the highest standards of academic performance, personal and professional conduct, integrity, and respect for others. Students enrolled in the MD program are required to uphold these standards of conduct, both in the academic setting and in the community. These standards are articulated in UW Medicine’s Policy on Professional Conduct, UWSOM’s Standards of Conduct and Professional Behavior, and the UW Student Conduct Code. These standards together will be referred to as “UWSOM’s academic and professionalism standards.”

WAC 478-121, Student Conduct Code for the University of Washington, gives UWSOM the authority to take academic action when a student fails to meet UWSOM’s academic and professionalism standards.

SPC may use any of the actions described in Section 4 and/or other alternatives to manage violations of UWSOM’s academic and professionalism standards. Students who do not fulfill SPC’s requirements may be considered for dismissal. Students who have violated UWSOM’s academic and professionalism standards must complete all required actions before being granted the MD degree from UWSOM.

Students are expected to abide by university, local, state, and federal regulations and laws. Infractions of these standards may result in actions by UW or UWSOM apart from whether there is any action that may be taken in civil or criminal court.

For alleged violations of UWSOM’s academic and professionalism standards that occur outside of the educational environment, the reported incidents may be managed through a review process within UWSOM or may be referred to the University’s Community Standards and Student Conduct Office (CSSC), depending on the allegation. SPC is not involved in determining if violations occurred; its role is to determine appropriate actions once violations of UWSOM’s academic and professionalism standards have been confirmed.

If CSSC performs an investigation, once the investigation is complete, CSSC will provide a report to SPC for consideration and determination of actions as part of UWSOM’s academic review process. This does not preclude CSSC from sanctioning the student as part of its charge as listed in the Washington Administrative Code (https://www.washington.edu/cssc/for-students/overview-of-the-student-conduct-process/).

SPC cannot alter CSSC’s decisions but reserves the right to take actions, independent of sanctions imposed by CSSC. SPC recognizes that there may be two parallel processes ongoing, those of UWSOM and those of CSSC. Therefore, there are two separate appeal processes, one within UWSOM and one within the University.

If an alleged violation of UWSOM’s academic and professionalism standards is sufficiently egregious and/or may impact the safety of self or others, Student Affairs Deans or other UWSOM officials with knowledge of the situation may act to remove the student from the clinical and/or educational setting. See the UWSOM’s Fitness for Clinical Contact Policy for details on this procedure.

When a student is alleged to have violated UWSOM’s academic and professionalism standards, a Student Affairs Dean will manage the process and may reach a resolution with the student. SPC may receive a report on the matter and may determine actions. In some circumstances, the University’s Community Standards and Student Conduct (CSSC) Office and/or UWSOM’s Misconduct Review Committee (MRC) may also be involved. Determination of jurisdiction for processing cases may be done in collaboration with CSSC and consultation with the Personnel Policy Unit at UWSOM and the University of Washington Attorney General’s office.

Investigations of alleged violations of UWSOM’s academic and professionalism standards occurring outside of the medical school program are typically conducted by the CSSC, which provides a report to SPC and may independently impose a sanction on the student. The student’s right to appeal a CSSC sanction follows the University’s Student Conduct Code guidelines, whereas the student’s right to appeal an SPC action follows SPC’s guidelines.

One SOM faculty member may be present at the student’s preliminary, informal, and/or formal hearing to serve as an advocate, at the student’s request. This is typically the student’s College Faculty mentor but may be a different faculty member of the student’s choosing.

The student may not be accompanied by legal counsel at any point during the academic review process. Student Affairs Deans may consult with UWSOM’s attorney at any time.

Reporting

A basic tenet of medical professionalism is that the profession is self-regulating. Thus, students and faculty are obligated to report any concerns about the conduct of peers or trainees. Any information suggesting that a UWSOM student possibly violated UWSOM’s academic and professionalism standards should be submitted to a Student Affairs Dean. A written statement of the alleged violation is required. Email is acceptable.

Reports relating to conduct outside the educational environment can be initially directed to a Student Affairs Dean or to the CSSC. These offices will decide jointly which of them, or both, will manage the process.

When a Student Affairs Dean receives information about a possible violation of UWSOM’s academic and professionalism standards, they will request a meeting with the individual(s) making the report and will request any relevant records those individuals may have. This meeting is to review the events surrounding the incident or concern. This meeting may be conducted in person or remotely, at the discretion of the Student Affairs Dean. The Student Affairs Dean may delegate their role to another appropriate individual.

Preliminary Meeting with the Student

If the Student Affairs Dean finds the report credible and concerning, the Student Affairs Dean and one other dean from the Academic, Rural and Regional Affairs offices will have a preliminary meeting with the student who is alleged to have violated UWSOM’s academic and professionalism standards. This meeting may be conducted in person or remotely, at the discretion of the Student Affairs Dean. The Student Affairs Dean may delegate their role to another appropriate individual. At this meeting the Student Affairs Dean or designee will provide the student the following information:

  • Notice of the allegations
  • The specific sections of UWSOM’s academic or professionalism standards that were allegedly violated
  • That the academic review process has been initiated
  • That any information the student shares will become part of the hearing documentation
  • That possible actions which may be taken by the UWSOM include but are not limited to: disciplinary warning, requirement for work to be re-done, disciplinary probation, mandatory leave of action, advanced information status, referral to WPHP, suspension, and dismissal.
  • That the student has a choice of informal or formal hearing and must make this choice within 7 days.
  • That once an informal hearing has occurred, and either the SPC Chair has received the ‘information only’ report or SPC has considered the report and determined actions, the student has waived their right to a formal hearing regarding the same allegations.
  • That UWSOM is obligated to forward the report of findings documenting the academic review process to the National Residency Matching Program.

Informal Hearing

The preliminary meeting may move directly to an informal hearing if the student so chooses or may be delayed to a future time. An informal hearing allows the student an opportunity to respond to the alleged violations of UWSOM’s academic and professionalism standards in a face-to-face meeting before any finding is determined or action is imposed.

The informal hearing is composed of the student, their faculty advocate as described above, the Student Affairs Dean or designee, and one other dean as described above. At this meeting, the Student Affairs Dean will present the information alleging that the student violated UWSOM’s academic and professionalism standards. After hearing this information, the student may respond to the allegations. Then the Student Affairs Dean conducts a careful and deliberate evaluation of the available information, conferring with the co-dean, UWSOM’s attorney, or other consultants as needed. The Student Affairs Dean then recommends appropriate action, if any, with consideration of the academic and behavioral attributes necessary to successfully complete the MD program. The informal hearing will result in one of these outcomes:

  1. The Student Affairs Dean may dismiss the allegations. This is applicable when the Student Affairs Dean determines that there is insufficient evidence that UWSOM academic and professionalism standards were violated. In this case, the Student Affairs Dean prepares an “information only” report to the Chair of
  2. The student acknowledges the violations of UWSOM academic and professionalism standards and accepts the actions recommended by the Student Affairs Dean. Once the student completes the actions, the Student Affairs Dean prepares an “information only” report to the Chair of SPC.
  3. The student acknowledges the violations of UWSOM academic and professionalism standards and accepts the actions recommended by the Student Affairs Dean but fails to complete them. In this case, the Student Affairs Dean prepares a report which is submitted to SPC. SPC considers the case and determines actions.
  4. The student acknowledges the violations of UWSOM academic and professionalism standards but does not accept the actions recommended by the Student Affairs Dean. In this case, the Student Affairs Dean prepares a report which is submitted to SPC. SPC considers the case and determines actions.
  5. The student acknowledges the violations of UWSOM academic and professionalism standards and mandatory leave of absence, suspension, or dismissal is recommended. In this case, the Student Affairs Dean prepares a report which is submitted to SPC. SPC considers the case and determines actions.
  6. The student does not acknowledge the violation of UWSOM academic and professionalism standards and/or the student requests to proceed to formal hearing.

A student has up to 24 hours to consider whether to acknowledge the violations of UWSOM academic and professionalism standards and sign a statement to that effect. This statement is prepared by the Student Affairs Dean.

The Student Affairs Dean’s report following an informal hearing documents the following information: the allegation, the information gathered from the informal hearing, the student’s acknowledgement of the violations if applicable, and the Student Affairs Dean’s conclusions and/or recommendations regarding appropriate actions based on the informal hearing. This report is retained in accordance with applicable retention policies.

Formal Hearing

Formal hearings occur when the student requests a formal hearing, or the Student Affairs Dean determines that evidence supports the allegations and the student does not acknowledge a violation of UWSOM academic and professionalism standards, either before or during an informal hearing process.

When either the student or the Student Affairs Dean requests a formal hearing, the Vice Dean for Academic, Rural and Regional Affairs will appoint the chair and members of a School of Medicine Ad Hoc Misconduct Review Committee (MRC). It is composed of faculty members with expertise in the areas relevant to the allegations. The Student Affairs Dean and Associate Dean for Curriculum are ex-officio (non-voting) members. The MRC provides the student a fair and impartial review of the allegations.

In preparation for the formal hearing, the Student Affairs Dean will provide the student with a written summary of the allegations and will inform the student of the following:

  • The student may be accompanied by a faculty advocate as described above, but not legal counsel
  • The MRC may request that the University’s legal counsel be present
  • The student may present evidence and witnesses on their behalf
  • The student may question any witnesses presenting against them
  • The possible actions which may be imposed by the UWSOM include but are not limited to disciplinary warning, requirement for work to be re-done, disciplinary probation, advanced information status, referral to WPHP, mandatory leave of absence, suspension, and/or dismissal.
  • That if violations of UWSOM academic and professionalism standards is confirmed, UWSOM is obligated to forward the report of findings documenting the academic review process to the National Residency Matching Program.

The Student Affairs Dean will inform the student of the scheduled hearing not less than 15 days prior to the hearing date. The student may agree to an earlier date.

At the formal hearing, the MRC will review information pertinent to the alleged violations, including but not limited to information from the informal hearing if one occurred, written or oral statements from the individual(s) reporting the incident or concern, and any relevant documentation. The student will have an opportunity to respond to the allegations.

At the end of the formal hearing, the MRC determines by simple majority that the allegations should be dismissed or that UWSOM’s academic and professionalism standards were violated. The student will be informed of the decision within 10 days by letter. The letter will be retained in the student’s academic record. MRC’s decision is final and not subject to further review or appeal.

When allegations are dismissed by the MRC, the Chair of the MRC prepares an “information only” report to the Chair of SPC.

When the MRC determines that the violations occurred, the Chair of the MRC prepares a report which details its findings of fact and recommendations on appropriate actions. This report is submitted to SPC. SPC considers the case and determine actions.

SPC Actions Following Informal and Formal Hearings

Reports of alleged violations of UWSOM’s academic and professionalism standards are considered by SPC in these situations:

  • An informal hearing occurred, the student acknowledged the violations of UWSOM academic and professionalism standards and accepted the recommended actions but did not complete them.
  • An informal hearing occurred, and the student acknowledged the violations of UWSOM academic and professionalism standards, but the student did not accept the recommended actions.
  • An informal hearing occurred, the student acknowledged the violations of UWSOM academic and professionalism standards, and mandatory leave of absence, suspension, or dismissal was recommended.
  • A formal hearing occurred, and the School of Medicine Ad Hoc Misconduct Review Committee (MRC) determined that UWSOM academic and professionalism standards were violated.

SPC considers the report(s) resulting from informal and/or formal hearings, and the student’s entire medical school record, within the context of UWSOM’s academic and professionalism standards in order to determine appropriate actions Considering these reports is part of SPC’s academic review process.

SPC’s consideration of a case following an informal or formal hearing generally includes an interview with the student, though students may opt out. The structure of this interview is the same as a dismissal consideration interview, even when dismissal is not being considered in that individual case. The purpose of the interview is for SPC to understand the student’s perspective on their violations of UWSOM’s academic and professionalism standards, within the context of the student’s entire academic record, so that SPC can determine an appropriate action plan. The violations as stated in the report(s) are not reconsidered during the interview.

Before the interview, SPC reviews the reports resulting from informal and/or formal hearings in addition to the student’s written statement, letters of support, and their entire academic record including Step exams, evaluations, evaluator concerns, and reports resulting from UW Community Standards and Student Conduct Office investigations.

Based on all the information reviewed and after hearing the student’s perspective, SPC may take any appropriate actions. SPC is not limited to the actions recommended by the Student Affairs Dean who managed the informal hearing or the chair of the Misconduct Review Committee who managed the formal hearing. The Chair of SPC will inform the student of the action plan by letter within 10 days.

If SPC votes for dismissal recommendation, the student may appeal to DAC as described in Section 4. If SPC votes for any action other than dismissal, the student may request a review by the Vice Dean for Academic, Rural and Regional Affairs. This request must be made in writing within 5 days of receiving notice of SPC’s decision. After that time, SPC’s decision becomes final.

Section 1. Operating Guidelines Overview

Role of SPC

The Student Progress Committee (SPC) exists to monitor medical students’ progress toward graduation and to determine if the standards of the University of Washington School of Medicine (UWSOM) are being met in individual cases. All areas of student progress are monitored, including promotion, remediation, probation, leave of absence, expansion, reprimand, suspension, dismissal, licensing exam performance, compliance, and graduation. SPC also recommends students for awards including Graduation with Honors, Graduation with High Honors, and Graduation Awards.

SPC considers each case on an individual basis within the context of UWSOM’s standards. SPC may allow latitude within its guidelines for managing a student’s progression in the medical school program when SPC members agree that the circumstances of the case support it.

SPC reviews a student’s record when there is concern about academic performance and/or conduct. UWSOM’s grading and evaluation system, SPC’s review process, and the process for addressing and managing allegations of unacceptable conduct provide for due process. This includes notifying the student of inadequacies, an opportunity for the student to respond to concerns about academic performance or unacceptable conduct, and careful and deliberate decision-making. When a student’s record, when viewed as a whole, does not show satisfactory progress, and/or there are reports of unacceptable conduct, SPC determines the appropriate course of action, with the advice of block, course, and clerkship directors, administration, and/or other requested consultants.

In order to graduate, students must:

  • Successfully complete all curricular requirements
  • Pass Foundations-2 and Patient Care Objective Standardized Clinical Evaluations (OSCEs)
  • Pass USMLE Step 1 and Step 2-CK
  • Demonstrate conduct in accordance with UWSOM’s academic and professionalism standards.

A pattern of evaluator concerns about a student’s performance or conduct may constitute a failure to meet graduation requirements, even if all curricular elements and exams are passed.

The UWSOM’s policies may differ from the University’s policies. This is due to the unique structure of the medical school, dispersed over academic and clinical sites in a five-state region. Due to the standards required for patient interactions, SPC’s guidelines for managing students’ academic progress and professional development may differ from the University’s policies.

Grades and evaluations are submitted by course, block, thread, and clerkship directors; these form the basis on which SPC makes decisions about individual students. SPC is not responsible for the UWSOM’s grading system and is not involved with grade appeals. These are the purview of Curriculum.

SPC does not investigate allegations of unacceptable conduct. When there is an allegation that UWSOM’s academic or professionalism standards have been violated, the inquiry is completed by a designated UWSOM or University process. Once this process is complete, SPC reviews confirmed violations and determines actions.

Composition of SPC and Voting Process

10-12 members of the UWSOM faculty serve as voting members of SPC. They are chosen by the Vice Dean for Academic, Rural and Regional Affairs and are approved by the Dean of the School of Medicine. One member serves as Chair. Quorum is reached when 51% of the voting members are present. Votes are determined by a simple majority of those present. The Chair votes when needed to achieve quorum, to break a tie, or to create a tie in order to allow more discussion.

Ex-officio (non-voting) members of SPC are present at meetings to provide SPC with relevant information about individual students and/or perspective on UWSOM’s curriculum. Current ex-officio members are:

  • Associate Dean for Student Affairs (serves as Administrative Dean to SPC)
  • Assistant Deans for Student Affairs
  • Associate Deans for Admissions, Colleges, and Curriculum
  • Regional Assistant Foundations Phase Deans
  • Regional Assistant Clinical Deans
  • Assistant Deans for Student Development, Student Support, Basic Sciences and Clinical Education
  • Representative from the Office of Healthcare Equity
  • Representative from the Department of Biomedical Informatics
  • Registrar
  • Director of Proactive Advising

Decisions Made on Behalf of SPC

The SPC Chair may decide individual cases on behalf of SPC or may convene a subcommittee of 3 or more SPC members plus the Chair to review cases urgently. A scheduled SPC meeting that does not reach quorum may also function as a subcommittee.

If a student accepts a decision made by the Chair or subcommittee on behalf of SPC, the decision is presented to SPC at the next scheduled meeting as “information only.” A student who does not accept a decision made by the Chair or subcommittee on behalf of SPC may request that SPC review their case and determine actions at the next SPC meeting. Such students remain in their current status, i.e., do not begin the recommended program or remediation, until their case is reviewed by SPC.

Suspension or dismissal may not be recommended by the SPC Chair or subcommittees. These actions can only result from a vote of the full SPC.

Confidentiality

SPC maintains strict confidentiality surrounding students’ academic performance and progress in the medical school program. The following individuals have knowledge of the student’s status and/or are informed when appropriate to facilitate the student’s successful progress:

  • SPC chair and SPC
  • Faculty and staff who serve as ex-officio members of
  • The student’s college mentor. College mentors are informed of any action taken by SPC regarding one of their
  • Relevant staff members who schedule appointments with deans, schedule students in courses and clerkships, write letters of good standing, maintain academic files,
  • Block, thread, course, and clerkship directors (or designees) who present or provide information to SPC about students having difficulty in their curricular component, and who need to manage remediation
  • Academic faculty of affiliated degree programs (e.g., Medical Scientist Training Program).
  • Director of Academic Support.
  • Anyone with legitimate need to know as defined by the federal Family Educational Rights and Privacy Act (FERPA).

Conflict of Interest

Voting and ex-officio members of SPC may have relationships with students reviewed at SPC.  To prevent conflicts of interest, SPC members are required to disclose that they have a conflict of interest and recuse themselves from student reviews, interviews, discussions, and voting when the student being discussed is:

  • A direct mentee, including students in the SPC’s member’s College Faculty group
  • A friend or family member
  • Related to a colleague or friend (child, spouse, etc.)
  • A current or former patient of the SPC member
  • In any other relationship with the SPC member, past or present, that creates a conflict of interest.

A faculty member recusing themselves will physically leave the meeting room during the review, interview, discussion, and vote portions of the SPC process for the student with whom the faculty member has a conflict of interest.

Course, block, thread, and clerkship directors and leaders may serve on SPC. When a student is under discussion because of a deficiency in that SPC’s member’s course at that SPC member’s site, that SPC member is required to recuse themselves from the interview, discussion, and vote. However, that faculty member may inform SPC about that student’s performance in their course before leaving the meeting. This faculty member does not need to recuse themselves from future meetings if the same student is reviewed for different deficiencies.

When students are being interviewed by SPC, they are given a list of SPC members in advance. The student may request that specific members of SPC recuse themselves, based on a direct relationship with those SPC members. If the faculty member disagrees with the student’s request for recusal, the SPC Chair will make the final decision.

Section 2. Curricular Requirements and Expected Timeline

School of Medicine Curricular Requirements are the purview of Curriculum, not SPC. Included here are timeline issues that are relevant to SPC actions.

Foundations Phase

The Foundations Phase Curriculum is intended to be completed in 21 months. The curricular requirements must be completed as a full-time, intact, contiguous curricular schedule unless a student requests or is mandated to take leave of absence. Students returning from leave of absence must re-enter the curriculum at the point they stopped and continue contiguously from there.

All Foundations Phase curricular requirements must be successfully completed before entering the Patient Care Phase.

Students are assigned to one of the UWSOM’s six regional campuses at enrollment and are expected to complete all Foundations Phase curricular requirements at that campus. Students who need to repeat curricular requirements may be assigned to a different regional campus by SPC.

Patient Care Phase

The six required clerkships must be completed as a full-time, intact, contiguous curricular schedule unless a student requests or is mandated to take leave of absence. Only under exceptional circumstances will permission be granted to delay a required clerkship into the final year or to take a required clerkship at another Liaison Committee on Medical Education (LCME) approved medical school.

Explore & Focus Phase

All Explore & Focus Phase curricular requirements must be successfully completed before the Physician’s Oath & Hooding Ceremony.

Objective Structured Clinical Examination (OSCE)

Passing Foundations-2 and Patient Care OSCEs is a graduation requirement. The Foundations-2 OSCE must be passed before entering the Patient Care Phase. The Patient Care OSCE must be passed at the end of the Patient Care Phase and before the Explore & Focus Phase, even for students planning to expand. A Student Affairs Dean may make exceptions to the timing of the OSCE in individual circumstances.

United States Medical Licensing Examinations (USMLE)

Passing USMLE Step 1 and Step 2-CK are graduation requirements.

Step 1

  • Students must complete all Foundations Phase requirements except Consolidation & Transition and Transition to Clerkships before taking Step 1, including any remediations.
  • For Step 1 deadline information, see UWSOM Policy Regarding USMLE Step 1 Exam.
  • Students must take Step 1 within 1 year of completing Foundations Phase.

Step 2-CK

  • Students must pass all Patient Care Phase clerkships, including any remediation, before taking Step 2-CK.
  • Students must take Step 2-CK no later than June 30 of the year prior to expected graduation year.
  • For students completing their Patient Care Phase off-cycle from the projected timeline, Step 2-CK must be taken within 12 weeks of completing the Patient Care Phase.
  • If a passing score is not recorded by the deadline for National Residency Matching Program certification, a delay of graduation may be necessary.

Voluntary Leave of Absence

Students may request leave of absence for personal reasons, academic reasons, or to participate in curricular programs such as research fellowships or concurrent degrees. Students may request personal leave to manage pregnancy, parental leave, personal illness, caregiving for family members, or other reasons. Going on leave to avoid failing a block, course, or clerkship is not allowed. Students who take leave may need to extend their graduation date.

Requests for leave go to Student Affairs Deans. A Student Affairs Dean may approve leave on behalf of SPC for up to 4 quarters. These leaves are reported to SPC as information-only. For additional leave beyond 4 quarters, students must petition SPC by submitting a letter explaining why they need extended leave and what actions they are taking to prepare for their return to the curriculum. Students who need more than 8 quarters to resolve an issue must withdraw from the curriculum, except in the most extenuating circumstances, as determined by SPC.

If a leave of absence follows Foundations Phase, the student must pass Step 1 before starting a fellowship or concurrent degree. If a leave of absence follows Patient Care Phase, the student must pass Step 2-CK before starting a fellowship or concurrent degree. Students taking personal leave are encouraged to complete Step exams before going on leave when feasible.

Expanded Curriculums (Expansions)

An expansion means that a student extends their graduation date beyond the usual 4 years. Leaves of absence, additional quarters of coursework, and concurrent degrees are common reasons for expansions. Students choosing to expand should plan their time away from the curriculum to fall between phases, i.e., not during Foundations or Patient Care phase. These phases are intended to be taken as full-time, intact, contiguous curricular schedules. Expanding during Explore and Focus phase is allowed.

Blocks and clerkships must be taken in a full-time capacity, e.g., a 6-week clerkship cannot be expanded and taken over 10 weeks.

Section 3. Events that Result in Review by SPC

“SPC Review” means that the student’s entire record, including academic performance, evaluator concerns, and findings from any UW or UWSOM misconduct processes are presented to SPC for discussion and determination of actions.

Fail Grades

Students receiving fail grades in blocks, courses, clerkships, and clerkship exams are reviewed by SPC.

Failure to Achieve Competency

Students receiving this designation in a thread are reviewed by SPC.

USMLE Step Exam Fails

Students who fail Step 1 or Step 2-CK are reviewed by SPC.

Failure to Take Step 1

Students who have not taken Step 1 within 1 year of completing Foundations Phase will be reviewed.

Failure to Complete Objective Structured Clinical Examination (OSCE)

Students who fail to successfully complete Foundations 2 or Patient Care OSCE are reviewed by SPC.

Evaluator Concerns

Evaluator concerns are internal designations, meaning they do not appear in the Medical Student Performance Evaluation unless further action occurs. Evaluator concerns are submitted by faculty within student evaluations or may take the form of written statements from any faculty member describing a performance concern. Evaluator concerns are received and reviewed by Student Affairs Deans. Students with evaluator concerns are reviewed by SPC at the discretion of a Student Affairs Dean when the student has additional academic and/or conduct concerns, or if there is a pattern of evaluator concerns.

Incompletes

A student who must leave a block, course, or clerkship due to illness or a personal emergency may be granted an “incomplete” by a Student Affairs Dean. If the student does not complete the work by the deadline set by Curriculum, the incomplete will convert to a Fail and will therefore be reviewed by SPC.

Registrar Drop

Students who must leave a block, course, or clerkship due to illness, personal emergency, or because they have been placed on a leave of absence, will receive a grade designation of “Registrar Drop” (previously referred to as a withdrawal) when permitted by the appropriate Foundations Dean or clerkship director in consultation with a Student Affairs dean. Students are not allowed to take a Registrar Drop to avoid failing a block, course, or clerkship. A student who does not complete a course and does not have permission to take a Registrar Drop will be assigned a grade of fail. All Registrar Drops are reported to SPC.

Former Quarter Drop

Students may consult with a Student Affairs Dean to begin the process of receiving a grade designation of Former Quarter Drop, previously referred to as Hardship Withdrawal Petition.

Failure to Complete UWSOM Compliance Requirements

Non-compliance with essential compliance requirements may be considered by the Student Progress Committee at the discretion of Student Affairs Deans.

Violations of UWSOM’s Academic or Professionalism Standards

SPC defines academic and professionalism standards of conduct by referring to UW Medicine Policy on Professional Conduct, UWSOM Standards of Conduct and Professional Behavior, and UW Student Conduct Code. These standards together are referred to as “UWSOM’s academic and professionalism standards.” Violations of these standards, whether within the educational environment or in the community, may be reviewed by SPC for discussion and determination of actions. This is part of SPC’s academic review process.

When an alleged violation of UWSOM’s academic and professionalism standards occurs, a Student Affairs Dean manages the process in accordance with the UWSOM Guidelines for Managing Alleged Violations of Academic and Professionalism Standards (Section 6.) When a formal or informal hearing occurs, the Chair of SPC may receive the report as “information only” or the full SPC may interview the student and determine actions.

Section 4. Actions and Sanctions for Managing Students in Difficulty

When an “SPC review” occurs, SPC reviews an individual student’s deficiencies and their entire medical school record, deciding on a course of action that considers academic performance, conduct, and evaluator concerns. More than one action and/or alternatives not listed may be used as individual cases warrant. SPC may set a timeline for actions to be completed and criteria for subsequent performance. The student will be informed of the plan in writing within 10 days and will work with Student Affairs to implement it.

SPC Actions may include but are not limited to:

  • Allow Remediation
  • Disciplinary Warning/Letter of Reprimand
  • Requirement for Work to be Re-done
  • Academic Probation
  • Disciplinary Probation
  • Mandatory Leave of Absence
  • Advanced Information
  • Referral to WPHP
  • Suspension
  • Dismissal

Actions that the National Residency Matching Program requires UWSOM to report in the Medical Student Performance Evaluation are requirement for work to be re-done, disciplinary probation, mandatory leave of absence, and suspension. Remediations will be reflected in the student’s official transcript.

Each action is described in further detail below.

Allow Remediation

Remediation of Courses and Clerkships

SPC decides whether a student may remediate. Block, course, thread, and clerkship directors may not remediate a student’s deficiency until SPC meets and determines an appropriate course of action based on the student’s overall performance. The student may have difficulty in more than one area and a coordinated plan may be needed for the student’s benefit.

SPC’s remediation plan is based on multiple factors, including but not limited to recommendations of the block, thread, course, or clerkship director, input from ex-officio members of the SPC, input from the student’s College Mentor, and the student’s overall medical school progress.

SPC may require that the remediation be completed before the student may continue in other coursework.

Typical remediation plans for students with a single deficiency are listed here:

  • Fail grade in a block: SPC usually accepts the block director’s recommendation for re- examination or repeat of the block.
  • Failure to achieve mastery in a thread: SPC usually accepts the thread director’s recommendation for taking the thread remediation course. Students with 1 or 2 thread deficiencies and no fail grades are automatically approved to take the thread remediation course without SPC involvement.
  • Fail grade in a course that is not part of a block: SPC usually accepts the course director’s or clinical skills director’s recommendation for remediation.
  • Fail grade in a clerkship: SPC usually accepts the clerkship director’s recommendation for repeat of the clerkship.
  • Fail grade on a clerkship exam without having failed the clerkship: SPC usually allows re-take of the exam. A student’s first clerkship exam fail is automatically approved for re-take without SPC involvement.

For multiple deficiencies, SPC determines an appropriate course of action considering the student’s entire record and any extenuating circumstances presented. SPC may require repeat of certain curricular requirements, even those previously passed. For example, SPC may require a student who has failed 2 or more blocks in Year 1 to re-start the curriculum, including retaking courses already passed.

A student who does not remediate on the timeline set by SPC, or who fails a remediation, will be reviewed again by SPC for further action.

Remediation of Step Exams: Step 1 Re-takes and Deadlines

When a student fails Step 1 on their first attempt and has no other deficiencies, SPC typically permits re-take. When a student fails Step 1 on their second attempt, SPC may permit re-take and/or take other actions, in light of the student’s entire record and any extenuating circumstances presented. A student who fails Step 1 a third time may be considered for dismissal.

When SPC permits re-take of Step 1, a deadline may be set by SPC. Typically, this deadline will be the end of the quarter following the one when the student received the failing score. For example, if a student receives a Step 1 fail during Summer quarter, SPC would assign the last day of Autumn quarter as their re-take deadline. Individual circumstances may warrant different deadlines.

Students who fail Step 1 are allowed to finish the current quarter’s clerkships. They are required to work with Student Affairs and Registration to adjust their clerkship schedule to allow adequate time to study for and re-take the exam. Dropping scheduled clerkships may be necessary.

A student who has not taken Step 1 within 1 year of completing Foundations Phase will be reviewed by SPC. SPC may require an interview with the student to understand the barriers. SPC may set a Step 1 deadline for that student and review the student again if the deadline is not met.

SPC may require that a student achieve a passing score on Step 1 before any clerkships are scheduled. This requirement is typical after a student has failed Step 1 or has been out of the curriculum for a year or more before attempting Step 1.

Remediation of Step Exams: Step 2-CK Re-takes and Deadlines

Students who fail Step 2-CK are allowed to finish any clerkships or clinical electives they have begun. If the student has no other deficiencies, SPC typically permits re-take. When a student fails their second attempt of Step 2-CK, SPC may permit re-take and/or take other actions, in light of the student’s entire record and any extenuating circumstances presented. A student who fails Step 2-CK a third time may be considered for dismissal.

Students who fail Step 2-CK are required to work with Student Affairs and Registration to adjust their schedule to allow adequate time to study for and re-take the exam. Delay of graduation may be necessary. Step 2-CK must be retaken and passed prior to the deadline for National Resident Matching Program Match certification. SPC may set a different deadline in specific cases.

Disciplinary Warning

A disciplinary warning is used for minor breaches in conduct, particularly when there is evidence that the student did not intend to deceive or abuse a right or privilege. The intent is to help the student understand and correct the deficiency. Example: a student accessed a family member’s medical record believing that this was reasonable to help their relative navigate their medical care. The warning may include specified assignments or activities for the student to complete. A disciplinary warning is documented with a Letter of Reprimand and is only reported in the student’s Medical Student Performance Evaluation at the discretion of Student Affairs Deans.

Requirement for Work to be Re-Done

SPC may require that coursework or other graduation requirements be redone to remediate serious but not egregious breaches in conduct. The intent is to have the student understand the consequences of behavior which the student knew was in violation of UWSOM’s academic and professionalism standards. Example 1: a student was found to have committed plagiarism in their Scholarly Project. The student was required to start over and complete a new project fulfilling the requirement. Example 2: a student deliberately and without attribution used another provider’s clinical note as if it reflected their own work with that patient. The student was required to repeat the clerkship. The National Resident Matching Program Match requires that the reason for work to be re-done appears in the student’s Medical Student Performance Evaluation.

Academic Probation

Academic probation serves to notify a student that dismissal will be considered if the student has additional deficiencies. SPC may put a student on academic probation for the following:

  • 2 or more block fails
  • 2 or more step exam fails
  • 2 or more clerkship fails

Failure to achieve mastery in threads  and fails other than those above will be considered in the totality of the student’s record when determining if the student should be placed on probation.

The above deficiencies do not require that a student be placed on probation. SPC uses discretion in the use of probation designations so that being placed on probation serves as a warning to the student that dismissal may be the next action. Unsatisfactory progress in any area that falls under SPC’s purview may result in academic probation.

Students on academic probation due to Foundations fail(s) and/or Step 1 fail(s) will typically be removed from probation when they achieve a passing score on Step 1. Students on academic probation due to clerkship fails will typically be removed from probation when the fail grade(s) have been remediated and the student has completed 4 quarters of coursework without additional fail grades. SPC may make the probation period longer or shorter depending on individual circumstances.

A student placed on academic probation during the Foundations Phase, then removed after passing Step 1, may be placed back on probation after a single additional deficiency at the discretion of SPC.

Students on academic probation may not take non-clinical electives, serve in leadership roles in student activities, pursue paid employment, work toward a concurrent degree, or any other activity that might interfere with their medical school performance without prior permission from a Student Affairs Dean.

Academic Probation is an internal designation and is not reported in the Medical Student Performance Evaluation.

Disciplinary Probation

Students may be placed on disciplinary probation when a violation of UWSOM’s academic and professionalism standards has occurred. If there are additional conduct issues while a student is on disciplinary probation, dismissal may be considered. The duration of disciplinary probation is determined at the time that it is imposed.

The National Resident Matching Program Match requires that disciplinary probation be reported in the Medical Student Performance Evaluation.

SPC votes to approve students’ removal from academic and disciplinary probation. Students must be removed from probation before they graduate.

Mandatory Leave of Absence

Students with academic or conduct issues may have leave mandated by SPC. SPC may stipulate what the student must do before returning. If no stipulations are made, the student may return from leave and register for courses without involvement of SPC. If stipulations are made, the student must petition SPC to return, demonstrating that they have met those stipulations. If stipulations are made and not met, SPC may recommend that the student remain on leave or may consider dismissal.

In cases where SPC approves a return from leave, SPC may set requirements for continuing in the curriculum and may place the student on academic and/or disciplinary probation. SPC may require an interview with the student before approving a return from leave.

Students who are placed on leave may need to extend their graduation date.

The National Resident Matching Program Match requires UWSOM to report mandatory leaves of absence in the student’s Medical Student Performance Evaluation.

Advance Information

In rare circumstances, SPC may place students on “Advance Information” status. This is used when a student has had certain types of academic or conduct difficulty. When on Advance Information status, course and/or clerkship directors receive formal, confidential notification of the difficulty before the student begins the course or clerkship. The objectives for using advance information are to provide the student with additional support in the area(s) of deficiency, to ensure that there is adequate feedback to the student, and to ensure that there is adequate evaluation of the area(s) of concern. Example: a student had several evaluator concerns around ineffective communication styles. Advance information status was put in place so that subsequent supervisors could closely observe for progress in this domain.

Advance information status is not reported in the Medical Student Performance Evaluation.

Communications regarding students on Advance Information status are managed by Student Affairs Deans. Further information is in the Advance Information Procedure.

Fitness for Clinical Contact

Academic, Rural and Regional Affairs deans and/or SPC have the right to prohibit a student’s continuation in the clinical setting if there are concerns related to patient care or patient safety, the ability to practice with reasonable skill and safety due to a mental or physical condition, the potential for compromising compatibility and effective functioning of the healthcare team, and/or evidence of substance abuse. Further information is in the Fitness for Clinical Contact Policy.

Referral to Washington Physicians Health Program (WPHP)

The opportunity for students to participate in direct patient care places responsibility on the UWSOM to ensure that patients are not placed at risk due to a student’s mental illness, physical illness, or impairment from drugs or alcohol. A variety of situations may lead to a student being referred to WPHP. Once referred to WPHP, the student must be endorsed by WPHP before being considered for re-entry into the curriculum.

SPC may require a student be referred to and endorsed by WPHP before continuing in the curriculum when circumstances suggest that physical illness, mental illness, impairment from drugs or alcohol, or other circumstances may be contributing to the student’s deficiencies. WPHP protects the student’s privacy while considering the possible underlying causes for changes in performance and/or problematic behavior.

If a student who is being reviewed by SPC has already been referred to WPHP, Student Affairs Deans may report that information to SPC as part of the student’s overall record. Students referred to WPHP by any UWSOM official other than SPC who feel the referral is unwarranted may request that SPC review their case. See Section 5 for details of this process.

Referral to WPHP is not reported in the Medical Student Performance Evaluation.

Suspension

Suspension is an institutional action separating a student from continuing in the UWSOM program for a specified period of time. SPC may issue a suspension when there is clear evidence of a serious violation of UWSOM, UW, or UW Medicine’s guidelines and/or policies for personal or professional conduct, including but not limited to:

  • Documented cheating in coursework
  • Intentional misrepresentation of patient information
  • Placing patients’ care or safety at risk
  • Unacceptable conduct in the community
  • Violating the University’s student conduct code
  • Violating local, state, or federal laws

After completing the suspension, the student will be interviewed by SPC and present documentation supporting their readiness to return. The student must demonstrate understanding and growth in the domain of personal or professional conduct that was violated. If the conduct is egregious, the student does not show insight into their conduct as being inappropriate for a physician-in-training, and/or the student does not demonstrate satisfactory progress in the conduct area of concern, SPC may consider dismissal.

If the student is permitted to re-enter the curriculum, SPC may place them on disciplinary probation with the expectation that their conduct will be at an acceptable level for the remainder of their tenure in the medical school. If there is another violation of UWSOM, UW, or UW Medicine’s guidelines and/or policies for personal or professional conduct, SPC may consider dismissal.

The suspension is part of the student’s medical school record and is included in administrative letters written about their performance, including the Medical Student Performance Evaluation. While suspended, the student may not be involved in any medical school programs or activities and should be absent from the medical school setting.

Dismissal

A student may be dismissed if they do not meet the academic and/or conduct standards for graduation set by UWSOM. If a student’s record, when viewed as a whole, does not meet UWSOM’s expected level of performance, SPC may recommend dismissal even though passing grades are recorded in individual courses. A dismissal recommendation may be made at any time during a student’s medical school enrollment. A student does not have to be placed on probation prior to being recommended for dismissal.

Dismissal may be considered for one or more of the following:

  • 3 or more block fails
  • 3 or more clerkship fails
  • Failure on repeated block, course, or clerkship
  • Additional fail grade while on probation
  • 3 or more step exam fails (same step or combination or steps)
  • Combination of 3 fails or deficiencies in 2 or more areas, which may include blocks, threads, courses, step exams, and/or clerkships
  • Major or persistent violations of UWSOM’s academic and professionalism standards
  • Failure to complete UWSOM compliance requirements

If SPC votes to consider dismissal, an interview with the student is planned for the next scheduled SPC meeting. The student is informed that they are under consideration for dismissal and is provided a detailed description of the concerns leading to SPC’s decision. The student is given at least 15 business days notice that they are required to appear at the next SPC meeting for their dismissal consideration interview. The SPC Chair has discretion to delay the interview under extenuating circumstances.

At the interview, the student may be accompanied by one advocate who is a member to the medical school faculty. The student must give their advocate’s name to the Student Affairs Office at least 10 business days before the meeting. The presence or appearance of a student’s legal counsel is not permitted.

The student must provide a written statement addressing the concerns leading to the dismissal consideration. The student may additionally request letters of support and other relevant documentation from outside parties. All written materials must be submitted to the Student Affairs Office at least 5 business days before the dismissal consideration interview.

Before the interview, SPC reads the student’s written statement, letters of support, and their entire medical school record including Step exams, evaluations, evaluator concerns, reports resulting from UWSOM informal or formal hearings, and reports from UW Community Standards and Student Conduct Office.

At the dismissal consideration interview, the student presents their perspective on their difficulties and their plans to address those difficulties, and then takes questions from SPC members. The student’s advocate, if present, may also share information and answer questions.

After the interview, SPC votes to either recommend dismissal or some other remedy that allows the student to continue in the curriculum.

If the decision is a dismissal recommendation, the student may request an appeal. The student must submit the request for appeal, in writing, to the Chair of SPC within 10 business days of the dismissal recommendation. Appeals are heard by the Dismissal Appeal Committee (DAC). The sole purpose and responsibility of DAC is to provide a fair and formal review of dismissal recommendations made by SPC. It is composed of 3 neutral faculty members, appointed by the Vice Dean for Academic, Rural and Regional Affairs, who do not participate in regular SPC meetings and have adequate knowledge of UWSOM’s standards to independently assess whether a student is meeting those standards. DAC convenes as soon as possible whenever a student requests a dismissal appeal.

DAC will consider the case at a meeting which includes the student, their faculty advocate, a Student Affairs Dean, and the Chair of SPC, all of whom present information about the events leading to the dismissal recommendation. DAC does not re-consider whether the student’s stated deficiencies are appropriate grounds for dismissal. The purpose of DAC’s review is to (1) consider new information that was not reasonably available during the initial SPC deliberation, (2) consider any evidence that discrimination or bias impacted the students’ academic participation or evaluation, and (3) consider any evidence that SPC’s decision-making was arbitrary or capricious.

A DAC member who has a relationship with the student that presents a conflict of interest, as described above for SPC members, will recuse themselves as soon as they know the identity of the student to be discussed. Students will be informed in advance of who is on DAC and may request that a DAC member recuse themselves, based on a direct relationship with that member. If the faculty disagrees with the student’s request for recusal, the Vice dean for Academic, Rural, and Regional Affairs will make the final decision. When there is a recusal, the Vice Dean for Academic, Rural and Regional Affairs will select an alternative faculty member to serve for that meeting.

At the end of the meeting the three DAC members vote to affirm or overturn the dismissal recommendation. The decision is by simple majority. The decision is communicated in writing to the student within 5 business days.

If DAC affirms the dismissal, the Faculty Council on Academic Affairs (FCAA) reviews the case to ensure proper procedures have been followed. If FCAA finds that process was followed correctly, the dismissal recommendation is forwarded to the Dean. The student has up to 10 business days after FCAA’s decision to contact the Dean to set a meeting to discuss the dismissal. The Dean’s decision is final and may not be appealed.

Students may withdraw from UWSOM at any point up until the Dean sustains the dismissal.

Students are usually allowed to continue in the curriculum during the dismissal review process. However, deans for Academic Affairs, including Student Affairs and Curriculum, as well as SPC, may at times seek to limit the student’s presence in the curriculum. Need for mandatory Leave of Absence and/or concerns about Fitness for Clinical Contact may apply to students in the dismissal review process as they do to other students.

If a student continues in the curriculum while under dismissal review, SPC will have oversight over what blocks, courses, or clerkships may be scheduled.

If the dismissal consideration or recommendation is based on fail grades, the student is not permitted to remediate those blocks, courses, or clerkships until the dismissal consideration is resolved by SPC or the dismissal recommendation is overturned through the academic review process.

If SPC’s dismissal recommendation is overturned by DAC, FCAA, or the Dean, SPC will determine the appropriate academic program and curricular schedule. This may include requiring a student to retake blocks, courses, or clerkships which were previously passed. SPC may place the student on probation, elect to provide Advance Information to block, course, or clerkship directors, require the student be endorsed by WPHP, and/or other requirements that SPC deems necessary to allow the student to make satisfactory progress toward graduation.

Withdrawal from the MD Program

Students typically withdraw from UWSOM if they decide that medicine is not the best career path, they are unable to complete the program for academic or personal reasons, or they are being considered for dismissal. Students choosing to withdraw notify a Student Affairs Dean. SPC reviews withdrawals as “information only.”

Section 5. Review of SPC Decisions

Review of Dismissal Recommendations

Dismissal recommendations may be appealed to the DAC and are automatically reviewed by FCAA and the Dean by the process described in Section 4.

Review of SPC Actions Other Than Dismissal

Students who disagree with any SPC decision other than dismissal may request a review. The student informs the SPC Chair that they are requesting a review within 10 business days of receiving SPC’s decision. After that, SPC decisions are final. The student must prepare a written petition and submit it at least 5 business days prior to the next SPC meeting. The petition explains why SPC’s decision is wrong and what alternative plan the student proposes to better allow success in the curriculum. SPC will consider the written petition at the next SPC meeting and decide if the student’s proposal is acceptable or not. This decision will be communicated in writing within 10 business days after the SPC meeting.

When SPC does not accept the student’s proposal, the student may accept the original decision or may request to appear in person to explain their plan further. When a student requests to appear in person, an interview is planned for the next scheduled SPC meeting. The SPC Chair has discretion to delay the interview under extenuating circumstances.

At the interview, the student may be accompanied by one advocate who is a member to the medical school faculty. The student must give their advocate’s name to the Student Affairs Office at least 10 business days before the meeting. The presence or appearance of a student’s legal counsel is not permitted.

In addition to their written petition, the student may present letters of support and other relevant documentation from outside parties for SPC to review. All written materials must be submitted to the Student Affairs Office at least 5 business days before the interview.

Before the interview, SPC reviews the student’s written petition, letters of support, and their entire medical school record including Step exams, evaluations, evaluator concerns, reports resulting from UWSOM informal or formal hearings, and reports from UW Community Standards and Student Conduct Office.

At the interview, the student presents their perspective on their difficulties and their plans to address those difficulties, and then takes questions from SPC members. The student’s advocate, if present, may also share information and answer questions.

After the interview, SPC determines the plan that the student must follow to continue in the curriculum. Based on all the information reviewed and the student’s presentation of their appeal, SPC may take any appropriate action described in Section 4 other than dismissal; SPC is not limited to the actions initially taken in response to the student’s deficiencies. This decision is final with no further review within UWSOM or the University. The student may withdraw from the curriculum if they do not agree with the decision.

Review of WPHP Referrals Not Issued by SPC

Students may be referred to WPHP by UWSOM officials other than SPC. A student who believes the referral is not warranted may appeal the referral to SPC. In this situation, the student petitions SPC in writing explaining why the referral is unwarranted. An interview is planned for the next SPC meeting. These interviews follow the same structure as other non-dismissal interviews.

If the student is disputing the factual basis of their referral to WPHP, a formal or informal hearing process should be pursued instead, not a review by SPC.

Before the interview, SPC reviews the student’s written statement describing why WPHP referral is unwarranted, letters of support, and their entire medical school record including Step exams, evaluations, evaluator concerns, reports resulting from any informal and/or formal hearings, and reports resulting from a UW Community Standards and Student Conduct Office investigation.

After the interview, SPC votes to uphold or reverse the referral to WPHP. This decision is final without further opportunity for appeal. Based on all the information reviewed and after hearing the student’s perspective, SPC may take any action described in Section 4 instead of or in addition to WPHP referral, except dismissal. Students may appeal those actions following the same process as any other SPC action.

Requests to Waive Graduation Requirements

Students may submit requests to waive graduation requirements to SPC. SPC’s decisions to waive or not waive are final.

Section 6. Guidelines for Managing Alleged Violations of Academic and Professionalism Standards

The UWSOM is committed to maintaining the highest standards of academic performance, personal and professional conduct, integrity, and respect for others. Students enrolled in the MD program are required to uphold these standards of conduct, both in the academic setting and in the community. These standards are articulated in UW Medicine’s Policy on Professional Conduct, UWSOM’s Standards of Conduct and Professional Behavior, UWSOM’s Technical Standards Policy and the UW Student Conduct Code. These standards together will be referred to as “UWSOM’s academic and professionalism standards.”

WAC 478-121, Student Conduct Code for the University of Washington, gives UWSOM the authority to take academic action when a student fails to meet UWSOM’s academic and professionalism standards.

SPC may use any of the actions described in Section 4 and/or other alternatives to manage violations of UWSOM’s academic and professionalism standards. Students who do not fulfill SPC’s requirements may be considered for dismissal. Students who have violated UWSOM’s academic and professionalism standards must complete all required actions before being granted the MD degree from UWSOM.

Students are expected to abide by university, local, state, and federal regulations and laws. Infractions of these standards may result in actions by UW or UWSOM apart from whether there is any action that may be taken in civil or criminal court.

For alleged violations of UWSOM’s academic and professionalism standards that occur outside of the educational environment, the reported incidents may be managed through a review process within UWSOM or may be referred to the University’s Community Standards and Student Conduct Office (CSSC), depending on the allegation. SPC is not involved in determining if violations occurred; its role is to determine appropriate actions once violations of UWSOM’s academic and professionalism standards have been confirmed.

If CSSC performs an investigation, once the investigation is complete, CSSC will provide a report to SPC for consideration and determination of actions as part of UWSOM’s academic review process. This does not preclude CSSC from sanctioning the student as part of its charge as listed in the Washington Administrative Code (https://www.washington.edu/cssc/for-students/overview-of-the-student-conduct-process/).

SPC cannot alter CSSC’s decisions but reserves the right to take actions, independent of sanctions imposed by CSSC. SPC recognizes that there may be two parallel processes ongoing, those of UWSOM and those of CSSC. Therefore, there are two separate appeal processes, one within UWSOM and one within the University.

If an alleged violation of UWSOM’s academic and professionalism standards is sufficiently egregious and/or may impact the safety of self or others, Student Affairs Deans or other UWSOM officials with knowledge of the situation may act to remove the student from the clinical and/or educational setting. See the UWSOM’s Fitness for Clinical Contact Policy for details on this procedure.

When a student is alleged to have violated UWSOM’s academic and professionalism standards, a Student Affairs Dean will manage the process and may reach a resolution with the student. SPC may receive a report on the matter and may determine actions. In some circumstances, the University’s Community Standards and Student Conduct (CSSC) Office and/or UWSOM’s Misconduct Review Committee (MRC) may also be involved. Determination of jurisdiction for processing cases may be done in collaboration with CSSC and consultation with the Personnel Policy Unit at UWSOM and the University of Washington Attorney General’s office.

Investigations of alleged violations of UWSOM’s academic and professionalism standards occurring outside of the medical school program are typically conducted by the CSSC, which provides a report to SPC and may independently impose a sanction on the student. The student’s right to appeal a CSSC sanction follows the University’s Student Conduct Code guidelines, whereas the student’s right to appeal an SPC action follows SPC’s guidelines.

One SOM faculty member may be present at the student’s preliminary, informal, and/or formal hearing to serve as an advocate, at the student’s request. This is typically the student’s College Faculty mentor but may be a different faculty member of the student’s choosing.

The student may not be accompanied by legal counsel at any point during the academic review process. Student Affairs Deans may consult with UWSOM’s attorney at any time.

Reporting

A basic tenet of medical professionalism is that the profession is self-regulating. Thus, students and faculty are obligated to report any concerns about the conduct of peers or trainees. Any information suggesting that a UWSOM student possibly violated UWSOM’s academic and professionalism standards should be submitted to a Student Affairs Dean. A written statement of the alleged violation is required. Email is acceptable.

Reports relating to conduct outside the educational environment can be initially directed to a Student Affairs Dean or to the CSSC. These offices will decide jointly which of them, or both, will manage the process.

When a Student Affairs Dean receives information about a possible violation of UWSOM’s academic and professionalism standards, they will request a meeting with the individual(s) making the report and will request any relevant records those individuals may have. This meeting is to review the events surrounding the incident or concern. This meeting may be conducted in person or remotely, at the discretion of the Student Affairs Dean. The Student Affairs Dean may delegate their role to another appropriate individual.

Preliminary Meeting with the Student

If the Student Affairs Dean finds the report credible and concerning, the Student Affairs Dean and one other dean from the Academic, Rural and Regional Affairs offices will have a preliminary meeting with the student who is alleged to have violated UWSOM’s academic and professionalism standards. This meeting may be conducted in person or remotely, at the discretion of the Student Affairs Dean. The Student Affairs Dean may delegate their role to another appropriate individual. At this meeting the Student Affairs Dean or designee will provide the student the following information:

  • Notice of the allegations
  • The specific sections of UWSOM’s academic or professionalism standards that were allegedly violated
  • That the academic review process has been initiated
  • That any information the student shares will become part of the hearing documentation
  • That possible actions which may be taken by the UWSOM include but are not limited to: disciplinary warning, requirement for work to be re-done, disciplinary probation, mandatory leave of action, advanced information status, referral to WPHP, suspension, and dismissal.
  • That the student has a choice of informal or formal hearing and must make this choice within 7 days.
  • That once an informal hearing has occurred, and either the SPC Chair has received the ‘information only’ report or SPC has considered the report and determined actions, the student has waived their right to a formal hearing regarding the same allegations.
  • That UWSOM is obligated to forward the report of findings documenting the academic review process to the National Residency Matching Program.

Informal Hearing

The preliminary meeting may move directly to an informal hearing if the student so chooses or may be delayed to a future time. An informal hearing allows the student an opportunity to respond to the alleged violations of UWSOM’s academic and professionalism standards in a face-to-face meeting before any finding is determined or action is imposed.

The informal hearing is composed of the student, their faculty advocate as described above, the Student Affairs Dean or designee, and one other dean as described above. At this meeting, the Student Affairs Dean will present the information alleging that the student violated UWSOM’s academic and professionalism standards. After hearing this information, the student may respond to the allegations.

Then the Student Affairs Dean conducts a careful and deliberate evaluation of the available information, conferring with the co-dean, UWSOM’s attorney, or other consultants as needed. The Student Affairs Dean then recommends appropriate action, if any, with consideration of the academic and behavioral attributes necessary to successfully complete the MD program. The informal hearing will result in one of these outcomes:

  1. The Student Affairs Dean may dismiss the allegations. This is applicable when the Student Affairs Dean determines that there is insufficient evidence that UWSOM academic and professionalism standards were violated. In this case, the Student Affairs Dean prepares an “information only” report to the Chair of SPC.
  2. The student acknowledges the violations of UWSOM academic and professionalism standards and accepts the actions recommended by the Student Affairs Dean. Once the student completes the actions, the Student Affairs Dean prepares an “information only” report to the Chair of SPC.
  3. The student acknowledges the violations of UWSOM academic and professionalism standards and accepts the actions recommended by the Student Affairs Dean but fails to complete them. In this case, the Student Affairs Dean prepares a report which is submitted to SPC. SPC considers the case and determines actions.
  4. The student acknowledges the violations of UWSOM academic and professionalism standards but does not accept the actions recommended by the Student Affairs Dean. In this case, the Student Affairs Dean prepares a report which is submitted to SPC. SPC considers the case and determines actions.
  5. The student acknowledges the violations of UWSOM academic and professionalism standards and mandatory leave of absence, suspension, or dismissal is recommended. In this case, the Student Affairs Dean prepares a report which is submitted to SPC. SPC considers the case and determines actions.
  6. The student does not acknowledge the violation of UWSOM academic and professionalism standards and/or the student requests to proceed to formal hearing.

A student has up to 24 hours to consider whether to acknowledge the violations of UWSOM academic and professionalism standards and sign a statement to that effect. This statement is prepared by the Student Affairs Dean.

The Student Affairs Dean’s report following an informal hearing documents the following information: the allegation, the information gathered from the informal hearing, the student’s acknowledgement of the violations if applicable, and the Student Affairs Dean’s conclusions and/or recommendations regarding appropriate actions based on the informal hearing. This report is retained in accordance with applicable retention policies.

Formal Hearing

Formal hearings occur when the student requests a formal hearing, or the Student Affairs Dean determines that evidence supports the allegations and the student does not acknowledge a violation of UWSOM academic and professionalism standards, either before or during an informal hearing process.

When either the student or the Student Affairs Dean requests a formal hearing, the Vice Dean for Academic, Rural and Regional Affairs will appoint the chair and members of a School of Medicine Ad Hoc Misconduct Review Committee (MRC). It is composed of faculty members with expertise in the areas relevant to the allegations. The Student Affairs Dean and Associate Dean for Curriculum are ex-officio (non-voting) members. The MRC provides the student a fair and impartial review of the allegations.

In preparation for the formal hearing, the Student Affairs Dean will provide the student with a written summary of the allegations and will inform the student of the following:

  • The student may be accompanied by a faculty advocate as described above, but not legal counsel
  • The MRC may request that the University’s legal counsel be present
  • The student may present evidence and witnesses on their behalf
  • The student may question any witnesses presenting against them
  • The possible actions which may be imposed by the UWSOM include but are not limited to disciplinary warning, requirement for work to be re-done, disciplinary probation, advanced information status, referral to WPHP, mandatory leave of absence, suspension, and/or dismissal.
  • That if violations of UWSOM academic and professionalism standards is confirmed, UWSOM is obligated to forward the report of findings documenting the academic review process to the National Residency Matching Program.

The Student Affairs Dean will inform the student of the scheduled hearing not less than 15 business days prior to the hearing date. The student may agree to an earlier date.

At the formal hearing, the MRC will review information pertinent to the alleged violations, including but not limited to information from the informal hearing if one occurred, written or oral statements from the individual(s) reporting the incident or concern, and any relevant documentation. The student will have an opportunity to respond to the allegations.

At the end of the formal hearing, the MRC determines by simple majority that the allegations should be dismissed or that UWSOM’s academic and professionalism standards were violated. The student will be informed of the decision within 10 business days by letter. The letter will be retained in the student’s record. MRC’s decision is final and not subject to further review or appeal.

When allegations are dismissed by the MRC, the Chair of the MRC prepares an “information only” report to the Chair of SPC.

When the MRC determines that the violations occurred, the Chair of the MRC prepares a report which details its findings of fact and recommendations on appropriate actions. This report is submitted to SPC. SPC considers the case and determine actions.

SPC Actions Following Informal and Formal Hearings

Reports of alleged violations of UWSOM’s academic and professionalism standards are considered by SPC in these situations:

  • An informal hearing occurred, the student acknowledged the violations of UWSOM academic and professionalism standards and accepted the recommended actions but did not complete them.
  • An informal hearing occurred, and the student acknowledged violations of UWSOM academic and professionalism standards, but the student did not accept the recommended actions.
  • An informal hearing occurred, the student acknowledged the violations of UWSOM academic and professionalism standards, and mandatory leave of absence, suspension, or dismissal was recommended.
  • A formal hearing occurred, and the School of Medicine Ad Hoc Misconduct Review Committee (MRC) determined that UWSOM academic and professionalism standards were violated.

SPC considers the report(s) resulting from informal and/or formal hearings, and the student’s entire medical school record, within the context of UWSOM’s academic and professionalism standards in order to determine appropriate actions Considering these reports is part of SPC’s academic review process.

SPC’s consideration of a case following an informal or formal hearing generally includes an interview with the student, though students may opt out. The structure of this interview is the same as a dismissal consideration interview, even when dismissal is not being considered in that individual case. The purpose of the interview is for SPC to understand the student’s perspective on their violations of UWSOM’s academic and professionalism standards, within the context of the student’s entire medical school record, so that SPC can determine an appropriate action plan. The violations as stated in the report(s) are not reconsidered during the interview.

Before the interview, SPC reviews the reports resulting from informal and/or formal hearings in addition to the student’s written statement, letters of support, and their entire medical school record including Step exams, evaluations, evaluator concerns, and reports resulting from UW Community Standards and Student Conduct Office investigations.

Based on all the information reviewed and after hearing the student’s perspective, SPC may take any appropriate actions. SPC is not limited to the actions recommended by the Student Affairs Dean who managed the informal hearing or the chair of the Misconduct Review Committee who managed the formal hearing. The Chair of SPC will inform the student of the action plan by letter within 10 business days.

If SPC votes for dismissal recommendation, the student may appeal to DAC as described in Section 4. If SPC votes for any action other than dismissal, the student may request a review by the Vice Dean for Academic, Rural and Regional Affairs. This request must be made in writing within 5 business days of receiving notice of SPC’s decision. After that time, SPC’s decision becomes final.

Effective: Current
Last updated: April 15, 2022
Policy Contact: Chair, Student Progress Committee, abaer@uw.edu; Education Quality Improvement Office, eqi@uw.edu