Course Director's Guide

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School of Medicine Policies

MISTREATMENT POLICY

All mistreatment is of serious concern at this institution and is strictly prohibited. The institution does not tolerate retaliation of any kind for reports of mistreatment. It is the policy of the Medical Center and the School of Medicine to maintain an educational environmental and workplace free from any type of mistreatment. The School of Medicine recognizes that in some instances, the perception of the individual who believes he or she was mistreated and the intent of the other person(s) involved are conflicting. Whatever the circumstance, students who believe they were mistreated are strongly encouraged to bring it to the attention of appropriate institutional officials (see below). Categories of mistreatment include general mistreatment, discrimination and sexual harassment.

General Mistreatment

The individual considering making a report of general mistreatment should first, if at all possible, attempt to resolve the matter directly with the alleged offender. Students may consult the associate dean for student affairs and/or the vice dean for medical education at any time for assistance. Such informal consultation always will be confidential, unless precluded by safety of the student or institutional policy. Students have the right to report such incidents without fear of retribution or retaliation. General mistreatment comes in many forms, including but not limited to verbal abuse, public humiliation, intentional neglect, assignment of tasks in retaliation, belittlement and unreasonable/intentional exclusion from an educational opportunity. For conduct to violate this policy and be considered general mistreatment, it must be more than merely offensive; it must be so objectively offensive and/or repeated, pervasive or severe that it effectively denies the victim access to UMMC’s resources and opportunities, unreasonably interferes with the victim’s environment or deprives the victim of some other protected right. Formal complaints of general mistreatment regarding faculty, residents and staff are made through the associate dean for student affairs and/or the vice dean for medical education to the director of human resources or the assistant director for equal employment opportunity. Formal complaints of general mistreatment regarding other students are handled through the School of Medicine’s Policy on Professional Behavior and made through the associate dean for student affairs and/or the vice dean for medical education. All formal complaints must be in writing and will be investigated. The institution investigates and responds to all reported incidents in a timely fashion.

Discrimination

Under Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act and their implementing regulations, no individual may be discriminated against solely on the basis of age, race, gender, religion, national or ethnic origin, disability, sexual orientation or veteran status. Allegations of discrimination (in any category) against a student must be reported immediately through the associate dean for student affairs and/or the vice dean for medical education to the director of human resources.

Sexual Misconduct

UMMC prohibits sexual misconduct in any form, including sexual assault or sexual abuse, sexual harassment and other forms of nonconsensual sexual conduct. Title IX of the Education Amendments of 1972 prohibits discrimination based on sex in education programs and
activities. It is the position of UMMC that sexual misconduct in any form will not be excused or tolerated. Criminal, civil and university disciplinary processes are available to a student or employee with a complaint. UMMC is committed to prompt, effective and fair procedures to investigate and adjudicate reports of sexual misconduct and to the education of the university community about the importance of responding to all forms of sexual misconduct. Special emphasis is placed on the rights, needs and privacy of the student or employee with the complaint, as well as the rights of the accused. At the same time, UMMC adheres to all federal, state and local requirements for intervention and crime reporting related to sexual misconduct. Students who believe they have been a victim of sexual misconduct are encouraged to contact the associate dean for student affairs and should submit a complaint against the accused in writing or in person to the Title IX coordinator, Office of Human Resources, (601) 815-5150. Students also are encouraged to immediately contact the UMMC Police Department (601) 815-7777 and/or call 911 if they have been sexually assaulted and to seek immediate medical attention. Students should seek medical attention even if they do not wish to pursue criminal charges or otherwise pursue a complaint against their alleged attacker. Students are strongly encouraged to read the entire UMMC Sexual Misconduct, Sexual Assault and Sexual Harassment Policy and Procedure (Title IX) for Students and Employees at https://www.umc.edu/Education/Academic_Affairs/Current_Students/Mistreatment_Policy.aspx.


POLICIES FOR CLINICAL CLERKSHIPS

Each of the policies below should be communicated to the students in the course syllabus.

  • Board Examination Failure Policy: The consequences for a first failure of a clerkship board examination will be to retake the examination as scheduled by the administration and course director. The student will receive an excused absence from the current course in order to re-take the failed examination. For a second failure, the student will be required to repeat the clerkship for which the failure occurred. For a third failure, the student will be referred to the Promotions Committee for further consideration. Such referrals should be made to the assistant dean for academic affairs. After receiving a passing score, students with more than one attempt on an examination, will have the minimum passing score for the exam (the lower limit of the Hofstee compromise) used to calculate the final grade in the course.
  • Clinical Skills Assessment (CSA) Failure Policy: Any student that fails a CSA examination will remediate it the next time it is offered at the Clinical Skills Center. The student will be released from duties of the current clerkship to attend this remediation examination. The student will have an incomplete for the clerkship under remediation until remediation is completed. If the student fails the remediation examination as well, then he or she will be required to repeat the entire clerkship, potentially delaying promotion to the next stage of training.
  • Absence Policy for Third Year Core Clerkships: Per the SOM policy on duty hours, each student is required to have 1 day free of clinical duties and formal educational activities per week, when averaged over 4 weeks. For example, for a 2-week clerkship, a student can expect 2 days off; for a 4-week clerkship, 4 days; and for an 8-week clerkship, 8 days. The clerkship director may schedule these days or may allow the student to select them.
    • If additional days are required for school or other professional functions, these days must be approved by the clerkship director for that rotation. In general, a total of no more than ½ day per week of the clerkship will be approved.

POLICY ON STUDENT DUTY HOURS

  • Duty hours are defined as all scheduled clinical and academic activities related to the training program, i.e., patient care (both inpatient and out-patient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

  • Scheduled duty hours are limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house activities.

  • Students are to be provided with one day in seven free from responsibilities to the program, averaged over a four-week period, inclusive of call and free from all clinical, educational, and administrative activities (other than reading and preparation time). One day is defined as one calendar day.

  • Students should have 10 hours free of duty and must have 8 hours off between Scheduled Duty Periods.

On-Call Activities

The objective of on-call activities is to provide students with continuity of patient care experiences throughout a 24-hour period. In-house call is defined as those duty hours beyond the normal workday when students are required to be immediately available in the assigned institution.

  • Students may be scheduled for In-house call no more frequently than every third night (when averaged over a four-week period).
  • Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours. In unusual circumstances, students, on their own initiative, may remain beyond their scheduled period of duty to continue to provide care to a single patient.
  • Students are limited to no more than 28 hours continuous duty in the hospital (24 hours in house call, plus 4 hours to complete post call patient care responsibilities).
  • No new patients may be accepted after 24 hours of continuous duty.

Oversite

  • Each Clerkship must have written policies and procedures consistent with the Institutional Requirements for duty hours. These policies must be distributed to the students and the faculty. Monitoring of scheduled duty hours is required with frequency sufficient to ensure an appropriate balance between education and service.
  • To monitor compliance with applicable institutional policies and requirements, the Office of Medical Education (OME) will assess each required clerkship at least annually. The extent and frequency of monitoring for each clerkship will be determined by the OME based upon the clerkship’s duty hour history, data collected by the OME.

Documentation of Duty Hours

  • Documentation of duty hours will be completed for all clerkships that have a clinical component in the M3 and M4 years.
  • Students will log duty hours electronically utilizing the system designated by the OME at a frequency determined by the Curriculum Committee. 

The Curriculum committee approved policy on May 23, 2019.


POLICY ON STUDENT SUPERVISION

The University of Mississippi Medical Center is dedicated to medical education and to providing excellent care for our patients. To fulfill this mission, it is recognized that students must participate in rendering services to patients. Students will be supervised at all times to protect the students and the safety of the patients. This document outlines the guidelines whereby the attending staff or their designee will provide supervision of students in the various settings of this institution.

Supervision consists of two specific levels: Direct Supervision and Indirect Supervision.

  • Direct supervision is defined as the supervising physician being physically present with the student and the patient during the encounter or procedure.
  • Indirect supervision with direct supervision immediately available occurs when the supervising physician and/or his designee is physically within the hospital or other site of patient care and is immediately available to provide direct supervision if needed.

Faculty Responsibility

Medical students are learners and are not licensed to provide independent patient care. At all times, the supervising attending physician retains medical and legal responsibility for the patient’s care and is ultimately responsible for the evaluation and management of the patient.

It is the responsibility of the supervising faculty to ensure all their designees, residents, fellows, and other licensed practitioners are appropriately prepared for their roles for teaching and supervision of medical students within their scope of practice. Some of the day-to-day supervision of medical students may be delegated to the appropriately prepared designee at the discretion of the supervising faculty. However, the supervising attending physician retains full responsibility for the supervision of the medical students assigned to them during their clinical rotation.

Clinical Supervision

  • Students will be supervised at all times by qualified faculty members or their designees.
  • Students must be provided with easily accessible, reliable, effective systems of communication with faculty and/or their designee at all times.
  • Student supervision will foster progressive responsibility and autonomy as appropriate throughout medical school education. Levels of responsibility will be determined by a student’s level of training and clinical skills.
  • Supervision will include formative constructive feedback at the midpoint and summative feedback at the end of a rotation/assignment.
  • Students may take histories, perform physical exams, and synthesize data. They must clearly identify themselves to patients as medical students. They are allowed access to the medical record. Senior M4 students can document in the medical record of patients in designated settings. All documentation will be clearly labeled as a medical student note. Student documentation must be reviewed by an attending physician or their designee. The students must then be provided with feedback.
  • Clinical decisions and orders can never be formulated or enacted by a medical student without an attending or their designees’ input.
  • All on call experiences are subject to the above rules.

Procedural Supervision

Medical students may participate in the care and management of a patient including invasive and noninvasive procedures under the supervision of an attending physician or their designee. The degree of supervision should take into account the complexity of the procedure, the potential for adverse effects, and the competency of the student to ensure the safety and comfort of the patient.

The physician and or their designee must have privileges to perform the procedure being supervised.

Approved by the Curriculum Committee on February 22, 2018.


POLICY ON PROFESSIONAL BEHAVIOR

Students enrolled in the School of Medicine must develop the professional behaviors expected of a physician. Students will be evaluated in the areas of attentiveness, maturity, cooperation, responsibility, personal appearance, respect (for authority, peers, patients and other members of the health care team), communication, judgment, ethics, honesty, morality, as well as other characteristics of professionalism important for a career in medicine.

Medical students will encounter a number of people who will note their behaviors. These observers may report compliments or concerns related to the professional behavior of a student through verbal, written, or other reporting mechanisms. Examples of report sources include: faculty members, residents, nurses, other health care providers, other medical center employees, medical school peers, patients, or patient’s family members. Reports of exemplary professional or unprofessional behaviors or concerns should be made to the assistant or associate dean for student affairs or the assistant or associate dean for medical education. (Approved by SOM Executive Faculty February 22, 2005; Revised July 30, 2019)


STUDENT/PRECEPTOR ASSIGNMENTS ON COMMUNITY-BASED ROTATIONS

A medical student may request an alternative preceptor assignment by emailing the course director or course coordinator for the involved clerkship. The requests are approved on a case-by-case basis. Changes are granted when the medical student and preceptor are mismatched or if the student’s housing options are inadequate. Medical students should be made aware of this process during clerkship orientation.  Under no circumstance will a student be allowed to remain in a hostile work environment.


NON-INVOLVEMENT OF PROVIDERS OF STUDENT HEALTH SERVICES IN STUDENT ASSESSMENT

The health professionals who provide health services, including psychiatric/psychological counseling, to a medical student have no involvement in the academic assessment or promotion of the medical student receiving those services.  A reminder has been appended to all clinical evaluations for faculty members who have provided such care to recuse themselves.


PROCEDURE REGARDING PERSONAL BELONGINGS DURING EXAMS

Personal items, e.g. book bags, should be stored prior to entry into the examination room. Students may not bring certain personal belongings into the testing area, including the following (unless specifically permitted by the course director):

  • Mechanical or electronic devices capable of receiving, storing or transmitting information, i.e. cellphones, hand-held computers, laptop computers, etc.
  • Watches with computer communication/memory capability 
  • Electronic paging devices 
  • Books, notes, study materials, or scratch paper
  • Recording or filming devices
  • Hats with bills or brims

If these items are brought to the examination, the proctor may take them and store them in the room until the student finishes the examination. The proctor and/or UMMC are not responsible for items left with the proctor as that is neither the primary function nor focus of the proctor during examinations. Individual departments may impose other restrictions not detailed above. In such case, these restrictions are detailed in their respective course syllabi. The National Board of Medical Examiners (NBME) provides specific instruction for the administration of the Subject National Board Examinations that are used by the School of Medicine. You will be informed of these instructions prior to the start of these examinations and are required to adhere to those instructions. Non-adherence to this policy in the School of Medicine will be considered to be unprofessional behavior on the part of the student and will be reviewed in accordance with the Policy on Professional Behavior.


POLICY REGARDING THE ACCURACY OF EDUCATIONAL RECORDS

The Family Educational Rights and Privacy Act of 1974 allows students to challenge the contents of their educational records on the basis of accuracy. Students who request that information be amended or deleted from their records on the basis of incorrect information should first file their request with the official primarily responsible for the information. If the matter is not resolved to their satisfaction, students may request a formal hearing before an appropriate institutional body or consult Section 99.36 of the law’s regulations for additional grievance procedures. The registrar will furnish a copy of the Family Educational Rights and Privacy Act of 1974 upon request. Notification of rights guaranteed under PL 93380 and policies and procedures pertaining to educational records is provided to all students through this catalog section, by a memorandum distributed at the time of registration and in the orientation sessions for the school year.