2.1 Technical Standards Policy

Standards for Admission, Retention, Promotion, and Graduation

Purpose & Scope
Note: Throughout the document, “student” refers to the applicant and medical student.

Introduction
The University of Washington School of Medicine (UWSOM) maintains a strong institutional commitment to training a diverse student population in order to provide excellent care to a diverse patient population. The UWSOM provides equal educational opportunities for qualified students with disabilities who apply for admission to the MD program or who are already enrolled. The technical standards are not intended to deter any candidate for whom reasonable accommodation will allow fulfillment of the complete curriculum.

As an accredited medical school, the University of Washington School of Medicine adheres to the accreditation standards described by the Liaison Committee on Medical Education in “Functions and Structure of a Medical School.”

Policy Statement
Technical standards refer to the cognitive, behavioral, psychological, and physical abilities required to satisfactorily complete all aspects of the UWSOM curriculum and to develop the professional attributes required of all students approved to graduate with the MD degree.

Medical students are expected to meet all graduation requirements, which include but are not limited to participating and achieving competence in the full curriculum, receiving satisfactory evaluations of academic and professional conduct, and successfully completing the appropriate United States Medical Licensing Examinations (USMLEs).

Students with a known or suspected disability who may require accommodations are encouraged to contact Disability Resource Services (DRS) for a confidential conversation. The student’s situation will be reviewed confidentially to determine what reasonable accommodations would permit the candidate to satisfy the expectations of the curriculum. This process is informed by the knowledge that students with varied abilities can become successful health professionals.

Requirements, Procedures and Guidelines
a. Intellectual, integrative, and quantitative abilities

Students are expected to have essential abilities in information acquisition, integration, and problem solving at entry and to gain and demonstrate higher levels of competence as they progress through the curriculum. These include, but are not limited to, the ability to do the following:

Comprehend and apply written material to independently accomplish curricular requirements and provide clinical care for patients
Master relevant content in basic science and clinical courses deemed appropriate by the faculty through a variety of sources including lectures, written material, use of computers and other forms of media, and simulations
Discern and comprehend dimensional and spatial relationships of structures
Demonstrate reasoning, decision-making skills, and sound judgment appropriate to the practice of medicine
Solve problems in a timely manner; this critical skill requires the ability to learn, reason, integrate, analyze, and synthesize data concurrently in a multi-task setting where there may be a high level of stress and distraction
Develop the skills to interact with, utilize and navigate an electronic medical record

b. Observational skills

Students must be able to acquire information through a variety of methods in order to gather information, integrate findings, and develop appropriate diagnostic and treatment plans. These include, but are not limited to the following:

Large group lectures
Demonstrations and laboratory experiments
Small group discussions and presentations, including team-based learning
Written material, audiovisual material, including computer-based material
Cadaver dissection and specimen examination
Simulations
One-on-one and small-group interactions with patients and other individuals

c. Communication

Students are expected to have foundational communication skills at entry to medical school and to gain and demonstrate higher levels of competence as they progress through the curriculum. With appropriate training, students must:

Communicate effectively in English verbally and in writing or electronically in classroom, clinical, and non-clinical settings with peers, patients, families, physicians, other members of the health care team and have the ability to comprehend written and verbal communications
Demonstrate the communication skills required to form effective professional relationships with members of the health care team, teachers and colleagues, and therapeutic relationships with patients
Gather a complete medical history which includes the ability to communicate and interact with patients, families, caregivers, and the electronic medical record in an effective manner in order to elicit information, assess non-verbal communication, describe changes in mood, activity, and posture; and work effectively with a patient’s interpreter when needed
Establish rapport in a way that earns patient, families and caregivers trust and promotes openness to a patient’s concerns and sensitivity to potential cultural differences
Process and communicate information on a patient’s status in an accurate, succinct, comprehensive and timely manner to members of the healthcare team
Recognize and communicate around urgent situations in which timely supervision, assistance, and consultation must be sought
Document information accurately for patient care in a timely manner

d. Physical Functioning

After a reasonable period of training, students must have the physical capacity, with or without accommodation to do the following:

Perform a physical examination including eliciting information by palpation, inspection, auscultation, percussion, and other diagnostic maneuvers
Perform diagnostic, therapeutic invasive procedures
Respond to and perform appropriate action in emergency situations
Complete timed demonstrations of skills
Demonstrate the use of precautions to avoid posing risks to patients and the student
Perform in outpatient, inpatient, surgical, and other clinical venues
Perform in a reasonably independent and competent way in sometimes chaotic clinical environments

e. Behavioral Skills and Ethical Conduct

Students must:

Arrive on time, be prepared, and wear attire appropriate to the situation and environment
Take responsibility for their education; participate, contribute to the learning environment, and receive and act on constructive feedback from members of the medical school community and healthcare teams
Demonstrate compassion, empathy, altruism, integrity, responsibility, dedication, fairness, and concern for self and others
Demonstrate integrity as manifested by truthfulness, acceptance of responsibility for their actions, accountability for mistakes, and the ability to place the well-being of a patient above their own when necessary
Demonstrate the ability to develop mature, sensitive, and effective professional relationships with patients, health care teams, and members of the medical school community
Demonstrate an ability to work with individuals with different beliefs that may affect their interactions
Demonstrate the emotional and psychological capacity to function effectively under stress, exercise good judgment and display adaptability to an environment that may change rapidly without warning and/or in unpredictable ways
Possess the stamina required to manage expected workloads outlined in the School of Medicine’s Required Clerkship Objectives
After adequate training, understand and apply appropriate standards of medical ethics
Function as a contributing member of the healthcare team, often within a multidisciplinary team-based environment, regardless of the specialty
Students are expected to comply with the UW Medicine Policy on Professional Conduct

f. Legal Requirements

Students must complete compliance requirements, including periodic criminal background checks, and remain in compliance from matriculation to graduation
Students applying for admission must acknowledge and provide written explanation of any charges or disciplinary action taken against them prior to matriculation in the School of Medicine.
Failure to disclose prior or new offenses can lead to rescinding the offer of admission, disciplinary action, or dismissal

Accommodations

Medical students must continue to meet the medical school’s technical standards throughout their enrollment with or without accommodations. Students are responsible for requesting accommodations and for providing the appropriate, required documentation of the disability in a timely manner to the University’s Disability Resources for Students (DRS) Office. The DRS Office will review the documentation and engage the School of Medicine and the student in an interactive process to review accommodation requests and to determine reasonable accommodation(s) on a case-by-case basis. See DRS Office webpage on the process for new students.

Reasonable accommodations are designed to effectively meet disability-related needs of qualified students, yet will not fundamentally alter essential elements of this program, create an undue burden for the University, or provide new programming for students with disabilities not available to all medical students. The School of Medicine in partnership with DRS is responsible for implementation of approved accommodations.

A student who develops or manifests a disability after matriculation may be identified to the UWSOM through a variety of sources, e.g., self-report, a report of accident or illness, or faculty observations of special aspects of poor academic performance. If the degree to which the student has become disabled raises concerns about the student’s ability to meet the technical standards, the student will be referred to the DRS designee assigned to the medical school.

Health or Safety Risk

Should the student become impaired such that they would pose a health or safety risk to patients, self, or others and that could not be managed with reasonable accommodations, the student may be placed on a mandated leave of absence to permit referral for evaluation and treatment and return to the curriculum when safe to do so as determined by an independent entity such as the Washington Health Physician’s Program. If patient safety cannot be assured, dismissal from the School of Medicine may be considered.

Standards for Admission, Retention, Promotion, and Graduation

Applicant/Student Acknowledgement of Review

UW School of Medicine: Foundations of Clinical Medicine Physical Examination Checklist