School of Medicine Policies

A controlled substance is defined as any substance in schedules I through V of section 202 of the Controlled Substance Act (21 U.D.V. 812). This categorization by federal legislation is understood by the University of Louisville School of Medicine to supersede any state, county or municipal statues which might be perceived to allow latitude for legal use.

School of Medicine Bulletin 2017-2019, https://louisville.edu/medicine/studentaffairs/student-services/copy2_of_ULSOM20172019Bulletin.pdf, pp. 12-14.

The School reserves the right to require administration of a UDS with an inquiry panel sufficiently broad as determined by situational need. A UDS panel may be supplemented with, or replaced by, other testing modalities including but not limited to those requiring blood, hair, nail and/or breath samples.

2.2. Continuity of Instruction Policy

EPC Approved: July 20, 2016

All medical students are urged to sign up for the UofL mobile phone emergency information system, RAVE (https://www.getrave.com/login/louisville), which provides real time text communications about any emergencies or long-term catastrophes.

In the event that the course/clerkship is no longer able to meet face-to-face, students should immediately logon to the RedMed course website, where the course director or his or her designee will provide instructions for adjustments to the meeting schedule, delivery of instruction, assignments, or examinations and deadlines.  Students are asked to check the RedMed site regularly throughout the interruption of instruction for updates.  The course director will also use email to communicate regularly with students.

In the event that students as a whole do not have access to the internet, alternative approaches to communicating with students will be arranged.  However, should this occur, students should, depending upon their individual circumstances, make every effort to stay current with course/clerkship assignments/readings.

In the event that a student is unable to attend class for an extended period of time, he or she should contact the course/clerkship director to discuss alternative means of fulfilling requirements.

2.3. UL SOM Medical Student Work Hour/Workload Policy

EPC Last Revised: May 29, 2019 

The aim in restricting work hours and course hours is to provide an optimum environment to facilitate medical student learning.

First and Second Year Courses

First and second year course evaluations will include questions about workload in courses, including student estimate of time spent completing independent learning assignments.  The EPC will review this information annually in order to assure a balanced workload and adequate time for independent learning for students.

Required Clinical Clerkships

Student duty during the clinical clerkships will be designed with these requirements in mind and clinical course directors will monitor student duty hours. All clinical rotations and elective rotations must adhere to the medical student work hour policy as defined below:

1.     Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.

2.     Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours. Students may remain on duty for up to 4 additional hours to participate in didactic activities, transfer care of patients, and maintain continuity of medical and surgical care.

3.     Clinical rotations that are scheduled as shift work, such as the emergency medicine elective and night float, will be limited to approximately 12 consecutive hours of patient care, but should not exceed 14 hours. Shifts should be separated by 10 hours between work periods, but must be separated by at least 8.

4.     Students must be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities (see EPC Days Off policy).

5.     Adequate time for rest and personal activities must be provided. This should optimally be a 10-hour time period provided between all daily duty periods and after in-house call.

Limiting required duty hours does not imply that medical students must cease providing essential patient care services at arbitrary cut-off times. Priority must always be given to patient safety and well-being and to avoid the transfer of patient care responsibilities to others at inappropriate times in the continuum of care (e.g., during an operative procedure, in the midst of a rapidly evolving clinical event).

Compliance

This policy will be monitored for compliance by the course directors, clerkship directors, elective course directors, the Vice Dean for Medical Education and the Associate Dean for Student Affairs. EPC minutes will document discussion of preclinical and clinical work hour patterns using data from New Innovations, course evaluations, the clinical liaison process and individual student reporting.  If any of these sources reveal that students have worked beyond the acceptable time frame described above, the Vice Associate Dean for Medical Education will meet with the specific course or clerkship director to assure compliance with the policy. 

Dissemination

This policy will be discussed with medical students at third year orientation and will be made available to them by referencing it in each clerkship syllabus and by posting it on RedMed. Additionally, the policy will be shared with all faculty, residents, and fellows who work with medical students at the beginning of each academic year via email from clerkship directors or clerkship coordinators.

2.4. Medical Student Supervision/Clinical Care Policy

EPC Approved: February 6, 2019

Purpose

To ensure safety of patients and learners, and a supportive environment for student learning and growth in the clinical setting.

Overview

In keeping with our combined duties to patient care/safety and education of students in the practice of medicine, and in keeping with accreditation requirements, this policy describes the requirements to meet the standard of appropriate supervision in the clinical environment.

Policy

Students of the University of Louisville School of Medicine and visiting students must be appropriately supervised when participating in required or elective clinical activities.

1.     Medical students may not provide care in an unsupervised fashion. Students are not credentialed independently. Students function under the direction of the credentialed staff member to whom they are assigned.

2.     Supervisors must either hold a faculty appointment or be supervised in their teaching and assessment role by an individual who has a faculty appointment and may include physicians, residents, fellows, and other licensed health professionals supervising an activity within their scope of expertise or practice.

3.     Students may be supervised at one of two broad levels as determined by the supervisor:

• Direct Observation: the supervisor is present with the student and the patient
• Immediately Available Indirect Supervision: the supervisor, while not in the presence of the student and/or patient, is immediately available to the learner and/or at the site of care to provide direct supervision

1. Determination of appropriate level of supervision is made by the supervisor, based on many factors, including:

• Level of training of the student
• Previous experience and skill of the student with the clinical activity and setting
• Familiarity of the supervisor with the abilities of the student
• Acuity of activity and level of risk to patient

5.     Students may not perform procedures without direct supervision by a licensed healthcare professional practicing within their scope of practice.

6. Students participating in an intimate exam (breast, pelvic, genitourinary, or rectal) must have a chaperone with them, irrespective of the gender of the patient or the student.

Procedures

1.     The supervisor reviews and independently verifies all student findings, assessments, and care plans, and documents this review.

2.     The director of the clerkship or course is responsible for communicating policies and procedures related to supervision to faculty and students participating in their curriculum, and for monitoring compliance with the policies and procedures with a report to the relevant governance committee.

3.     The director of the clerkship or course is responsible for developing and communicating standard procedures through which students can report concerns regarding adequate and appropriate supervision of what they may deem a violation of this policy.  Procedures may include, but are not limited to reporting through the Student Affairs website (to report mistreatment or negative learning environment), direct reporting to a clerkship or course director or coordinator, and documenting concerns in course or clerkship evaluations at the end of the course or clerkship.

Expectation of Faculty and Clerkship Directors

1. Model professional behavior in interactions with patients, learners, staff and all other individuals in the health care team.

2. Inform patients and/or family members about the role of the medical student or trainee involved in patient care.

3. Provide opportunities for students to demonstrate responsibility and ownership for patient care responsibilities. These opportunities include, but are not limited to taking patient histories; performing complete and/or focused physical examinations; and reporting and entering findings in the patient’s medical record with the explicit approval of the patient’s supervising attending physician. The supervising physician will be responsible for reviewing student documentation and countersigning progress notes.

4. The faculty is ultimately responsible for the evaluation, treatment, management, and documentation of patient care.

Expectations of Students

1.     Maintain professional behavior standards with the supervising physician, other members of the medical team, including resident physicians, other health professionals, members of the staff, patients and any other individuals encountered in the clinical setting.

2.     Maintain self-awareness of own competence and seek assistance/advice when clarification is needed.

3.     Inform patients and/or family members of their status as a medical student and the name of the supervising physician under whom they are working.

4.     Proactively inform the supervising physician or clerkship director concerns about levels of supervision (excessive or sub-standard).

2.5. Expectation for Using RedMed

Educational Program Committee Approved: July 18, 2012
 

Year One and Year Two Courses

1. All face-to-face teaching sessions placed on calendar as events with the correct designation (lecture, small group, IL, lab) and at least one teaching faculty member identified, and independent learning activities placed on calendar as Milestones.
2. Syllabus and other materials that are used continuously or apply to an entire course posted on the course home page on RedMed. Syllabi must also be posted on Blackboard for SACS compliance with U of L.
3. Selecting and posting Program Objectives/Course goals and Session objectives: This is the step that allows RedMed to demonstrate that the curriculum supports the educational standards for the school, a key LCME standard.
   1. Course director selects SOM Program Objectives from list (that apply to the course as a whole) as Course Goals
   2. Individual faculty (or their designate) selects Program Objectives that apply to their individual teaching event from the Program Objectives list for the course. Individual faculty or their designate also enters specific learning objectives for each individual event and links them to the event’s Program Objectives.
4. All course materials assigned for student learning (lecture notes, handouts, PowerPoints, practice questions) must be posted. These assigned materials should be posted no later than 1 week prior to the learning event, to allow time for studying ahead.
   1. Groups of lectures covering a single topic, i.e., Renal Pathology 1-5, may post all of the necessary course materials once within the first lecture in a set and indicate they have done so in the description of the first learning event in the series.
   2. Do not repost the same teaching materials more than once as it will lead to unnecessary duplicate printing by students. Modified or updated documents that are uploaded will be flagged as new documents for student review, and outdated materials should be removed when updated materials are posted.
   3. UME staff will post links to via Panopto the next business day after the lecture is given.

Clerkships

Clerkships must include information about patient logging on RedMed in their syllabus and remind students about using the patient log during orientation. All patient logs in the clinical years will be kept on New Innovations only.

2.6. Extra Credit Policy

EPC Reviewed: February 6, 2013

Extra credit assignments/points are not allowed.  All activities deemed worthy of inclusion in a course or clerkship must be included in the “total points possible” for that course, thus eliminating the potential to exceed 100%.

2.7. Formative Assessment & Feedback Policy

EPC Last Reviewed: May 29, 2019

Didactic Courses in Preclinical Years

All courses must provide formative feedback to students early enough to allow students sufficient time for remediation. 

Each course must provide graded formative feedback.* Graded formative feedback includes feedback on any graded assignment, including quizzes.

Each course must also provide at least one of the following types of ungraded formative feedback:

• Practice problems with solutions
• Practice tests with solutions
• Teacher consultation

Students must receive ungraded and graded formative feedback to assess their progress in meeting a course’s goals while there is still sufficient time in the course to allow for changes in studying and approach to material. In practice, this means that both forms of feedback must be delivered to students while there are at least 2/3 of the overall course points remaining.  Feedback must occur by at least the midpoint of the course.

Course/thread directors must be available to meet with students who have concerns about their performance in a course. They may refer certain students to the Learning Specialist. The Learning Specialist will assess student needs and refer the student, if indicated, to the appropriate resources, e.g., tutoring and/or meeting with their Advisory Dean. Students are responsible for following up with the referred resources.

Formative feedback practices must be described in each course syllabus; these will be reviewed by the

Undergraduate Office of Medical Education (UME) and reported to the Educational Program Committee (EPC) as part of the syllabi review process each year.

*If a course is less than four weeks, formative assessment, both graded and ungraded, will be given by at least the midpoint of the course

Percent of Final Grade

Formative assessment assignments (including quizzes, if any) will account for 20-30% of the final course grade in courses that are four weeks or longer.

Required Clinical Clerkships

All clerkships must provide mid-clerkship feedback to students.  Residents should be encouraged to contribute to mid-clerkship feedback, however attending physicians are ultimately responsible for providing feedback and signing the mid-clerkship feedback form.

Mid-clerkship feedback must be delivered by the midpoint of a clerkship rotation or during a phase of the clerkship that will allow time for the student to make any adjustments or improvements prior to the end of the clerkship, if necessary. 

Clerkship directors are required to review all clinical evaluations and meet with any student found to be at risk for failure based upon written feedback; this meeting should be used to develop an action plan to help the student improve his/her performance. 

Mid-clerkship feedback practices must be described in each clerkship syllabus; these will be reviewed by the UME and reported to the EPC each year as part of the syllabi review process.

2.8. Narrative Assessment Policy for Required Courses and Clerkships

EPC Last Reviewed: January 6, 2016

1. Students in required courses with longitudinal small group experiences and/or laboratory experiences with same facilitator for five or more sessions must receive narrative assessment, either formative or summative, on areas other than content or skills mastery.  These include the Interdisciplinary Clinical Cases and Longitudinal Standardized Patient Program of the Introduction to Clinical Medicine course; and Problem Based Learning sessions. Required clinical clerkships also must include narrative assessment.
2. Narrative assessment must include feedback and observations related to behavior, attitudes, interpersonal skills, interactions with peers and faculty, and/or professionalism.
3. Narrative feedback must address both the student’s strengths and specific areas for improvement.
4. Courses that provide narrative feedback must describe the narrative feedback process in their syllabus.
5. The Introduction to Clinical Medicine course, Problem Based Learning sessions, and required clinical clerkships must include both formative and summative narrative assessment. Summative assessment must be factored into student’s final grade. Other courses may include summative or narrative assessment based on the course design and EPC review and direction.
6. Narrative assessment must be completed on New Innovations and must be reviewed by both the student and the course director.
7. Summative comments must accompany the final grades to Student Affairs.
8. Course evaluations must include questions about student satisfaction with narrative feedback. Undergraduate Office of Medical Education will monitor survey answers for student satisfaction with narrative feedback. The Educational Program Committee will review as part of annual course evaluation.
9. If a student concern surfaces in the narrative feedback, the course director must discuss the concern with the student and the Associate Dean for Student Affairs.)

2.9. Self-Directed Learning Policy

EPC Last Reviewed: March 4, 2020

Self-directed learning sessions that incorporate all of the following elements must be included as a required part of the ULSOM curriculum:

1. Medical students’ self-assessment of their learning needs
2. Independent identification, analysis, and synthesis of relevant information
3. Independent and facilitator appraisal of the credibility of information sources
4. Students are assessed on and received feedback on their information-seeking skills

In order to assure a learning environment that incorporates these elements in a cyclic manner as a curricular requirement, problem-based learning sessions (PBL) with graded assessments are incorporated into the first and second year of the curriculum. These PBL sessions meet all components of the LCME definition of self-directed learning (SDL).

• The EPC will discuss PBL topics in the context of the proposed schedule for each course in the first two years of the curriculum. 

2.10. Service-Learning Policy

EPC Last Reviewed: May 6, 2015

Effective Date and Service-Learning Definition

Effective with the class of 2016, all students shall be required to complete an EPC-approved service-learning activity prior to graduation.  EPC-approved activities include: 

• AHEC Project in the Family Medicine clerkship
• Mission Trips/Service Trips
• Student-Run Clinics

A service-learning activity is defined as a structured learning experience that combines community service with preparation and reflection. *

Required Learning Objective

All service-learning activities should include the following learning objective: Students will develop an appreciation for community service and the contributions that physicians can make to their communities through such service.

Requirement for Reflection by Students

In order to qualify as a service-learning experience, a reflection must be included.  Students may complete the reflection component individually or as part of a group.  This component must be described in the syllabus of required courses, or in the course form in the case of electives.

Documentation of Service-Learning Activities by Students

Students must document their service-learning activities using the service-learning database.  They must include the name of the service-learning activity and the number of hours involved; they must also upload their completed reflection assignment. 

Procedures for Providing Feedback to Student’s Reflection

A faculty member will provide feedback to students on their service-learning reflection assignments as follows:

1. If there is a specified director of the service-learning activity (i.e., sponsor of international trip, student clinic directors, etc.), he/she will provide feedback to the student.
2. If there is no specified director, the Associate Dean for Student Affairs, in conjunction with the Service-Learning Coordinator (SL Coordinator), will identify an appropriate faculty member to provide feedback.

Criteria for Approving Service-Learning Activities

New service-learning opportunities may be proposed by students or faculty members by submitting a proposal to the SL Coordinator.  Any proposed service-learning activity that meets the service-learning definition as verified by the Associate Dean for Student Affairs and the SL Coordinator will be considered an approved service-learning activity.

Notification to Students Regarding Service-Learning Experiences

The SL Coordinator in Student Affairs will distribute a list of EPC-approved service-learning experiences to students by August 1 annually.  In addition, the SL Coordinator will post a copy of this service-learning policy and maintain a current list of activities to a Service-Learning webpage at the Medical Student Affairs website.  The SL Coordinator will be responsible for updating this list quarterly.

Tracking of Service-Learning Experiences – Procedures and Schedule

The SL Coordinator will produce and examine service-learning database reports on student completion of service-learning activities, reflection, and feedback.  The SL Coordinator will provide composite reports to the Educational Program Committee in January (to include activities completed from July – December) and July (to include activities completed from January – June) of each year. 

Educational Program Committee Responsibilities

• Review UME survey results regarding student satisfaction with service-learning experiences and reflection feedback annually in July.
• Discuss student completion of service learning and reflection requirements.  Address any deficiencies.

2.11. Student Assignment to Learning Experiences (Clerkships)

EPC Approved: July 17, 2019

The School of Medicine assumes responsibility for managing students’ selection of and assignment to learning experiences and responding to requests for change.

Regional Campus

Enrollment in the Trover regional campus for the clinical phase of the curriculum occurs prior to matriculation to medical school. Enrolled students who would like to withdraw from Trover Campus need to contact the Associate Dean for Student Affairs. The Associate Dean for Student Affairs will confer with Undergraduate Medical Education deans before making the final decision.

Clerkship Rotation Assignment

Assignment to clerkship rotations will be done in a fair and consistent manner. Student are informed by the Undergraduate Medical Education Office of the process to request the order of clerkships. Any request for changes in assignment should be sent to the Director of Curriculum Management Systems in the Undergraduate Medical Education Office.

Clerkship Site Assignments

Students will be allowed to rank specific sites and/or services within each clerkship. Clerkship site/service change requests will be processed by the individual clerkship. A student may email a clerkship director and coordinator to formally request an alternative site/service assignment at any time before or during his or her attendance at the site. The clerkship director and coordinator will determine if a change is warranted. Each change request will be evaluated on the nature of the request, impact on other students, and available options. Requests based on health issues, conflicts of interest, accommodations, compliance issues and mistreatment will be given priority.

If there is an issue that affects multiple clerkships, the student can contact the Associate Dean for Student Affairs who will work with the clerkship directors to determine site/service assignments.

2.12. Student Use of Electronic Medical Records

EPC Last Reviewed: May 29, 2019

The following rules apply to student use of electronic medical records. Students should be able to access electronic medical records using their own personal login information.

1.     Students should be able to enter a full note including history of presenting illness, past medical history, family history, review of systems, physical exam, laboratory/imaging data, and assessment and plan.

2.     Student notes should become a permanent part of the patient record.

3.     Students should be able to view all patient notes, labs, radiology reports, pathology reports and images.

4.     Students should have the ability to create orders. All student orders must be signed by a resident or attending physician.

5.     A faculty member must review student notes to ensure accuracy and appropriateness and provide feedback to students.

6.     A faculty member must sign student note.

7.     All required clerkship syllabi must include this policy. 

2.13. Students as Scribes Policy

EPC Last reviewed: May 29, 2019

 Scribes are defined by the AAMC as “individuals whose role is to document as the physician performs the service.” * 

Medical students shall not participate as a scribe in any capacity for any physician or clinical rotation that participates in students’ educational experiences.  Students are allowed to write notes under their own user IDs, but these shall be attributable only to the student and are not to be used as physician notes.  Furthermore, students may not receive compensation for writing their own notes, nor shall they be compensated for completing charts or electronic medical records during any clinical rotation during the time they are enrolled in the rotation.

This policy is meant to ensure that scribe duties do not overlap with educational responsibilities at any time.  Students are permitted to work as scribes; however, they can do so for pay only when the work is done outside of any rotation or elective in which they are currently enrolled.  They are not allowed compensation nor can they be required to scribe if it is related to education/school in any way.

If a student is asked to write a note or scribe under anyone’s name other than their own, the student should report the request to any of the following: Clerkship Director, Student Affairs, Associate Dean for Medical Education, Assistant Dean for Medical Education.

2.14.  Required Patient Diagnosis and Procedure Logging Process:

Educational Program Committee Approved: June 5, 2019

Educational Program Committee Last Revised: May 18, 2022

The Educational Program Committee (EPC) sets the list of diagnoses and procedures students are required to see in each required clerkship.

The purpose of this log in managing the required clinical curriculum is twofold:

1. to ensure every educational site provides sufficient patient numbers and diversity to represent the range of diagnoses required for the clerkship; and
2. to monitor across sites within a clerkship and make sure the patient load is comparable so that students at different sites have enough time to study.

The EPC will review student logs every 6 months to evaluate the required diagnosis list for each clerkship as well as the site assignments for students to maintain the highest quality clerkship educational experience.  Accurate student data is key to ensuring these decisions are delivering the kind of patient experiences students need and want in their clerkships.

Each clerkship has required diagnoses and procedures. Recommendation for these required diagnoses and procedures are made to the EPC by the M3-4 Subcommittee. The EPC then selects the final diagnoses and procedures and assigns them to each clerkship, including the required level of participation. All required diagnoses and procedures must be seen and logged at least once during that clerkship to complete the clerkship educational requirements. Students should log patient diagnoses/procedures in all of the following circumstances:

1.  Assigned patients, defined as: the patients students interview, examine, write notes or histories on; see on their own or with a preceptor in clinic; directly participate in procedures or surgeries on; or are personally assigned to follow from admission or night float. Some examples:

•       If a student sees the same patient in the hospital for five days, log them completely, once.

•       If a student personally cares for 5 patients in clinic on the same day with the same diagnosis such as asthma, log all 5 patients separately on that day even though they have the same diagnosis.

•       If a student has already seen a patient with that required diagnosis and logged it, but cares for a new patient with the same diagnosis in the hospital, log the patient.

2. Patients seen and discussed by the student’s team or in clinic or after rounds while the student is present and learning from their care should also be logged the first time they are encountered by the student.

3. Patients that develop new diagnoses on subsequent days, ex. acute kidney injury or nosocomial infection, may have that diagnosis added to their log.

4. Patients seen in small groups or conferences when the patient/survivor is present, should be logged (ex. OB/GYN Ovarian Cancer Survivors session).

5. Virtual or online patient cases that the student is directed to use to fulfill a required diagnosis should be logged, with “virtual patient” chosen in the “location” field.

6. Procedures have a minimum required level of participation that is assigned by the EPC. This will be indicated to the student within the logger as well as during orientation to the clerkship and in the clerkship syllabus. Although all levels of participation may be logged, i.e., observation, the minimum expectation for participation identified by EPC must be met to pass the clerkship and will be monitored. Levels of participation include:

Levels of Participation for Required Diagnosis are:

Level 0 – Virtual Patient Case

Level 1: Active Exposure: Student actively observes clinical care of patient during key patient care tasks and subsequently discusses the interaction with the provider; participated in discussion for care of teammate's patients.

Level 2: Active Clinical Participation: Student actively participates in the clinical care of patients by performing key patient care tasks.  This can include obtaining a patient history; conducting a physical examination; presenting the case including a discussion of differential diagnosis, assessment, and plan; and/or accepting a patient handoff with active listening and then performing required next steps in care.

Levels of Participation for Required Procedures are:

Level 0: Simulated procedure.

Level 1: Active Exposure: Student actively observes the specific demonstrated procedure and subsequently discusses the interaction with the provider.

Level 2: Active Participation (Assist): Student assists in the performance of a specific procedure under direct supervision.

Level 3: Active Participation (Full): Student fully performs a specific procedure under direct supervision

The following should NOT be logged:

• Patient cases discussed in small groups when the patient is not there to take part
• Morning report
• Morbidity & Mortality conference
• Autopsy conference
• Any other didactic sessions where the facts of the patient’s case are shared but that the patient does not attend and/or that does not affect the actual care of the patient.

Monitoring of timing of log completion and points for completion:

Students are required to update their patient diagnosis and procedure logs at least weekly to help improve accuracy of logging as well as identify required diagnoses that are not being seen. Clerkship coordinators will check student logs and points will be docked if no entries are being made on at least a weekly basis. Students are also prompted to review their diagnosis and procedure logs with their supervising physician when they ask for formative feedback using the mid-clerkship feedback form, so that gaps in their clinical experience can be addressed.

Students who are missing required diagnoses in the last week of a clerkship should email their clerkship director and coordinator notifying them and asking them for guidance. They may either direct the student to a patient/team/site that will let them meet the requirement, or if that is not possible, they will direct the student to complete an online or virtual patient case or simulated procedure, and log that completion in the logging system. No student who has contacted the clerkship director appropriately a week prior to the end of the rotation and followed their directions will be docked points for missing a required diagnosis.

2.15. Privacy of Student Records

EPC Last Reviewed: September 9th, 2020

The University of Louisville hereby notifies students concerning the Family Educational Rights and Privacy Act (FERPA) of 1974. This Act, with which the institution intends to comply fully, was designed to protect the privacy of educational records, to establish the right of students to inspect and review their education records, and to provide guidelines for the correction of inaccurate or misleading information. Students also have the right to file complaints with the Family Educational Rights and

Privacy Act Office, Department of Education, concerning alleged failures by the institution to comply with the Act.

The University has adopted a policy which explains in detail the procedures to be used by the University for compliance with the provisions of the Act and the regulations adopted pursuant thereto. FERPA information can be found online here.

Questions concerning the Family Educational Rights and Privacy Act may be referred to the FERPA Officer, University Archives and Records Center.

2.16. HSC Immunization Requirements

The following immunizations are required for Health Sciences Students

All students in the Schools of Dentistry, Medicine and Upper Division of the Nursing School including Graduate Nursing programs, Audiology and Speech-Language Pathology are required to have the immunizations listed below, in addition to an annual TB skin test. Please print and complete the appropriate U of L Immunization Compliance Form (student or resident/fellow) and submit it, along with all official documentation of your immunizations.

Questions concerning the Health Science Campus requirement can be directed to Immunize@louisville.edu.

Campus Health Services, located on the Health Science Campus, can take care of any immunizations you may need to be compliant.

Why We Require Vaccinations

Requirements:

 Tetanus-Diphtheria Acellular Pertussis (Tdap)

• 1 Adult Tdap vaccine (Tetanus, Diphtheria, Pertussis).

Measles-Mumps-Rubella (MMR)

• Documentation of serologic immunity OR
• MMR vaccines (2 doses Measles, 2 doses Mumps and one dose Rubella if administered separately).

Hepatitis B Vaccine (HepB)

• doses of vaccine followed by HepBSAb titer, reported with a QUANTITATIVE value.

Varicella (Chickenpox) Vaccine

• doses of vaccine OR
• Positive antibody titer. Indeterminate titers require one dose vaccine.

Baseline and Annual TB (Tuberculosis) testing required

• No previous TST or your testing has elapsed >14 months: 
• Complete two TSTs, at least one week apart.
• No prior history of positive TST:
• Proof of two annually consecutive TSTs: one within 90 days of your start date, OR
• Interferon Gamma Release Assay (IGRA) (Quantiferon TB Gold or T-spot) within 90 days of your start date.
• Prior history of (+) TST or IGRA, or active TB:
• Provide documentation of positive test results, medication treatment, and latest Chest x-ray report.
• If you received the BCG vaccine and your first or second TST were "positive" you will need to obtain an IGRA blood test.
• Complete TB Questionnaire (TBQ) upon starting and on an annual basis.
• Hepatitis A (recommended):
• doses vaccine

Seasonal Influenza:

• Vaccine is required annually but not available until Fall. You will be notified regarding its availability. Free to all students.

Pending Vaccine Documentation:

You will be contacted by e-mail once documents are reviewed and additional documentation may be requested by Campus Health Services.

2.17. Mistreatment Policy

Educational Program Committee Approved: May 15, 2019

Educational Program Committee Last Revised: September 3, 2024

The University of Louisville School of Medicine is committed to ensuring an environment that is respectful of diversity of opinion, race, gender, religion, sexual orientation, age, disability and socioeconomic status.  Mutual respect and collegiality among faculty, residents, students and staff is essential to maintaining an environment conducive to learning. All members of the University community are expected to adhere to the Code of Conduct. 

Student Mistreatment is defined as a behavior that shows disrespect for the dignity of others and unreasonably interferes with the learning process. It includes harassment, discrimination, or physical threats.

Specific examples of mistreatment can include, but are not limited to, being:

• Subjected to offensive remarks or names
• Pressured into performing personal services
• Intentionally neglected or left out of conversations
• Belittled or humiliated

Any abuse or misconduct of a sexual nature will be reported through the Title IX process as outlined by the University of Louisville.

Students may report mistreatment using any of the following avenues:

• Directly report concerns about mistreatment confidentially to the Associate Dean for Student Affairs, the Assistant Dean for Student Affairs, the Vice Dean for Undergraduate Medical Education, the Assistant Dean for Clinical Skills.
• Complete this online form with the option of anonymously reporting a mistreatment.
• Document the mistreatment on course evaluations.

All reports submitted through these mechanisms will be received by the Associate and Assistant Dean for Student Affairs and will be reviewed with the Vice Dean for Undergraduate Medical Education immediately. Trends will be monitored. The individual mistreatment incidents as well as trends will be brought to the attention of the assistant dean for basic science education (if the mistreatment occured during the basic science education) or the assistant dean for clinical education (if the mistreatment occurred in the clinical space) as well as the responsible course or clerkship director and Program director. The responsible supervisor will have ten business days to review the available documentation, discuss with the person accused of the mistreatment, initiate a corrective response and communicate this to the Associate Dean for Student Affairs.

If trends are identified, the Vice Dean for Faculty Affairs (if faculty involved) or Associate Dean for GME (if resident involved), will be notified as well as the Chair, or appropriate administrator at the clinical site.

Incidents submitted through this form may be made anonymously, however, UofL is limited in its ability to investigate and respond to anonymous reports. The preference is for all reports to include contact information such that follow up can occur.

Retaliation against students reporting mistreatment is regarded as a form of mistreatment and will not be tolerated. Accusations that retaliation has occurred will be handled in the same manner as accusations concerning other forms of mistreatments.

If you require an immediate emergency response to protect your safety or the safety of others, notify law enforcement authorities immediately.

LCME Related Elements

Element 3.6: Mistreatment

2.18. Criminal Background Check Policy

A Criminal Background Check will be administered through AAMC on all applicants at the time of acceptance, and on alternate applicants at the request of the Admissions Office. Applicants must consent, submit to, and satisfactorily complete a criminal background check investigation as a condition of matriculation into ULSOM. For more information go to the following web address: https://louisville.edu/medicine/admissions/policies/criminal-background-check-policy.

2.19. Exposure to Infectious and Environmental Hazards Policy

EPC Last Revised: September 16, 2020

Policy:

All medical students will be educated and trained in the prevention of exposure to infectious diseases and environmental hazards including process for evaluation, diagnostic testing and treatment as appropriate. 

A copy of this policy is posted in the on-line Medical Student Bulletin as well as on the School of Medicine Redmed student site at https://redmed.louisville.edu/lcms.

Procedure:

1. Bloodborne Pathogens and Environmental Hazard Training
   1. Students are introduced to the concept of infection control, work-related exposure and environmental hazards upon matriculation through Bloodborne Pathogen and Environmental Hazard Training module at the beginning their first year of medical school and through annual refresher training thereafter.
   2. Training meets all state and federal requirements in the OSHA Bloodborne Pathogen Training standard. 
   3. Student upon completing the training and quiz attest that they have read and understand the BBP and Environmental Hazards Policy. 
   4. Students will receive additional training regarding occupational exposures during Junior Clerkship orientation just prior to starting their junior year.    
2. Information Cards
   1. Students receive a plastic information card that is carried with their ID card that has instructions on the initial management of an exposure or injury and how to contact Campus Health for further guidance.      
3. Exposure or Environmental Hazard Injury Evaluation and Management Procedure:
   1. Immediate First Aid Procedure:
      1. Wash or irrigate blood or other body fluid with soap and/or water.
      2. Mucous membrane exposure – flush with copious amounts of water. 
      3. Report the exposure to immediately to supervisor (resident or attending)
   2. Urgent Follow Up Procedure
      1. Contact Campus Health Services Exposure Hotline at 502-852-6446 as soon as clinically safe to do so but preferably within 1 hour.   
      2. The hotline is answered by the Campus Health Service and is available 24/7 for consultation. 
      3. The hotline is staffed by providers from the Campus Health Service who will assist the student with the assessment of BBP exposures or environmental hazards injuries. 
      4. Students may also simply walk-in to the HSC Health Center for an urgent evaluation and/or treatment for BBP exposures or environmental hazard injuries during regular office hours.  
4. Visiting Medical Students:
   1. All visiting medical students must provide proof of current  bloodborne pathogen and Environmental Hazard training with their VSAS application.
   2. The visiting student coordinator will include information regarding Bloodborne Pathogen Exposure and Occupational Environmental Injury Policy in the student’s acceptance email at least one week prior to their arrival on campus.
   3. The coordinator will also provide instructions on how to attest that they have read and understand the policy.
   4. Upon arrival visiting students will receive an exposure card with the hotline number to carry with their ID badges once the coordinator has verified that the student has attested that they have read and understand the School of Medicine Bloodborne Pathogen and Occupational Environmental injury Policy.
   5. Visiting students follow the same procedures outline in Sections 2 and 3 above and are treated like any other UofL School of Medicine medical student including BBP initial and follow-up testing as well as prophylactic medications for up to 28 days at no cost.     
5. Cost of evaluations and/or prophylaxis

1. All costs of BBP evaluations, laboratory tests, and post-exposure prophylaxis for up to 28 days including serial surveillance testing for up to 6 months for properly reported bloodborne pathogen exposures are covered by Health Professionals Fee at the Campus Health Center. 
2. Any treatment needed for a clinical condition that develops as a result of the exposure or injury are covered by the student’s health insurance policy.
3. Students who are determined to have been exposed to a patient with a communicable illness (e.g. meningitis, hepatitis A) are offered prophylactic medications when determined to be necessary by the Campus Health Service at no cost to the student. 

2.20. Students Infected with Blood Borne Pathogen Policy

EPC Approved: June 3rd, 2020

The intent of this policy to limit the possibility of transmitting a BBP infection to or from a student or patient.  This policy applies to all medical students enrolled in the University of Louisville (“UofL”) School of Medicine (“School of Medicine”), as well as all visiting medical students.

Further, this policy defines the procedures for the assistance of students infected with bloodborne pathogens (“BBP”), which is defined by the Occupational Health and Safety Administration (OSHA) as infectious microorganisms in human blood that cause disease in humans.  These pathogens include, but are not limited to, Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV).

Procedure:

1. Admissions
   1. An applicant’s BBP status will not be used as a determinant of admission or matriculation to the School of Medicine.
2. Bloodborne Pathogen Training
   1. BBP training is required of all medical students upon matriculation and annually thereafter.  Upon completion of the initial BBP training or annual refresher training, students will attest within the training module that they have read and understand the Infected Student Policy.
3. Students Responsibilities and Rights
   1. Responsibilities
      1. Any student engaged in patient-care activities who knows, or reasonably believes that they may be infected with a BBP is expected to seek expert medical advice.  
      2. Any student engaged in patient-care activities who knows, or reasonably believes that they may be infected with a BBP must conduct themselves responsibly for the protection of patients and other members of the UofL community.
      3. To disclose that they have an active BBP infection (disclosure of the specific virus is not necessarily required) to the Executive Director of Campus Health Services, who will arrange for a review by the Expert Review Panel in accordance with Section 5.

1. If a student sustains an injury that may have exposed himself or herself or, if the student is infected and may have exposed a patient to the infected student’s blood or bodily fluid, the student shall immediately notify the attending physician or the responsible faculty member about the incident, who should then communicate with Campus Health Office to initiate an evaluation.
2. Rights
   1. Any student with a chronic BBP infection has the right to request:
      1. Reasonable accommodations for an ADA recognized disability through the University’s Disability Resource Center.
      2. Right to appeal the report provided by the Expert Review Panel in Section 5 to the Dean of the SOM. 
   2. The student has right to have reasonable accommodations including parallel or alternative opportunities for patient-care activities. 

1. Visiting Medical Students:
   1. Must comply with the HSC Immunization Policy.
   2. Must provide proof of BBP and hazards training or complete UofL’s BBP and Hazard Course. 
   3. The visiting student coordinator will include information regarding this policy in the student’s acceptance email at least one week prior to their arrival on campus.
   4. The coordinator will also provide instructions on how to attest that they have read and understand the policy.
   5. Visiting students with an active BBP illness are required to notify the Visiting Student Coordinator before their arrival date.
2. Expert Review Panel
   1. Composition
      1. The panel shall be comprised of, but not limited to, the following individuals:  Executive Director Campus Health Services, infectious disease specialist, specialist in infection control; a medical ethicist, and a representative from the Disability Resource Center.  Additional representatives such as hospital infection control staff are included on an as needed basis to advise in non-voting capacity. 
      2. The HSC Counsel will serve in an advisory capacity but is not a member of the committee.
   2. Purpose of Expert Panel
      1. Determine if reasonable accommodations recommended by the Disability Resource Center can be reasonably accommodated by the SOM
      2. Make individualized recommendations regarding the nature, duration and severity of the risk, the probability an injury will occur, and whether and to what extent reasonable adjustments or modifications can be made to mitigate risk.

1. Provide recommendations for adjustments or modifications for a student infected with an active BBP infection to the Associate Dean of Student Affairs
2. Provide guidance to the student, clerkships, school or affiliated facilities as needed.
3. Provide resources regarding career counseling
4. Process
   1. The Expert Panel reviews the recommends from the DRC and medical history provided by the student.
   2. To protect the student’s identity all information is deidentified during the review process. 
   3. The Expert Review Panel will monitor the status of a student with an active BBP infection, which may include the student undergoing periodic follow-up evaluations in order to furnish a report to the Expert Panel including laboratory studies indicating viral loads, etc.      In cases where a BBP infection has become chronic or progressed additional adjustments or modifications may be made by the committee. 
   4. Although the School of Medicine may be able to operationalize reasonable accommodations and make adjustments or modifications for a student with a chronic BBP infection through graduation, this is not a guarantee that the student, once graduated, can be licensed, secure a residency or other training position, obtain malpractice coverage or disability insurance in any given state due to individual state licensing boards and state laws.
   5. Once finalized by the Expert Panel, a report of the recommended adjustments or modifications, if any, shall be provided to the student and the Associate Dean of Student Affairs for implementation. The Expert Panel may supplement the initial report as needed in the course of monitoring a student. 

1. Appeal Process
   1. A student has the right to appeal recommendations made by the Expert Review Panel by submitting, in writing, a proposed amendment to the recommendations along with the supporting rationale for such amendment to the Dean of the SOM.   A student may submit additional documentation from a healthcare provider in support of the amendment. 
   2. The student shall forward the appeal to Dean of the School of Medicine, along with a copy of the Expert Panel report within ten (10) business days from the receipt of the Expert Panel’s report.
   3. The Dean will review the appeal and provide a written decision within ten (10) business days from the date of receipt of the appeal. 
2. Confidentiality, Limitation of Disclosure, and Notification
   1. The School of Medicine recognizes the importance of protecting the confidentiality and privacy of any student who has an active BBP infection to the greatest extent possible and within the bounds provided by law under HIPAA and/or FERPA.      
   2. The SOM also has the responsibility to protect against a direct threat to the health or safety of others.
   3. The SOM has the responsibility to protect a student with an active BBP infection from being placed in educational situations where the student clinical experience could threaten the health of the student.    
   4. The School of Medicine Expert Review Panel may recommend notification to patients when a student may have exposed a patient to a BBP on a case by case basis after considering the nature and severity of the risk, confidentiality issues and legal responsibilities. 
      1. If the Expert Review Panel recommends patient notification, the panel will submit a written report outlining the facts of the case and the need for patient notification to the Dean of the SOM who will in turn notify the appropriate clinical administrators.

3. Curriculum

3.1. Step 1, Step 2 Policy                                                                 

Educational Program Committee Approved: February 18, 2004 Educational Program Committee Last Revised: June 12, 2024

Step 1

All students are required to pass Step 1 of the United States Medical Licensing Examination (USMLE) at the national passing level prior to progressing in the third-year curriculum. There are some situations, however, that may prevent students from taking and passing the exam according to the usual timeline. The primary purposes of this policy are to ensure all students are engaged in advising that need it, to keep students on time for the optimal progression through the curriculum, and to limit however possible the need for students to take leaves of absences (LOA) related to Step 1 or delay a required clerkship, due to the adverse effect this can have on their fourth-year match schedule.

This policy applies to students in the ULSOM four-year MD program curriculum and students in the Oral & Maxillofacial Surgery (OMFS) program curriculum prior to beginning M3 rotations. Students in the combined MD/PhD program are expected to take the exam prior to beginning the PhD portion of their education (see associated MD/PhD policies).

Step 1 examination is optimally scheduled during May and June following successful completion of the second-year curriculum and an independent dedicated study period. Step 1 may not be scheduled or taken for students who have not completed or remediated all M1-2 curricular requirements.

Below are the specific requirements in place to ensure all students are adequately prepared to take this exam on an  optimal timeline:

1. All students in the independent dedicated study period must submit two NBME practice exam scores for Step 1.  Each practice exam must be taken timed (not on tutor-mode) to be usable to track student progress. Non-timed exam scores will not be accepted. This score and screenshot of the score report should be emailed to the designated individual Affairs from the Step 1 progress committee. Two NBME self-assessment exams are required to test for score validity.
2. Students must submit their first NBME score by the fourth Monday following the beginning of the independent study period or two weeks prior to their Step 1 exam date (whichever comes first). The second NBME score must be submitted one week before their scheduled exam.
3. Students who have not reached that year’s required minimum cutoff score* by the fourth Monday following CBSE or two weeks prior to their scheduled Step 1 exam, are required to engage in the advising process with the Step 1 Progress Committee.
4. Students scoring at or above that year’s required minimum cutoff score*on an NBME self-assessment are required to take Step 1 prior to the start of M3 orientation.
5. Students not meeting the required score on their NBME self-assessment or are not able to schedule the Step 1 exam prior to the M3 orientation will be reviewed for permission to delay their FIRST M3 clerkship and enter the Directed Studies elective.
6. Students who fail to engage with the Step 1 Progress Committee, fail to submit CBSSA scores as directed, or elect to take the exam without meeting the required minimum cutoff score, will receive a Letter of Concern (Policy 5.11 Professional Accountability) which may result in documentation of professionalism concerns in the MSPE letter or a hearing with the Student Promotions Committee. 

DIRECTED STUDIES

Directed Studies is a continuation of Step 1 preparation intended for students who have fully utilized their dedicated study period but require additional time to continue their studies. It is not designed to extend the dedicated study period to allow for vacations, weddings, research, or other events. Acceptance into Directed Studies is determined by the Step 1 Progress Committee and is not guaranteed. Further details regarding Directed Studies are provided below:  

1. In order to be considered for the Directed Studies elective, students must engage with the advising process as laid out by the Step 1 Progress Committee. Students deemed ineligible who still require additional time for exam preparation will need to take a personal leave of absence (LOA) to continue their studies.  

2. In July, students approved for Directed Studies will enter the 1-credit hour Directed Studies course and delay the first scheduled clerkship in their track until the beginning of M4 year. 

3. Earning credit for the Directed Studies elective requires that students continue to engage with the advising process, including reporting scores or emailing/calling with updates, and attending meetings with advisors as required by the Step 1 Progress Committee. 

4. Students must take Step 1 before the end of their directed studies course so that they can start the next clerkship in their previously determined schedule. Failure to do so will necessitate a LOA to continue studying for the exam. 

5. Failure to meet communicated deadlines for score and progress reporting set by the committee will result in the student being withdrawn from Directed Studies and placed on a LOA. 

6.  Students taking a LOA may be required to return any previously disbursed loans that they received at the start of third year. Due to this and other significant financial aid implications, all students taking a LOA who receive financial aid must meet with and discuss their situation with the Financial Aid office prior to making a decision. 

7. Students who take a LOA to prepare for Step 1 must secure a passing score on Step 1 to be re-enrolled in school and return to 3rd year clerkships.

8. Students who delay a clerkship for Directed Studies are not able to be included in M3 class rank calculations.  

*The required score on the NBME self-assessment may change over time due to possible changes in the passing score and is decided yearly by the Student Progress Committee and announced to students prior to the study period.

STEP 2

Students are not permitted to take Step 2 until they have successfully completed all required rotations and courses in years 1-3 of the curriculum. All students are required to pass Step 2 of the United States Medical Licensing Examination (USMLE) at the national passing level during their fourth year and before receiving the Doctor of Medicine Degree. The primary purpose of this policy is to ensure that students finishing their medical education have adequate basic and clinical science preparation to be successful in a residency program and eventually to be licensed.

All students who have not reached the year’s required minimum cutoff score* on the CCSE will be required to engage in the advising process with Undergraduate Medical Education/Student Affairs. This process will require an NBME self-assessment submission at or above the passing cutoff, at least one week prior to their scheduled NBME exam. The practice exam must be taken timed (not on tutor-mode) to be usable to track student progress. Non-timed exam scores will not be accepted. This score and screenshot of the score report should be emailed to the designated individual in Medical Student Affairs.

Students must attempt the Step 2 exam before the last semester of their fourth year. Any exceptions must be approved by the Associate Dean of Student Affairs.

  Failures of Step 1 or 2

When the scores are received, students who did not pass Step 1 or Step 2 exam will meet individually with members of the Step 1 Progress Committee to assess their individual needs and to develop a plan to retake the exam.

Students who receive a failing Step 1score while on a clerkship will be given the option of completing their current clerkship or withdrawing immediately from their clerkship. Students who have not previously taken Directed Studies (above) will be permitted to delay the following clerkship and enroll in the Directed Studies course for up to the length of that clerkship. If students require additional time (beyond the length of the next clerkship) to study for and retake the exam, they must take a formal leave of absence (LOA).

Students who have a failing score on Step 1 will not be permitted to begin a new clerkship without remediating the exam.

Students who are on a leave of absence may be re-enrolled and resume their third-year curriculum only after receiving a passing score for Step 1.

Students will be permitted up to three (3) attempts within a twelve (12) month period. The 12- month period will begin with the date of their first attempt. Failure to secure a passing score by the end of the 12-month period will result in referral to the Student Promotions Committee with the recommendation for dismissal.

*Unique situations will be address an individual basis by the Student Progress Committee.

3.2. M1-4 Curriculum and Electives Policy

Educational Program Committee Approved: February 20, 2013

Educational Program Committee Last Revised: May 17, 2024

The curriculum of the School of Medicine should foster the development of graduates who are knowledgeable, skillful, and ethical while providing an opportunity to individualize the student’s experiences based on his/her own unique needs and interests. Required courses ensure that the program’s objectives are being met and assessed at the minimum expected level for every graduate as required by the EPC for MD program candidates. Electives are provided to broaden and balance the overall educational development of each student, while allowing for career exploration and assuring that students are prepared for their desired area of graduate medical education and residency training.

A candidate for the degree of Doctor of Medicine from the University of Louisville School of Medicine must meet the following requirements:

1. Satisfactory completion of the medical school curriculum and USMLE Step 1 and Step 2 examinations.
2. Satisfactory demonstration of ability, ethical character, responsibility, integrity and professional characteristics suitable for a career in the practice of medicine.
3. Satisfactory discharge of all financial obligations to the University.
4. Students with federal loans and grants must attend a group or individual exit interview with the Medical Student Financial Aid Office and complete the exit interview information sheet as required by federal regulations before Commencement of the year in which graduating.

To satisfy the second requirement above, students must comply with the rules and regulation of the University, the School of Medicine, and the laws of the city, state and federal governments.  In addition, students are expected to possess and, effective interpersonal skills and professional qualities consistent with the expectations of the medical profession.  Consequently, the Dean, in accordance with the procedures set forth in the REDBOOK, may consider any questions of a student's unwillingness, failure, or inability to fulfill these expectations to be an academic matter. The School of Medicine may terminate the attendance of any student at any time or strike from the list of candidates for the degree any student whom the Dean determines is or will be unable to satisfy the standards of professional fitness required of all candidates for the Doctor of Medicine degree.  Conduct that may result in such a determination by the Dean includes but is not necessarily limited to academic dishonesty, neglect of study, and illegal or inappropriate behavior. 

Three-year Rural Medicine Accelerated Track (RMAT) Requirements

The RMAT track may enroll up to two students annually and must require students to complete all of the core objectives and assessments of the four-year MD program as well as a minimum of 130 weeks of instruction prior to graduation. RMAT candidates must also complete additional program objectives and assessments related to their ability to evaluate and address community health needs in a rural setting. Several RMAT-only courses within this track fulfill the required objectives for courses that are not completed by RMAT students and contain the required assessments or equivalent assessments for those courses. Specifically, the courses that are added to the curriculum for RMAT students are: RMAT-1, RMAT-2, RMAT-3, RMAT-4, and RMAT-5 as well as the longitudinal primary care clinic placement during the third year. These courses and requirements are placed in RMAT to fulfill the programmatic objective and assessment requirements found within the M3 Family Medicine Clerkship, the M4 Acting Internship, and M4 Palliative Care Rotation, and the M4 Intensive Care Unit Rotation.

First and Second Year

The first- and second-year curriculum shall consist of 37 required weeks in M1 and 33 required weeks in M2. Students are required to pass or successfully remediate any course in this phase as described in the Student Promotions Committee Guidelines. Students may choose to take EPC-approved electives (if offered); however, electives are not required during the first and second year.

While students are welcome to take electives for elective credit, any electives taken in the first or second year will not count towards elective requirements for the third or fourth year. This includes the required courses for the Rural Medicine Accelerated Track program, RMAT-1 and RMAT-2, should the student elect to leave this accelerated track and return to the 4-year curriculum track. All required course and elective credit hours are calculated according to the EPC’s policy governing awarding credit to courses and clerkships.

Third Year

The third-year curriculum shall consist of 44 required weeks plus 6 weeks that are available for electives. The 44-week curriculum will include seven core clerkships, identified below. The first- and second-year courses must be passed or successfully remediated. Students entering third year will complete rotations in the following clerkships:

• Family Medicine – 6 weeks
• Internal Medicine – 8 weeks
• Neurology – 4 weeks
• Obstetrics and Gynecology – 6 weeks
• Pediatrics – 6 weeks
• Psychiatry – 6 weeks
• Surgery – 8 weeks

Electives:

o There are no required electives in the third year, however, there are 6 weeks in the third-year schedule that can be used for electives or for vacation. Up to 4 of the 6 weeks can be used for career exploration. *Financial aid may be impacted if no electives are taken.

o The Directed Studies elective can be taken during the third year for 1 week of credit. This would count for 1 elective week of the 6-week elective total.

o No more than 6 elective credit hours during third year can apply toward the fourth-year 26-28 weeks of required electives described in the next section.

Fourth Year

The fourth-year curriculum shall consist of 34 required weeks as described below. The third-year clerkships must be passed or successfully remediated prior to entering this phase of the curriculum. Students must complete all of the requirements below as well as the minimum required weeks of elective time in order to graduate from the MD program. Students have the responsibility of thoroughly investigating electives and then discussing them with an advisory dean, clerkship or residency program director, faculty mentor, or the Assistant or Associate Dean of Student Affairs who then must approve the student’s schedule. The signed approval form must be returned to the registrar in Student Affairs.

• Acting Internship (Anesthesia, Emergency Medicine, Family Medicine, Internal Medicine, Neurosurgery, Obstetrics & Gynecology, Orthopedics, Otolaryngology, Pediatrics, or Surgery) – 4 weeks. Acting internships must be completed at the student’s home institution.
• Intensive Care rotation (Medical, Surgical, or Pediatrics) – 2 weeks
• Palliative Medicine rotation – 1 week
• Advanced Cardiac Life Support (ACLS)
• Topics in Clinical Medicine (TCM) Course
• Electives – 26-28 weeks  

a)  Up to 6 weeks of electives available in third year may be used to fulfill part of the fourth-year requirement. The Directed Studies elective can be used during third year to fulfill 1 week of this requirement; students can take the Directed Studies a second time during fourth year for an additional 1 week of elective credit.

b)  Students may take up to a maximum of 16 weeks of electives at other institutions.

1. Electives should be planned to include Residency Preparation Track Recommendations and other areas of interest.

3.3. Comprehensive Basic Science Exam for Second-Year Students and Comprehensive Clinical Science Exam for Rising Fourth-Year Students

Educational Program Committee Approved: November 19, 2014

Educational Program Committee Last Revised: April 17, 2023

All second-year students are required to take the Comprehensive Basic Science Self-Assessment (CBSE) offered by the National Board of Medical Examiners. The cost of the required CBSE will be covered by the School of Medicine. This is a proctored standardized examination provided by the NBME

All rising fourth-year students are required to take the Comprehensive Clinical Science Examination (CCSE) as they finish their required M3 clerkships. Several dates will be offered by the UME office due to the different dates that students finish their requirements, and students are expected to schedule with the UME office for the available date that is closest to the end of these required clerkships to plan their study for Step 2 CK.

The purpose of requiring students to take both examinations at these points in their curriculum the CBSE is to help students identify areas of strength and need as they enter dedicated Step 1 and Step 2 study and to evaluate students’ long-term retention of curricular material over time.  Support and advising is available to all students following these examinations.

4. Student Assessment and Academic Performance

4.1. Non-Involvement of Providers of Student Health Services in Student Assessment/Location of Student Health Records

EPC Revised: September 16, 2020

Non-Involvement of Providers of Student Health Services in Student Assessment

Students have the right to strict confidentiality of their health and medical conditions, inclusive of both physical and mental health or learning disability.

Any clinical preceptor and/or faculty member who provides psychiatric care, psychological counseling or physical health services to a student must have no role in the academic assessment of, or in decisions about, the promotion or graduation of that student.

Likewise, advisory deans must have no role in the academic assessment or promotion of their assigned mentees.

This policy does not prevent clinical preceptors and/or faculty from treating students in an emergency situation. In these instances where students are treated by clinical preceptors, care should be handed over to qualified clinicians after the student is stabilized. In all such cases, decisions should be made with the best interest of the student’s health taking precedence. Once a preceptor has provided clinical care, he/she cannot be that student’s primary assigned clinical instructor or evaluator.

Clinical preceptors and/or faculty members who have provided clinical care services to a student may function as a large-group classroom teacher and may provide general support for classroom-based learning experiences. However, they may not participate in assessment or grading activities for that student.

A formal statement will be included on both student and faculty evaluation forms for all third-year clerkships, acting internships, intensive care rotations, palliative care rotations, Humanism and Compassion in Medicine sessions, and Problem-Based Learning (PBL) sessions. On the student evaluation form, the statement reads, “To my knowledge, I (Students will mark have or have not) received psychiatric, psychological counseling, or other health care services from this faculty/fellow/resident. On the faculty/fellow/resident evaluation form, the statement reads, “To my knowledge, (Faculty/resident/fellow will mark have or have not) provided psychiatric, psychological counseling, or other health care services to this student.”

Any member of the Student Promotions Committee is required to recuse him or herself if they have been involved in providing psychiatry, psychological counseling, or other health care services to the student being discussed.

This policy will be included in all required course and clerkship syllabi. This policy will also be discussed at all student orientations and at the annual new faculty orientation and the new resident orientation.

Location of Student Health Records

All student health records are subject to HIPAA and FERPA requirements for confidentiality and are stored in an electronic medical record (EMR) in a special security group within Campus Health.  Mental health records for psychiatry and counseling notes are secured and accessible only to the mental health care providers and executive director of campus health services.  The security lock on mental health records cannot be accessed utilizing “break glass”.  No medical school personnel have access to the records.   

4.2. Standardized Grading, Honors, & Remediation Policy

Educational Program Committee Approved: April 18, 2012

Educational Program Committee Last Revised: May 17, 2024

Required M1-2 Courses

To increase the consistency of student assessment between courses within the educational program, 1^st and 2^nd year courses will follow the requirements below. Introduction to Clinical Medicine (ICM) courses 1 and 2 are exempt from any regulations marked with an asterisk*:

1.     All M1-2 courses will be graded Pass/Fail.

2.     Course grade composition will consist of 70-80% high stakes assessments (e.g., high stakes exams, NBME custom exams, clinical skills exams) with 20%-30% formative, low-stakes assessments (e.g., PBL, TBL, SoftChalks, quizzes). *

3.     Course or thread directors must monitor student aggregate performance on high stakes exams and make corrective adjustments if assessments perform outside the expected acceptable performance range. Course leadership will perform this review with support from UME, including providing past performance data, statistical and qualitative analysis of item and exam performance as well as course overall performance, and identification and analysis of factors influencing the educational experience and student performance on assessments. Review will be performed after every major examination and again at the end of the course. Decisions made by the course director following these reviews are final.

4.     Actions taken by course directors after analysis and discussion with UME may include, but are not required to include:

a. Adjustment of exam or quiz scores either immediately following an assessment, or at the end of the course when performing retrospective review of overall performance.

   b. Accepting additional answers or all answers for items that perform poorly.

c. Addition of points to any assessment grades as appropriate, limited by the top scoring student in the class for that assessment, whose score cannot exceed 100%.

  5. Universal minimum criteria for “Pass” vs “Fail” grades:

a. ≥70.0% minimum overall course grade required by all courses (rounding is not permissible).

b. A ≥70.0% average on the summative exams within the course is required to pass, regardless of overall grade average.

i.  High stakes exams include section, unit, or module exams; NBME custom exams; and other high-stakes exams that assess knowledge prior to going on to new material within a course or to other courses.

ii. Courses may have additional Pass/Fail requirements that are outlined in the syllabus.

6.   Final course grades in all courses, including ICM 1 and ICM 2, must accurately reflect the results of all of the evaluation methods used in a course in a student’s grade. Comments made on any assignment or evaluation that recommend failing a student must be investigated by the course director and if substantiated by the course director is sufficient grounds for course failure despite overall grade average.

7.    Courses that require cumulative NBME custom examinations will award 12.5% percent of the overall course high stakes assessment grade from this source in M1 and M2. There are no “must-pass” final examinations in M1 and M2.    

8.   Remediation of courses: See Remediation Policy for M1-2 Major Courses (4.9)

Required Clinical Clerkships

GRADING POLICY

To increase the consistency of student assessment between courses within the educational program, all M3-4 courses will use the following grading criteria:

1. Overall grades for clerkships will follow this rubric:

a. NBME shelf exam equated percent correct score = 40%

b. Evaluation score = 40%

c. Administrative responsibilities = 5%

d. Other course components, at clerkship director discretion =15%

2. All M3-4 courses will be graded Honors, High Pass, Pass, or Fail. Each clerkship’s threshold score for Honors, High Pass, and Pass will be determined separately.

a. Honors: All passing range evaluations, fulfills all administrative responsibilities, and meets the    Honors Score threshold for each clerkship (see clerkship syllabus for details).

b. High Pass: Does not meet Honors criteria, however, has all passing range evaluations and meets the      minimum High Pass Score threshold set for each clerkship (see clerkship syllabus for details).

c. Pass: 4^th percentile on the NBME shelf set for each clerkship (see clerkship syllabus for details) of the student’s year AND all passing range clinical evaluations AND ≥70% average in the course overall. Students who do not meet all 3 of these requirements have failed the course. Off cycle students will be evaluated for pass/fail based on the number of clerkships they have completed to date.

   d. Fail: Students may receive a grade of “Fail” for the following reasons:

              i. Failure to achieve the 4% threshold for each clerkship’s NBME Shelf Exam

             ii. Receipt of a “Fail” on a clinical evaluation (See below)

             iii. Gross professionalism violations, academic dishonesty, or medical malfeasance, or other conduct deemed worth of Failure by the Clerkship Director

             iv. At the discretion of the Clerkship Director

3. Failing NBME Shelf: Students who fail the NBME shelf examination for a single clerkship will be given an “incomplete” grade for the clerkship and allowed to retake a different NBME shelf exam for that clerkship at the end of the M3 year. The pass/fail decision for this shelf retake will be based on the academic year that they failed the clerkship shelf regardless of when the retake occurs. Students who pass the retake shelf using the criteria above will have their incomplete grade corrected to “Pass”, a notation made in the RedMed gradebook, and their new transcript grade resubmitted. The student will receive the minimum passing NBME shelf score and course grade will be recalculated. Students who fail the retake the shelf using the criteria above will have their “incomplete” grade changed to “failure” and required to meet with the Student Promotions Committee.

Students who fail the clerkship or fail the shelf retake and who are required to repeat the entire clerkship will have their original clerkship failing grade recorded on their transcript, in RedMed, and for class rank purposes. Their retake of the entire clerkship will give them a new, additional grade that is calculated and weighted according to the rules of the academic year that they repeat the clerkship.

4. Failing Clinical Evaluations: A failing clinical evaluation or written recommendation to fail a student from any evaluator, regardless of numeric evaluation grade, if investigated and substantiated by the clerkship director, is sufficient grounds for clerkship failure despite overall grade average or shelf score.

1. Withholding Honors/High Pass: The clerkship director or clinical department reserves the right not to award Honors or High Pass scores if the student demonstrates a deficiency in any core competency (patient care, medical knowledge, interpersonal and communication skills, systems-based practice, practice-based learning and improvement, professionalism) regardless of numerical score.

CLERKSHIP EVALUATIONS

All clerkship directors will have authority over instructors providing graded student evaluations and written feedback. Specifically, clerkship directors can delineate who evaluates students during clerkships. Clerkship directors shall have oversight in the mechanism of student evaluation grade calculation and components.

Students may participate in the selection of their evaluators only at the discretion and direction of clerkship directors.  Completed clinical evaluations as assigned by clerkship directors and coordinators will stand as submitted, pending CD review for extenuating circumstances. If it is perceived that students have attempted to solicit or produce evaluations from biased or non-representative sources, that student may be given a grade of “fail” for either/or their evaluation grade and clerkship grade as decided by the clerkship director. Additionally, students who attempt to falsify or manipulate evaluations will be subject to the ULSOM Code of Conduct (5.2).

MID-CLERKSHIP (FORMATIVE) FEEDBACK

All clerkships shall provide mid-clerkship feedback to students.  Residents should be encouraged to contribute to mid-clerkship feedback, however attendings are ultimately responsible for providing feedback and signing the mid-clerkship feedback form.

Mid-clerkship feedback must be delivered by the midpoint of the clerkship.

Clerkship directors are required to review all clinical evaluations and meet with any student found to be at risk for failure based upon written feedback. This meeting should be used to develop an action plan to help the student improve performance. 

Mid-clerkship feedback practices must be described in each course syllabus; these will be reviewed by the UME and reported to the EPC each year.

OSCE PERFORMANCE FOR CLERKSHIPS

Student performance on OSCEs/SP Encounters will be monitored through all clerkships and followed by the by either the M1/2 or M3/4 subcommittees as lead by the SP Director. Those students whose performance falls outside one standard deviation below the mean/median score on two separate OSCEs shall be required to remediate these OSCEs until a passing score can be achieved. This remediation will occur following additional instruction as outlined by the Clinical Skills Committee, under the direction of the Assistant Dean for Clinical Skills and the SP Program Director.

CLERKSHIP REMEDIATION

1. A student may not remediate a clerkship without going through Student Affairs.

2. Passing grades must be attained on all remediated work.

3. Remediation of a clerkship is not permitted until the end of the academic year.

4. Student Affairs will address all special situations.

4.3. Grade Reporting and Testing Policy

Educational Program Committee Approved: January 16, 2013
Educational Program Committee Last Revised: May 17, 2024

1.     All course/clerkship requirements, including examinations, should be completed by the last day of a course/clerkship, unless extenuating circumstances are documented.  These special cases should be handled by course or clerkship directors on an individual student, case-by-case basis.

2.     Decisions about honors/pass/fail criteria developed by clerkship faculty and pass/fail criteria by course faculty must be in compliance with any applicable Educational Program Committee (EPC) or School of Medicine (SOM) guidelines.

3.     All course and clerkship grades must be released to students and to Student Affairs within four to six weeks of the last day of a course or clerkship rotation.  In addition, students must receive written evaluation comments with their final clerkship rotation grades.

4.     The UME Coordinator will report any course or clerkship with grades not received within four weeks after a course or clerkship rotation ends to the Vice Dean of Medical Education.  The Vice Dean will contact the course or clerkship director and advise the date by which grades absolutely must be received by students (i.e., the date that falls six weeks after the end of the course/rotation).

5.     The undergraduate medical education office tracks course and clerkship grade receipt dates, and confirms all courses andclerkships were in compliance .

6.     The senior registrar will provide an official annual report to the EPC in September of each year regarding grade report dates. The report will include ending dates of courses and clerkship rotations, the date grades were received for each, and whether or not grades were received within the six-week time frame.  The September report should be a cumulative report for the full academic year.

7.     1.     In addition to senior registrar reports, course and clerkship directors will report compliance with grades being issued to students within six weeks of the end of the course or clerkship on their annual course or clerkship director portfolio questionnaire.

8.   Deferred grades may be awarded only to students who are unable to complete a preclinical course due to illness or other unforeseen circumstances; a deferred grade may not be awarded to a student in academic difficulty.

9.   All required courses will be included in class rank computations.

Electronic Exams

Technology Failure:

The following rules apply when a student experiences problems during an electronic exam:

1. Any regional campus issues, i.e., a power failure at one campus or fire drill at one campus that does not affect another campus, will be handled regionally according to the guidelines.
2. Students should immediately report to the exam monitor when experiencing issues with their computer during an exam.
3.  If the issues cannot be resolved with the exam monitor, a representative from IT will assess the issue and work to resolve any technical difficulties.  The IT representative will report findings to the Senior Associate Dean for Undergraduate Medical education and clerkship/course director, who will determine whether the reported technical issues could affect a student(s) exam outcome.  
4.  If any reported technical issues were deemed to directly affect a student(s) exam outcome, the following steps will be followed:
5. If a technology failure occurs during the block of time when an exam is scheduled, students are required to to stay in the exam room until formally dismissed by SOM faculty or staff.
6. The Senior Associate Dean and clerkship/course director will determine whether the technical issue was on the part of the user, ULSOM or the software team providing the exam.
7. If the ULSOM or the software team providing the exam is responsible for the reported technical issues, the course/clerkship director will work with the Senior Associate Dean of the UME to determine a retake exam date based on availability of a new exam and open days for testing. 
8. An option to retake the exam on the agreed date, as determined by the clerkship/course director, will be offered to affected students.
9. If a student(s) opts to retake the exam, he or she must accept the retake exam outcome as the final grade.  He or she will not be able to choose the higher of the two grades. 
10. If technology failure or other event/disaster prevents all students from starting the exam, or interrupts the testing experience for all students, the clerkship director and UME office will be notified, and the following procedure followed:
    • If the exam never started and service is not reestablished:
      • Students will be given permission to leave the testing room and instructed to check their email for updates. It will be the goal to re-launch the exam as soon as service is restored.
      • Students will be instructed to stay on campus and given updates 15 minutes before the hour letting them know if they should return to the testing room to start the exam.
      • Updates will be given to the students via email by the clerkship director or coordinator.
      • If service is not restored, the exam will be rescheduled for the first day possible the next week, and students updated via email when the rescheduled date and time and location is known.
      • Students who have vacation in the week following an exam interruption or failure that cannot be corrected will have their exam rescheduled the day that they return from vacation.
      • Students who are starting another course the next working day will be scheduled for their exam at the soonest date possible in cooperation with the course director for that next course.
      • Clerkship directors and UME office staff and faculty will work together with the next clerkship on the track schedule to ensure that the rescheduled time and date is chosen collaboratively with minimal impact on the next clerkship.
    • If the exam is started but service is interrupted, affected students will be required to stay in the exam room as staff and faculty contact the NBME/ExamSoft and work to restore service.
      • Students will not be able to access their belongings or phones or talk to each other during this time as they have had access to the exam questions.
      • If a prolonged outage occurs the exam will be canceled and a new exam date rescheduled using the process above.

4.4. Administrative Responsibilities Grade Policy

Educational Program Committee Revised: May 3, 2022

The Administrative Responsibilities grade is intended to credit students for timely and attentive participation in their learning process.  The grade should comprise 2.5% of the final grade and will be based on the student’s participation in formative feedback, completion of case logs, duty hour reports, and documentation of self-directed learning when applicable.  The clerkship may include additional components in their syllabus that contribute to this grade.  Student will receive 0% for any instance of non-compliance or 2.5% for full compliance.  Students must complete the Administrative Responsibilities criteria to be eligible for Honors.

Students will receive a one-time reminder in each clerkship to log administrative information. points will not be awarded to a student that fails to complete all administrative responsibilities.

4.5. Approved Formats for Graded Assessments

EPC Reviewed: February 19, 2020

 Approved written assessment formats for all years based on best practice guidelines include:

1. Essay questions, provided they have a clearly written rubric prior to the exam that reflects scoring, including points given for partial credit;
2. Short-answer questions, provided they have a clearly written best answer rubric prior to the exam that reflects scoring, including points given for partial credit and allowance for synonyms or spelling/grammatical errors that do not change the meaning of the answer given;
3. Fill-in-the-blank questions, with a written best answer and synonyms for the best answer accepted for the same credit;
4. One-best-answer multiple choice questions, including extended-choice type questions (choices A-H);
5. Matching questions;
6. Vignettes that give rise to multiple linked questions within the same assessment;
7. Negative stem, “none of the above,” or K-type questions will not be accepted in graded assessments.

General best practice rules for writing one-best-answer items:

1. Each item should focus on an important concept that links back to a specific learning objective assigned by faculty;
2. Each item should assess application of knowledge, not recall of an isolated fact;
3. The stem of the item must pose a clear question about the specific problem or situation described in the stem, and it should be possible to arrive at an answer with the options covered (i.e., do NOT use, “Which of the following statements is correct about this diagnosis?” but rather, “Which of the following risk factors in this patient’s history increased the likelihood of contracting this disease?”);
4. All distractors must be homogeneous, i.e., should fall into the same category as the correct answer (e.g., all diagnoses, tests, treatments, epidemiologic data, etc.);
5. Avoid technical item flaws that give the answer away or add irrelevant difficulty (e.g., one or more distractors do not flow grammatically from the stem, uses absolutes like “always” or “never” in answer choices, uses imprecise statements about frequency like “often” or “usually” that test takers will interpret variably).        

4.6. Appeal Policy for Course and Clerkship Grades

4.7. Awarding Credit Hours to SOM Courses and Clerkships

EPC Reviewed: August 22, 2020

Introduction:  The University of Louisville policy states that “in general, one credit hour of lecture, discussion, or seminar requires at least 50 contact minutes per week during a regular semester.”

Historically, the number of credits per course has been determined by “face to face contact time.”  For the past year, the Educational Program Committee (EPC) has been reviewing credit hours for all required SOM medical student courses, primarily due to changes in course hours and design of the courses themselves.  The University also requires all units to submit documentation of the unit’s process for assigning credits to courses.  This policy governing credits in the MD program for the School of Medicine supports most strongly LCME elements 6.3 and 8.8. Element 6.3 exists to ensure that teaching and assessment of self-directed learning skills is taking place within the formal curriculum. Element 8.8 exists in part to ensure that sufficient time is preserved in the student class schedule for students to complete additional self-directed learning on their own time outside of required class activities.

The EPC uses the guidelines below for assigning credit hours, effective AY 2016-2017. 

Guidelines for Preclinical Courses:

1. The total number of credits for each preclinical required course will be calculated as follows: all required course learning activities will be totaled using the list of EPC-generated learning experiences (see number 2 below).  This total will be divided by 15 (the nationally used average for weeks per semester), which will produce the total number of credits for each course.  The EPC will round off to the nearest credit or half credit. 

1. The following required learning experiences will be used to calculate credit count for preclinical courses: live or recorded lecture, independent study, formal/scheduled test preparation or test review sessions, small group activities, preceptor/shadowing experiences, team-based learning (TBL), problem based learning (PBL), standardized patient encounters, laboratory sessions, clinical correlations (lectures), and patient simulation experiences. 

For example, a course that includes the following required learning activities will be listed as a 3 credit hour course: 35 hours of lecture, 5 hours of lab, and 7 hours of independent learning activities will be a 3-credit course (total = 47, divided by 15 = 3.1, which, when rounded off to the nearest half credit would be 3 credits).

1. In general, only learning experiences that are required and structured will be used to calculate course credit hours.  Self-directed learning occurring outside of the classroom environment will NOT be included in the credit hour calculation.  Other activities not included are homework, studying, practice questions, quizzes and examinations. It is anticipated that medical students will spend an average of 40 hours per week in out-of-class self-directed learning activities.

1. The EPC will be consulted to address questions regarding credit hour calculations.

Guidelines for Clinical Courses:

1. “Clerkships” are courses that require student attendance and work primarily in the clinical care environment with some classroom contact time Clinical work can range based on patient needs, season of the year, and area of study between 40-80 hours per week. The total number of credit hours for each required clerkship will be calculated using a 1 week = 1.25 credit hours formula.  For all other clinical rotations, they will be calculated using a 1 week = 1 credit hour formula.

Distinguishing between Independent Learning and Self-Directed Learning:

• Independent study: Opportunities either for medical student-directed learning in one or more components of the core medical curriculum, based on structured learning objectives to be achieved by students with minimal faculty supervision, or for student-directed learning on elective topics of specific interest to the student. (Element 6.3)
  • Independent learning experiences support the LCME “self-directed learning” standards 6.3 and 8.8 and are generally a replacement for content that was previously taught via lecture, ex. online learning modules, posted resources with specific learning objectives and self-assessments, etc.  Independent learning activities are linked to assessments in the course, will be included in credit hour calculations, and will appear on the schedule.
• Self-directed learning: Includes medical students’ self-assessment of their learning needs; their independent identification, analysis, and synthesis of relevant information; and their appraisal of the credibility of information sources. (Element 6.3)
  • The LCME definition above of self-directed learning can occur as part of scheduled class time with peers in a group learning environment, or out of class based on the students’ needs. Some self-directed learning is required as part of the formal curriculum and is linked to assessment, ex. problem-based learning sessions.
  • Self-directed learning that occurs as part of scheduled class time with peers in a group learning environment and has an attendance and assessment requirement will appear on the schedule and will be included in credit hour calculations (ex. problem-based learning case times).
  • Additional self-directed learning that happens outside of the classroom on the student’s own time will not appear on the schedule and will not be included in credit hour calculations (ex. completing extra practice questions, homework, researching topics, reviewing assigned readings or class materials to deepen learning.)

4.8 Distinction Track Policy

4.9 Summer Remediation Policy for M1-2 Major Courses

Educational Program Committee Approved: June 12, 2024

General Eligibility Criteria
• A student is eligible for summer remediation if they fail a major course (defined as greater than four credit hours) during the first or second year of medical school.
• Eligibility requires passing 50% or more of exams and achieving a final high-stakes grade of 68% or higher (No rounding of grade is allowed).
• Summer remediation is already available for courses less than four credit hours.

Major M1/M2 Courses and Exam Requirements
• Clinical Anatomy, Development, and Examination (CADE): Must pass three of six high stakes, written exams (not practical) to be eligible for remediation.
• Molecular Basis of Life, Defense, and Disease (MBLDD): Must pass three of six high stakes exams to be eligible for remediation.
• Human Systems in Health and Disease (HSHD1): Must pass three of five high stakes exams to be eligible for remediation.
• Human Systems in Health and Disease (HSHD2): Must pass two of four high stakes exams to be eligible for remediation.

Limitations
• Any student who has previously failed a major course is not eligible for remediation of any major course.
• Students may only remediate one major course in the first two years. If a student fails an additional major course, they must appear before the Student Promotions Committee.
• Students can refuse summer remediation and repeat the failed semester the following year. However, these students will not be eligible for future summer remediation of a later failed M1-2 major course.

Remediation Schedule and Structure
• Remediation is only offered in the summer.
• There will be a minimum one-week break after the end of the spring semester before remediation starts.
• Remediation will consist of a six-week block.
• There will be a final NBME custom exam at the end of the six-week block, covering the entirety of the remediated course. Students must make a 70% or higher on the NBME custom exam to pass remediation.
• The highest grade achievable through remediation is 70%.
• Efforts will be made to set the P value of NBME custom exams at ~82%.

Additional Course Remediation
• If the Student Promotions Committee approve the remediation a major course and minor course, then remediation for the Biostatistics and Evidence-Based Medicine and the Introduction to Clinical Medicine courses will follow successful remediation of the major course, before starting M2 or entering the Step 1 study period.

Exam Scheduling
• Exams will be conducted on the undergraduate medical education (UME) schedule, not on a student-preferred schedule. All students from the same year will test on the same day.

Academic Probation and Support
• Students failing a major course will be on academic probation until the successful completion of two additional semesters.
• Students must meet with a learning specialist to create a learning strategy and work with a tutor from the time of failure, through remediation, and the following semester.
• Students must engage with the academic advising system weekly (learning specialist/student success coordinator).  Students must meet with supervising faculty upon faculty request. 
• The student will be referred to the Student Promotions Committee if they are non-compliant with academic advising and communications during remediation.

Grading and Records
• Students eligible for remediation will receive a failing grade for the course initially. If they pass remediation, a separate grade of “pass” will be entered on the transcript. If they fail remediation, the grade will remain “fail” and the student will be referred to the Student Promotions Committee to repeat the semester, the year, or face dismissal.
• Remediated work will be noted on the Medical Student Performance Evaluation (MSPE).

4.10. Good Standing Policy

Educational Program Committee Approved: September 6, 2023

All ULSOM students are expected to remain in good standing throughout their time in medical school. A medical student in good standing has met the academic and professionalism requirements of the medical school and is eligible to continue enrollment, while not being subject to any form of remediation, probation, suspension, or disciplinary censure.

A student in good standing:

1. Has received the minimum required ULSOM passing grades in all courses, clerkships, electives, standardized patient exams, and other mandatory requirements/exercises
2. Is not currently on academic probation
3. Has passed the appropriate USMLE exams within the recommend time period during medical school
4. Makes adequate progress towards graduation
5. Completes all required immunizations, certifications, and trainings (HIPAA, OSHA, etc.)
6. Conducts themselves in accordance with the professional and academic ethics governed by the UofL Code of Conduct and ULSOM Honor Code as well as other professionalism requirements governed by ULSOM policies: School of Medicine Policies < University of Louisville
7. Has not been the recipient of any adverse actions or sanctions by either the medical school (Student Promotions Committee) or by the University

Loss of good standing:

1. Loss of good standing ends a student’s eligibility for some special programs or activities which include, but are not limited to, the following:
   1. Eligibility to run or retain an elected school office
   2. Eligibility to be appointed to or retain scholarly appointments:  ex. Includes such positions as course representatives, academic officers, EPC representatives, admission committee representative, student promotions committee representatives
   3. Eligibility to be considered for or continue in the Distinction Tracks (see Distinction Track Policy for specifics)
   4. Eligibility to be considered for internal awards
   5. Eligibility to be recommended for external awards, scholarships, membership for national organizations or educational experiences
   6. Eligibility to be approved for conference travel
   7. Eligibility to take clinical electives at other institutions
2. Loss of good standing may result in loss of scholarships depending on individual scholarship criteria.

Return to good standing:

1. A student may return to good standing upon completion of the required remediation, or upon completion of the required probationary time frame.

5. Professionalism and Promotion

5.1. Medical Student Performance Evaluation & Medical School Transcript Policy

EPC Approved: September 4, 2019

MSPE

The MSPE is comprised of School of Medicine’s identifying information; three noteworthy characteristics written by the student (approved by Associate Dean for Student Affairs unless student requests another person), academic history, professional progress, academic progress (including academic performance, preclinical coursework and clerkship evaluations) and a summary statement.  The MSPE is a template with the student’s information and clinical evaluations and is generally signed by the Associate Dean for Student Affairs. If a student has concerns regarding a potential conflict of interest with the Associate Dean the student may request to have the Assistant Dean for Student Affairs or the Vice Dean for Undergraduate Medical Education work with him/her on his/her MSPE and sign the document.

All students will have an individual meeting with Associate Dean for Student Affairs in the spring of their third year, unless another of the Dean’s representative (see above) is designated.  At this meeting they will discuss their career plans, CV and their completed MSPE questionnaire, along with three noteworthy characteristics. All students will have their final noteworthy characteristics to the Residency Match Administrator by July 1.

All students will be able to review, in person, a copy of the first draft of their MSPE in early September. Students will review the letter and request corrections to any clerical or typographical errors, while in the Student Affairs office.  Any errors noted by the student will be edited and the student will sign a release for the MSPE to be uploaded to residency application services for distribution to programs.  The MSPE cannot be photographed, copied, or taken out of the office by the student. 

A student who has substantive concerns regarding the tone and/or accuracy of their MSPE can submit a written request with the specific concerns noted, to the Residency Match Administrator within 48 hours of reviewing the MSPE. An advisory committee consisting of undergraduate medical education leadership will review the draft MSPE with the noted concerns and if warranted, will amend the MSPE for balance and accuracy. The review committee’s decision and any MSPE amendments will be conveyed in writing to the student. The decision of the review committee will be final and the approved document will be the final MSPE.  The student may review final edits and sign a release to allow the school to upload the document to residency application services to be distributed to residency programs.

MEDICAL SCHOOL TRANSCRIPT

A copy of each student’s transcript will be uploaded in mid-September so that it will be available to programs when they begin downloading residency applications on October 1.  Students must sign a release to allow the school to upload the document to residency application services to be distributed to residency programs.

An updated copy of the transcript will automatically be uploaded by the Student Affairs office if a student has a third year clerkship grade added after September 15.

A student may request one updated transcript be uploaded to residency programs at any time before rank begins.

All students must sign the MSPE and medical school transcript release form for these documents to be uploaded and sent out to residency programs.