Evaluation, Grading and Promotion of Students

1.1 Standard Curriculum
The Standard Curriculum leads to the completion of the MD degree in four (4) consecutive years following matriculation into the school. Any changes to the standard curriculum must be approved by the Student Evaluations and Promotions Committee (SEPC).

1.2 Research Year
Students may request a Research Year at Boston University between the M2 and M3, or M3 and M4 years, which will result in a 5th curricular year. The students must meet the curricular research year requirements to participate in the research year. A Research Year is an optional curricular pathway and does not fulfill any M3 or M4 degree requirements.

1.3 Modified Curriculum
A modified curriculum is when a student is approved by the SEPC to complete the 3rd or 4th year in up to 4 semesters.

A 3rd or 4th year student for a Modified Curriculum for research, internships, clinical experiences, additional educational opportunities, academic, or personal reasons. In the Modified Curriculum, the curricular year is modified and must be completed in no more than 4 semesters. Students may be required to enter a modified or decelerated curriculum by the SEPC.

Students in the 1st and 2nd year curriculum do not have the option to enter a modified curriculum due to the integrated curriculum design. A student who experiences academic, personal or family difficulties in the 1st and 2nd curricular years may petition the SEPC for a leave of absence.

1.4 Decelerated Curriculum
A student who experiences academic difficulties in the 3rd or 4th curricular years may be required by the SEPC to enter a Decelerated Curriculum. The remaining courses of that curricular year will be spread out over an extended period as determined by the SEPC. A Decelerated Curriculum may continue for up to one additional curricular year. Performance of a student admitted to the Decelerated Curriculum may be re-viewed by the SEPC at any of its meetings. The student may be placed on academic probation by SEPC. All subsequent failures for a student in the Decelerated Curriculum will result in review by the SEPC and may result in dismissal from the school (see section 5).

1.5 Repeat Year
A student who receives a final grade of F in a course in the first three years of the curriculum, will be re-quired to repeat the coursework in the next year and may be placed on probation by the SEPC. Students with absences in excess of 14 days within a course may be required by the SEPC to repeat the course. A 4th year medical student may be able to repeat a failed course in the same academic year. Students should refer to individual course grading policies for more details on the remediation process.

A student who is required to repeat a course in the 1st and 2nd year is required to return to the curriculum and will be enrolled in a repeat year. Students in a repeat year must retake any course that they have failed. Any course with an incomplete grade must be retaken in its entirety. A course that has a pass grade may be audited by the student or at the requirement of SEPC but a new grade will not be issued. No student will be allowed to repeat any course more than once.

1.6 Degree Completion Time Requirements
Students must complete the MD program (or MD component, if enrolled in a dual degree program) in no more than six years. All exceptions to curricular length must be approved by SEPC.

Dual Degree programs
For students enrolled in the MD/PhD program, the PhD portion must be completed within no more than 5 years. Other dual degrees(MD/MPH, MD/MBA, MD/JD, MD/MS etc.), the additional degree must be completed within the time frame specified by the program.

The Academic Record reflects the academic history of the student at Boston University maintained by the Office of the Registrar.

In addition to serving as a record of courses taken and grades, the student’s Official Transcript documents the student’s participation in the Modified/Decelerated curriculum, interruptions in the student’s progress through the curriculum, and administrative actions such as Suspension or Dismissal.

All students graduating from the school are provided with a Medical Student Performance Evaluation (MSPE). The MSPE is an official document that provides a comprehensive summary of a medical student’s academic performance, professional behavior, and personal qualities during their time in medical school, and includes Probation status. The MSPE is part of the residency application for all specialties and is part of the permanent record.

2.1 Student Evaluation and Assessment
Students are evaluated based on the objectives set for each course and according to the competencies and program objectives defined by the Medical Education Committee. Student evaluation and grading criteria are defined in the course information guidelines/syllabus for all courses and are provided to students at the start of every course.

2.2 Grades and Definition of Grades
Once a student initiates a course or clerkship, a grade will be recorded. The grading system is used to de-fine levels of competence and must be expressed as one of the grades listed below. Medical students must earn Pass or higher for all courses to be eligible for promotion and graduation. Grades are informed by multiple factors. Grades cannot be changed once they are on the official transcript except through the grade appeals process.

Grading Policies of the academic year in which the student is taking the course will apply even if changes to grading policies are made in subsequent and future years.

First and second year courses

• Pass (P): Awarded when a student’s work in a course meets or exceeds the minimum requirements for competence in that course.
• Fail (F): Awarded when a student’s work in a course fails to meet the minimum requirements for competence in that course.

Third and fourth year courses and clerkships

• Honors (H): Awarded only for third and fourth year clerkships and rotations and signifies that the student’s has a demonstrated performance that consistently exceeds the expected competency level for that rotation.
• High Pass (HP): Awarded only for third and fourth year clerkships and rotations. Indicates a student has a demonstrated performance that consistently meets the expected competency level for that rotation but is not at the level defined for Honors.
• Pass (P): Awarded when a student’s performance in a rotation meets the minimum requirements to meet the expected competency level for that rotation.
• Pass** (P*+): Awarded when a student’s performance in a rotation meets the requirements for competence in a course offered for Pass or Fail grades only.
• Fail (F): Awarded when a student’s work in a rotation fails to consistently meet the minimum requirements for competence. Students are required to remediate all fail grades in order to graduate, by repeating the course.

Students who do not complete a course in any year of the curriculum:

Incomplete (I)– Due to extenuating circumstances (family emergency/personal emergency/prolonged ill-ness,), when one or more requirements of the course, clerkship, or rotation have not been completed by the scheduled end-date. An incomplete may also be assigned following the grading policy, for example in the case of a first-time shelf failure, or first-time LPA failure, or following the policy on delayed clerkships in the case of a Step 1 failure. An Incomplete grade is an internal grade marker and will not remain on the Official Transcript once it has been remediated. All incomplete grades must be resolved within one year of the date the incomplete grade was published. If not remediated within one year, the Incomplete will be converted to a Fail grade which will appear on the Official Transcript. Any deviations requires SEPC review and approval.

Any student who has completed less than half of any clerkship/course rotation will need to take the entire course from the beginning. Any student with incomplete grades in the first two curricular years, and/or with absences in excess of 14 days, may be asked by SEPC to repeat the course given the amount of curriculum that has been missed. This may lead to a repeat year.

The Registrar and Medical Education Dean must be informed by the student/course director/Student Af-fairs Dean of the inability to complete the course due to an extenuating circumstance before the Incomplete can be assigned. A student cannot enroll in another course for credit during those course dates for which an Incomplete is being assigned. A remediation plan must be documented and approved by the course director and Medical Education Dean.

Withdraw (W): Assigned as the final grade in any course from which the student withdraws after the course has begun. The Withdraw grade can be assigned at any time before the completion of a course. A grade of W will be given to any student who is enrolled in a course at the start and then withdraws after the course has started and does not meet the definition of incomplete. A student who is assigned a grade of Withdraw from any course will be required to retake the same course or a similar alternative approved by the ADME before promotion or graduation.

A W grade cannot replace a Fail grade.

2.3 Transparency of Transcript
Grades for all courses will appear on the Official Transcript.

Courses in the first two years of the curriculum in which a student receives an initial course grade of Fail (defined in the course guidelines) will receive a Fail/Pass once the remediation(defined in the course guide-lines) has been successfully completed. A transcript notation will specify whether the grade was remediated by exam, coursework, or both.

A final grade of W will remain on the transcript.. Any repeated course will be listed on the transcript and the word “Repeat” will be included as a transcript note. An initial grade of Fail which has not been remediated will remain as a Fail if a student steps out of the curriculum prior to completing the remediation process. All Incomplete, Withdraw and Fail grades must be remediated in order for the student to be eligible for promotion and graduation.

The original final evaluation narrative will be included in the MSPE, in addition to the final evaluation from the repeated clerkship. The original Fail grade will remain on the transcript. The repeated course will be listed again, and a transcript annotation will be added.

2.3.1 Recording of All Grades
Grades for all courses taken for credit by students, including those taken in excess of degree requirements in the 4th curricular year, will be recorded on the transcript and will be subject to the medical school’s pro-motions guidelines.

2.4 Grade Reconsideration and Appeals
The Course, Clerkship, and Rotation Directors determine grades based on the assessments in the course and the grading policies described in the course information guidelines or clerkship/rotation syllabus. Any student who wishes to appeal their grade and how they were graded should follow the grade reconsideration policy below.

A student who chooses to appeal a grade must follow these procedures:

1. A student can request a grade appeal once the final grade has been submitted by the director. Any deviation from the appeals policy must be petitioned to the SEPC.
2. Students are responsible for reviewing the grade appeal policy
3. Students must submit a written grade appeal to the Registrar to initiate the process, including the Course Director, no more than 15 business days after the final grade is officially recorded in the Registrar’s office. This appeal can be for the final grade, and/or the final narrative. The Registrar will share deadline for response.
4. The written appeal must include the date of the rotation, the reasons for the grade appeal and what components of the grade are being appealed, and the student’s specific concerns for why the grade should be changed. Appeals cannot be made to individual faculty and must be to the course director. Individual faculty cannot be emailed and requested to make changes to the grade after they have submitted their evaluation form/grade. The course/clerkship director is required to contact the individual faculty contributing to the grade as part of the appeals process when applicable.
5. The Course Director must provide a written decision to the appealing student within 30 calendar days of receipt of the appeal.
6. A student may request sequential reviews of the appeal in the following order within 10 calendar days of receipt of the appeal.
   • For clerkships and fourth year rotations, the Vice Chair of Education, Medical Student Director of Education or Chair of the Department as long as they are not the original appeal responder. The leadership committee must provide a written decision to the student within 15 business days of receipt of the appeal.
   • For preclerkship courses after the course director’s response and for 3rd and 4th year after the Department Education Chair response, the Associate Dean of Medical Education. The Associate Dean must provide a written decision to the student within 10 business days of receipt of the appeal. The decision of the Associate Dean is final.

If any student contends that a grade was due to discrimination (i.e. race, ethnicity, gender, etc.) the student should meet with the Title IX coordinator and file a Title IX complaint and contact the Equal Opportunity Office.

Professionalism is a core competency and critical component of the student’s overall performance in medical school and lapses may be reported by faculty at their discretion. Initial episodes of unprofessional behavior should be addressed as a learning opportunity and with a sole focus on remediation. Additional details describing the student code of conduct and the mechanism for reporting as well as potential consequences of unprofessional behavior are available at: https://www.bumc.bu.edu/camed/education/medical-education/policies/professionalism/.

Details regarding professionalism expectations are available to all students and can be found here:

1. Medical Student Code of Academic and Professional Conduct, with particular emphasis to Section 1.2 and Appendix 1: https://www.bumc.bu.edu/camed/about/diversity/prs/medical-student-disciplinary-code/
2. The Section on Assessment and Grading in all Course Guidelines
3. Association of American Medical Colleges Exhibit A: Teacher-Learner Expectations: https://www.bumc.bu.edu/camed/files/2015/05/AAMC-Teacher-Learner-Expectations.pdf

The end goal of all interventions regarding professional conduct is to provide the student with specific concerns about their behavior and foster and support the student’s development as a physician. Students must be directly informed of the behavior of concern, as close to the event as possible, by the individual who observed the unprofessional behavior. Clear communication between student and faculty is of paramount im-portance, and prompt and specific feedback must be shared directly with the student. Students must have the opportunity to respond to concerns and participate in the development of remediation plans. Students are expected to respond and acknowledge communication from faculty within 24 hours. Students should also document and summarize their understanding of the professionalism conversations shared with them and email intended actions steps after meetings to faculty or deans.

Procedures
Professionalism concerns, even if deemed minor, identified via SEIC will be shared at the meeting with the Student Affairs Office. The student’s core advisor and student affairs dean will be notified for formative purposes by the Student Affairs representative at SEIC. Professionalism concerns that did not result in referral to the SEPC but are determined to be significant by the clerkship director may be included in the student’s final clerkship summative narrative

Egregious and/or repeated lapses in professional conduct related to either clinical or course/clerkship responsibilities, may require further action by the SEIC (as described above), referral to Physician Health Ser-vices, referral to the SEPC or the Disciplinary Committee. An SEPC referral for professionalism can come from the Associate Dean for Medical Education or Student Affairs based on notification of faculty concerns regarding the student or lapses in communication with the Deans or Registrar’s offices. Recurrent professionalism concerns identified by the SEIC will result in a Letter of Professionalism Concern from the SEIC. If a student receives two such notices, they will be referred to the SEPC

Professionalism concerns referred for review by the SEPC or the Disciplinary Committee are considered for inclusion in the Medical Student Performance Evaluation (MSPE) Professionalism section, as decided by the relevant committee, and may be reportable to relevant licensing boards. Students will be notified in their SEPC letter if the professionalism concern will be included in their MSPE.

4.1 Student Early Intervention Process (SEIP)
The SEIP is the process by which students who are experiencing professionalism or academic difficulty or at risk of professionalism or academic difficulty are identified. The goal of SEIP is to ensure students are being referred to and are using the available resources (tutoring, coaching, advising) and have been notified when there are patterns of concern.

4.1.1 The Student Early Intervention Committee (SEIC)

Student Early Intervention Committee (SEIC) Operating Procedure
SEICs are medical school committees that monitor student progression through the curriculum and identify students who are at academic or professionalism risk. The Medical Education and Student Affairs Offices in collaboration with course and clerkship directors are responsible for identifying students who are struggling to meet the academic and professionalism standards and thus progress through medical school as expected.

SEIC recommendations are intended to notify students of identified concerns and to provide suggested or required support and remediation to ensure successful and timely progression through the curriculum. SEIC recommendations may be fed forward to advisers, course and clerkship directors to provide support for the student. SEPC reviews all SEIC recommendations.

Committee Members
The Preclerkship Phase SEIC (M1 and M2), chaired by the PCS chair, comprises the PCS Chair, course di-rectors and course managers for academic years 1 and 2, the Associate Dean of Medical Education (ADME), Associate Dean of Student Affairs (ADSA), Director and Administrative Manager of the Coaching Program and Director of the Academic Enhancement Office (AEO) and the Registrar. The SEIC meets quarterly and reviews all students. This committee meets quarterly and reviews all students.

The Clerkship Phase SEIC (M3), chaired by the CCS chair, comprises the M3 Clerkship directors, the ADME, and the ADSA, Director and Administrative Manager of the Coaching Program the AEO director and the Registrar. This committee meets quarterly and reviews all students.

The Post Clerkship Phase(M4) SEIC, chaired by the CCS chair, comprises the a subset of directors of the required 4th year rotations (Geriatrics, directors of the IM subinternship and Surgery subinternship and two other subinternship directors, the chair of the Elective Subcommittee or designee, and 2 additional elective directors and two 4th year course managers. Representatives shall be appointed by the SEIC M4 chair and the Associate Dean of Medical Education (ADME), Associate Dean of Student Affairs (ADSA), Director and Administrative Manager of the Coaching Program and director of the Academic Enhancement Office (AEO) and the Registrar. This committee meets twice a year, July/Aug and Dec/Jan.

All members of the SEIC will be listed on a website linked from MEO and SAO.

SEIC Academic or Professionalism Example Criteria to Identify Students at Risk

Academic

• Greater than one learning progress assessment (LPA) fail at any point in a year-long course or across courses
• Scoring in the lowest 10% on 2 or more LPA’s, shelf exams or OSCE’s/OCRA’s in an academic year
• Failing a shelf exam
• Greater than one clinical skills concern by faculty in doctoring, clerkships or clinical assessments (OSCE’s, OCRA’s) across a year
• 2 LPA fails in one year
• 1 course fail in a year

Professionalism

• Repeated lapses in meeting curriculum expectations for professionalism (such as attendance, course assignments) despite documentation of notification by course director/manager
• Recurrent lapse in more than one domain of administrative professionalism (i.e., university compliance, evaluation compliance, clerkship administrative tasks)

SEIC Potential Recommendations to Students
Recommendations may include required meetings with faculty, individual and group tutoring, office hours, coaching and meeting with Academic Enhancement Office specialists, meeting with an Associate Dean, ad-visor or coach and/or other actions such as a formal professionalism notification and referral to the Student Evaluation and Promotion Committee (SEPC), etc. All SEIC recommendations will be shared with the SEPC.

SEIC Referral to SEPC
The SEIC can require students with significant or repeated academic or professionalism concerns to meet with the Student Evaluation and Promotion Committee (SEPC) for additional review.
Examples of reasons the SEIC would refer to students to SEPC include:

• Professionalism Referral
  • Two or more written professionalism notifications by SEIC, ADME, ADSA during the four years
  • Repeated lapses in responding to communication, e.g. correspondences from administrators, course directors, and/or deans despite documented event(s) and documented feedback.
  • Failing to meet SEIC recommendations after written notification
  • Repeated lapses in attendance to mandatory sessions, including required coaching, despite notification.
• Academic Referral
  • Two or more Learning Progress Assessment fails within the preclerkship phase (regardless of reexamination policies)
  • Two or more clerkship shelf exam failures (regardless of reexamination policies) in one or multiple clerkships
  • Failure of a remediation exam in the preclerkship phase.
  • Two or more of any of the following: course fails, doctoring summative assessment or end of third year assessment at any point in the curriculum

Any student who has previously met with SEPC and continues to have professionalism/ academic concerns may be referred to SEPC at any time.

SEIC Notifications to Student

1. Letter of Academic Concern Example

A Letter of Academic Concern will be shared with the student via the SEIC email drafted and signed by the SEIC chair on behalf of the SEIC with the subject line: Academic Concern Notification, with a copy to the chair of SEPC. The text of the email will be:

Dear student X,
I am writing to notify you that on a date here a review of your academic and professionalism record by the Student Early Intervention Committee identified your performance as a significant academic concern.
The committee discussed the following concerns during the meeting: XX reasons for the letter of concern
The committee has recommended the following: XXX
Your SAO dean and adviser will also be notified. You are required to meet with the SAO to review the recommendations. Please email the ADME Dean if you have any further questions regarding this notification.

2. Letter of Professionalism Concern Example

A Letter of Professionalism Concern will be shared with the student via SEIC email drafted and signed by the chair of the SEIC on behalf of the SEIC with the subject line: Professionalism Concern Notification, with a copy to the chair of SEPC. The text of the email will be as follows:

Dear Student X,
I am writing to notify you that on date here a review of your academic and professionalism record by the Student Early Intervention Committee identified your performance as a significant professionalism concern.
The committee discussed the following concerns during the meeting: XX reasons for the letter of concern.
The committee has recommended the following: XX
Your SAO dean and adviser will also be notified and you are required to meet with the SAO to review the recommendations. Please email the ADSA if you have any further questions regarding this notification.

3. SEPC Letter Referral Example

Dear XXX
I am writing to notify you that on date here a review of your academic and professionalism record, by the Student Early Intervention Committee identified your performance as a significant academic concern.
The SEIC has referred you to the Student Evaluation and Promotions Committee (SEPC).
The reasons for this referral include XX
Your SAO dean will also be notified and you are required to meet with the SAO to discuss the meet-ing. Your advisor, the registrar and the chair of SEPC have also been cc’d. Please email the ADSA if you have any further questions regarding this notification.

4.1.2 SEIC to SEPC Referral Process

1. SEIC identifies students of concern
2. The ADME or designee emails SAO Senior Policy Officer with the list of names for the SEPC meet-ing, including name of student, year, and reason for SEPC referral.
3. The Chair of the SEIC committee notifies the students that they have been identified as a student of concern and are being referred to SEPC
4. The ADSA and ADME discuss optimal timing for the student’s appearance at the SEPC (e.g., which meeting, taking into account their academic schedule, scheduled exams, personal concerns).
5. The SAO Senior Policy Officer notifies the students via email that they have been placed on the SEPC agenda by the SEIC at least three business days prior to the SEPC meeting, including the reason for the referral to the SEPC.

4.2 Student Evaluation and Promotion Committee (SEPC)
The role of the Student Evaluation and Promotion Committee (SEPC) in accordance with Chobanian & Avedisian School of Medicine policies and standards, the SEPC evaluates a student’s academic and professional body of work, and makes recommendations in the best interest of academic progression and patient care;

SEPC roles includes: 1) Considering student petitions for exception to school policy, 2) holistically reviewing students who are not meeting the competency standards and failing to progress through the curriculum as expected 3.) determining appropriate actions for any student referred for academic or professionalism concerns including additional requirements and expectations for the student 4) determine students’ readiness for promotion from one phase of the curriculum to the next or graduation.

Students will be referred to the SEPC directly by an Associate Dean(Medical Education/Student Affairs) or via the SEIC (described in section 3.1) when there is significant concern or a lack of academic or professionalism progress as defined by:

• Two or more Learning Progress Assessment fails within the preclerkship phase(regardless of reexamination policies)
• Two or more clerkship shelf exam failures(regardless of reexamination policies)
• Failure of a remediation exam in the preclerkship phase.
• Two or more of any of the following: course fails, doctoring summative assessment or end of third year assessment at any point in the curriculum. Any final grade of Fail in the 3rd or 4th year
• Previously referred to the SEPC for academic or professionalism concerns and continues to demonstrate academic or professionalism difficulties
• Previously referred to SEPC and does not meet the SEPC requirements listed in the final letter

SEPC decisions are based upon the student’s entire academic and disciplinary record, if any, at the time of the meeting. SEPC actions may include, but are not limited to, requiring:

• Required tutoring, academic enhancement meetings, coaching, course work remediation
• repeating the year
• a Decelerated Curriculum or a LOA
• probation for a defined period
• Suspension for a defined period of one semester or more
• referral to Physician Health Services for further assessment or monitoring
• dismissal from the medical school.
• Professionalism concern documentation in MSPE

4.2.1 Composition
The Composition of the SEPC is outlined in Article 5, Section G5 of the Boston University Chobanian & Avedisian School of Medicine Bylaws at: https://www.bumc.bu.edu/camed/faculty/busm-bylaws/.

A member of the SEPC who may have a conflict of interest in a particular case, such as having served as the student’s ad-visor, personal physician, or is the Director of a Course/Clerkship being discussed, shall be recused from that student’s case. Quorum is defined as >50% of the voting members in attendance for any SEPC actions.

4.2.2 Recusal and Conflict of Interest
Any faculty who has identified a conflict of interest with the student being reviewed may recuse themselves from the meeting and decision making regarding the student. Faculty must recuse themselves if: 1.) If they are a course/clerkship director who has taken an action such as awarding a failing grade that contributes to the adverse action being proposed against a student. 2.)Clinical faculty who have provided health care to the student being reviewed or are a member of the student’s family.

4.2.3 Expedited Procedures
The SEPC Chair, after discussion with the Associate Dean of Student Affairs, may, in place of a formal meeting, email SEPC members to request approval of a student’s petition. SEPC members may approve the petition or request a meeting for resolution. In addition, the Associate Dean of Student Affairs may act on petitions from students who are in good academic standing without previous lapses in professional conduct or previous appearances before the SEPC. Such actions may include approving or denying petitions:

• for a Leave of Absence (LOA) for personal reasons;
• for a medical LOA;
• to enter a Modified curriculum; and
• to return to the curriculum from a LOA.

4.2.4 Student Generated Petitions
All student petitions must be prepared in consultation with the Associate Dean of Student Affairs (or de-signee) and must comply with the rules established by the Faculty of Medicine governing evaluation, grad-ng, and promotion. All petitions must be typed, dated, signed, addressed to the SEPC, and received by the Office of Student Affairs at least three (3) business days before the scheduled meeting, unless an emergency prevents the student from complying with the deadline.

4.2.5 Procedure
The SEPC meets monthly, or as necessary, to assess student readiness for evaluation and promotion for all four years of MD curriculum.

All students on the SEPC’s agenda will be notified by email of the date, time, and location of the meeting at least THREE business days prior to the meeting. Students will be informed of the right to appear at the meeting and/or to submit a written statement to the SEPC. A student is not required, but is strongly encouraged, to attend the meeting. Within 24 hours of notification, a student must contact the appropriate Student Affairs officer to indicate whether or not the student will attend. If a student does not respond, the meeting date will be held as planned, with or without the student present.

A student may bring a faculty advisor to the SEPC meeting. The advisor may present information to the SEPC, but will not participate in the general discussion about the student. Neither the student nor the advisor may be present during discussion, deliberation, or voting on the petition. Attorneys are not permitted to attend SEPC meetings.

Records and other documents relating to a student on the SEPC’s meeting agenda are available to Commit-tee members prior to or at the meeting. Upon request, the student will have the opportunity to review in advance all documents to be submitted to the Committee. The student should have the opportunity to dis-cuss adverse reports or evaluations with the appropriate Course Director, Clerkship Director, or Rotation Director before the SEPC acts on any reports or evaluations.

The Chair will communicate the SEPC’s decision to the student in writing within 10 business days.

Students can only appeal decisions made by SEPC in a formal letter. A student who plans to appeal the SEPC’s decision and notifies the Registrar in writing of their intent to appeal, may remain registered and participate in courses or clerkships during the appeals process until they either miss the deadline for the next appeal or the Dean upholds the SEPC decision . No course or clerkship grades obtained during the ap-peal period will be recorded on the student’s medical school transcript if the SEPC decision is up-held. Students are responsible for tuition charges during this period.

4.2.6 Disciplinary Proceedings Reports to the SEPC
When a student in the MD or any of the combined MD programs has been found responsible for violating any disciplinary code of academic or professional conduct of the University, the SEPC shall be notified of the University’s final determination. The SEPC may review the final decision and the student’s complete academic record and may determine if other action is appropriate. If a student in a combined degree pro-gram is brought to the respective promotions or disciplinary committee, the SEPC shall be notified.

4.2.7 Committee Records Retention
Records of all SEPC meetings, as well as meetings of the Committee on Appeals, will be kept for six (6) years after the graduation or separation of the students on the agenda.

4.3 Committee on Appeals

4.3.1 Composition
The composition of the Committee on Appeals is outlined in Article 5, Section G7 of the Boston University Chobanian & Avedisian School of Medicine Bylaws at: https://www.bumc.bu.edu/camed/faculty/busm-bylaws/. A committee member who may have a conflict of interest in a particular case, such as having served as the student’s advisor, personal physician, or is the director of a course/clerkship being discussed, shall be recused from that student’s case. Quorum is defined as >50% of the voting members in attendance for any Appeals decisions.

4.3.2 Recusal and Conflict of Interest
Any faculty who has identified a conflict of interest with the student being reviewed may recuse them-selves from the meeting and decision making regarding the student. Faculty must recuse themselves if: 1.) If they are a course/clerkship director who has taken an action such as awarding a failing grade that con-tributes to the adverse action being proposed against a student. 2.)Clinical faculty who have provided health care to the student being reviewed or are a member of the student’s family.

4.3.3 Procedures
Appeals must be submitted in writing within ten (10) business days after a student receives written notice of a SEPC decision. The Associate Dean of Student Affairs may grant an extension of the filing deadline if requested within the 10 day period. The Committee on Appeals will hear any appeal of a SEPC decision and take such action as it finds appropriate with respect to the original decision.

Students may elect to appear before the Committee on Appeals alone or accompanied by a faculty advisor. The advisor may present information to the committee but will not participate in the general discussion about the student. Neither the student nor the advisor may be present during discussion, deliberation, or voting on the appeal. Attorneys are not permitted to attend meetings of the Committee on Appeals. If a student, referred to Physician Health Services (PHS) by the SEPC, chooses to appeal PHS’ determinations, the student must sign an unrestricted release of information, allowing PHS to share information with the Appeals Committee.

The Chair of the Committee on Appeals is responsible for obtaining all relevant information from the ap-propriate Associate Deans, Registrar and the SEPC chair via email or in-person and share it with the committee at least 24 hours before the meeting date.

The recommendations of the Committee on Appeals should comply with the Policies and Procedures for Evaluation, Grading, and Promotion of Boston University Chobanian & Avedisian School of Medicine MD Students. The Committee on Appeals may grant or deny a student’s appeal, or may modify the SEPC’s decision.

The Chair of the Committee on Appeals will communicate the Committee’s decision to the student in writing, within ten business days.

The Committee on Appeals will report all decisions to the Dean of the School of Medicine.

4.3.4 Additional Appeals
A student may submit a written appeal to the Dean of the School of Medicine within ten (10) business days after receipt of the written decision of the Committee on Appeals. The Dean may affirm, modify, or reverse the decision, or remand matters to the Committee on Appeals or the SEPC for reconsideration, and will communicate the decision and rationale to the student in writing. The Dean’s decision is final.

5.1 Qualifications for Promotion
To be promoted to the next curricular year, medical students must meet all requirements of the current curricular year and satisfactorily adhere to all University standards. A student’s academic and professional performances are both subject to evaluation.

5.2 Academic Standing
Students in “good academic standing” are defined as enrolled students who have performed at a passing level in all courses and are not on probation or suspended.

Students who have earned deficient grades (W, F) are not in good standing until each deficient grade has been remediated.

5.3 Standards and Requirements for Promotion

5.3.1 Failure to Qualify for Promotion
Students may not qualify for promotion if the student has

• Failed any courses/clerkships and has not remediated the course
• Has a W or I on a course
• A student who has not taken Step 1 cannot progress to 3rd year
• A student who has not passed Step 1 cannot progress to 4th year
• A student must remediate all third year grades at the beginning of the fourth curricular year at the earliest possible date, depending on availability, and will be promoted to fourth year upon successful completion.

5.3.2 USMLE Step Exams
Each student must:

• take the USMLE Step 1 examination to be promoted to the third curricular year and;
• pass the USMLE Step 1 examination to be promoted to the fourth curricular year.

All entering 3rd year students must take USMLE Step 1 prior to the first day of the transitional clerkship in order to begin the third year. This includes a student who is not progressing directly from the second year to the third year (due to LOA, dual degree, or research year).

If a student wishes to delay block 1, they must do so in writing and submit it to the Student Affairs Office one week before the transitional clerkship start date.

5.3.3 MD/PhD Student Promotion to PhD phase
To matriculate into the graduate years, MD/PhD students must be eligible at that time to matriculate into the third year of medical school. Therefore, they must pass step one and have no first- or second-year courses that are incomplete. To expose students to laboratories for doctoral dissertation work, students are required to complete a minimum of two separate rotations. These are conducted after summer 1 and summer 2. Once these requirements are completed, and upon acceptance into a laboratory, the students begin their graduate education and research training in the major departments or areas of their chosen specialization within GMS. Oral defense and dissertation submission must be completed and approved prior to returning to the third year of the medical school curriculum.

5.3.4 Promotion to Third Year
Prior to entering the third year curriculum and starting clerkships, a student must attend the Transitional clerkship and complete all compliance requirements including ensuring that the student’s health records comply with the medical school’s expectations for entry. The Transitional Clerkship only needs to be take once but students may still need to update compliance requirements and repeat requirements if they are starting clerkships in an academic year different from the year they took the Transitional Clerkship. They must contact the Transitional Course Manager to review one month before the start of their first 3rd Year Clerkship.

5.3.5 Promotion to Fourth Year
Promotion to the fourth year requires a student to have completed the Transition to Fourth Year module, successfully completed all third year requirements, and completed all compliance requirements. A student who has delayed one or more core clerkships, or has not yet remediated all core clerkships by the Fall of their fourth year, will not be allowed to participate in fourth year rotations in the specialties of any incomplete clerkships. Students may not participate in outside electives until they have passed all core clerkships.

5.3.6 End of Year Third Assessment (EOTYA)
Students must have completed the end of third year assessment to participate in any 4th year course. Any student who receives a fail on the EOTYA will be required to remediate the assessment on a date determined by the MEO and will be required to have clinical coaching in 4th year until cleared by their coach. . Students who fail the EOTYA retake will have subsequent curricular schedules modified/adapted by the ADME with additional direct patient care rotations including an additional Sub I requirement. Students may continue in 4th year rotations as they await the retake.

5.3.7 Fourth Year Graduation Requirements
In order to graduate from the medical school, students must have a passing grade in all courses and have completed all of previous requirements as outlined above.

USMLE Step 2
Any student who plans to graduate must take USMLE Step 2. Each student must take USMLE Step 2 by November 1 of the academic year in which the student is graduating and, in order to be certified in the Match.

Rotation Requirements
Students are required to complete 36 weeks of fourth year rotations to graduate.

• 8 weeks of required rotations
• 28 weeks of electives
• Of the 36 weeks, a minimum of 24 weeks must be classified as clinical
• Up to 12 weeks of credit can be earned for rotations classified as non-clinical
• Up to 16 weeks of rotations can be completed in a given sub-specialty

Students must take their 8 weeks of required rotations and at least 8 weeks of electives within the Cho-banian & Avedisian School of Medicine elective catalog. Up to 20 weeks of electives may be taken outside the School’s academic catalog, including at an outside medical school or hospital.

And

• Complete the Transition to 4th Year Course
• Complete the Back to the Classroom Course

Procedures
A student must review with their fourth year schedule with their Field-Specific Advisor or Student Affairs Dean, sign and submit it to the Office of the Registrar no later than 12 weeks after the beginning of their fourth curricular year. A student is not permitted to change their fourth year schedule after Block 18 has commenced.

A student who plans to take a fourth year extramural elective(s) at another medical school, institution, or organization must be in good standing at the time of application, and during the scheduled rotation. All policies and procedures described on the registrar’s website must be followed. The student will evaluate the elective upon their return.

A student who plans to take a fourth year Global Health Elective must meet and receive approval from the Director of Medical Student Global Health, whether arranged through the school’s International Health Program, or arranged independently by the student. The Director will explore objectives, travel safety and other areas during the meeting. The director may consult with the appropriate Chobanian & Avedisian School of Medicine department.

A student who plans to take a fourth year Research Elective for Credit must submit the research project proposal for approval by the Research Committee. The elective must be approved at least six weeks prior to beginning the research project. Up to twelve weeks of Fourth Year research elective credit may be awarded for research. MD/PhD students may seek a research continuation, earning up to 12 weeks of cred-it in the fourth year.

Any additional time spent doing a research project will not be eligible for elective credit. Approved re-search projects conducted outside the medical school will count as an outside elective for credit.

Additional Rotations Beyond Degree Requirements
All electives taken for credit in excess of degree requirements will be recorded with grades on the transcript. Students may complete up to 48 credits in total in the fourth year.

Time Allowed in Specialties
Credit will be granted for no more than 16 weeks of fourth year rotations and/or electives in any one sub-specialty. The 16 weeks of subspecialty rotations (including the Sub-Internship), does not include non-clinical electives. Research electives are NOT included as part of this limit.

5.4 Probation
Probation is a serious disciplinary step taken by the SEPC and can lead to dismissal. Probation is not noted on the student’s transcript, but will be included in the student’s Medical Student Performance Evaluation and becomes a part of the student’s Academic Record . The probation will be available to appropriate ex-ternal professional organizations that request such information, including, but not limited to, state medical registration boards. Probation status may be reported to the Board of Registration in Medicine when seeking a license.

If a student is required to appear before SEPC for a continued or new concern (academic or professional-ism), the student may be placed on probation. Any student repeating a year (first or second year) will be placed on probation. A student may also be placed on probation for repeated, sustained professionalism concerns.

A student on Probation continues in the curriculum, but is not in good academic standing, will be monitored by the SEPC and is required to meet the standards and remediation requirements set forth by the SEPC. A student on probation is not allowed to remain in any leadership roles within extra-curricular activities, un-less allowed by the SEPC. Students on probation are not permitted to participate in away rotations. Stu-dents on probation are not permitted to serve as peer tutors, or to participate in Teaching electives.

Upon remediation of all deficient grades, and with continued satisfactory performance, the student may petition the SEPC to be removed from Probation. Any student placed on probation will be reviewed at the end of the academic year. A determination will be made whether they are removed from probation and allowed to continue in the curriculum or will continue on probation. Probation status may be shared with one or more course or clerkship directors – including the student’s past performance in previous courses and clerkships. Any future Fail grade, puts the student at risk for dismissal.

5.5 Suspension
The SEPC may suspend a student whose professional or academic performance is of significant concerns. When the health, safety, or welfare of students, patients, or other members of the medical school community are deemed to be at risk due to the behavioral or presence of the student, the student may be sus-pended.

Any student who is suspended will be notified in writing within ten (10) business days of the date of the Sus-pension. The notification will include the length of the Suspension (up to one year) and outline any requirements for the student’s return to the curriculum. A Suspension will be noted on the student’s transcript and on the student’s academic record.

Suspended students are required to comply with the requirements of the SEPC. Suspended students are prohibited from participating in the curriculum are not permitted to avail themselves of any Boston University services on any Boston University campus or participate in any BUSM extracurricular activities, and are required to turn in all Chobanian & Avedisian School of Medicine and Boston University property, including, but not limited to, identification cards.

When a suspended student reenters the curriculum, the student will be placed on Academic Probation for a period of time to be determined by the SEPC.

5.6 Dismissal
The school reserves the right to dismiss any student, including a student on a LOA, for failure to maintain a satisfactory Academic Record, including acceptable professional behavior. A student may also be dismissed for not complying with SEPC requirements regarding prior performances. A student who is dismissed from the school may petition the appeals committee (see Section 4) for reinstatement.

Grounds for Dismissal include, but are not limited to:

• Failure to comply with decisions of the SEPC or the Committee on Appeals, including compliance with Physician Health Services recommendations if applicable.
• Three or more final course grades of fail within a curricular year.
• After a repeat year, any Fail grade.
• Failure to sit for Step 1, one year from the completion of the Independent Study Period(ISP) or last Step 1 attempt.
• Failure to pass USMLE Step 1 after three attempts.
• Persistent or egregious breaches of the student code of conduct
• Greater than six years in the curriculum or beyond the period allowed by SEPC

Dismissed students are required to turn in all Chobanian & Avedisian School of Medicine and Boston University property. Identification cards will be deactivated.

A Leave of Absence (LOA) is defined as one semester or more away from the curriculum. Absences of less than one semester are defined in section 6.3, below.

A student may petition the SEPC for a LOA for academic, personal, financial, administrative, or non-urgent medical reasons. A petition for a LOA should be prepared in consultation with the Associate Dean of Stu-dent Affairs or designee and must articulate the reasons for the requested LOA.

If a student initiates a LOA before the completion of a course or clerkship, the student will receive a grade of Withdraw or Incomplete for that course/clerkship as per school policy. A student on an approved LOA is a matriculated student; however, that student is not registered for any courses in the School of Medicine curriculum. For a student requesting LOA related to academic difficulties, the SEPC may impose curricular requirements to be completed upon the student’s return to the curriculum.

6.1 Medical LOAs

6.1.1 Student-initiated Medical LOA
A student’s petition for a medical LOA should include:

• A letter from the student’s treating healthcare professional documenting that a medical leave is necessary and its likely duration.
• Any plans the student has to address any current academic difficulties or those that might result from an extended period away from the curriculum.

6.1.2 School-initiated Medical LOA
If the Associate Dean of Student Affairs has evidence that a medical student may be a danger to themselves or to others, or is not fit to perform functions required of a medical student in non-clinical, clinical, or laboratory settings, the Associate Dean may act immediately to remove the student from the curriculum and place them on an emergency absence, pending full evaluation by the SEPC or Disciplinary committees. The Associate Dean will meet with the student to inform them of the nature of the fitness concerns and need to put them on emergency LOA while allowing for an opportunity to respond.

The student will then be required to come before either the SEPC or Disciplinary Committee, which may take the following actions:

• Temporarily suspend the student from participating in all or part of the Chobanian & Avedisian School of Medicine program, if deemed warranted to protect the safety and well-being of the student or others in the University community, including the medical school’s affiliates.
• Require the student to provide satisfactory evidence of fitness, which may include the results of a medical evaluation of fitness by the student’s treating medical provider or by the Physician Health Services of the Massachusetts Medical Society to determine whether the student can perform safely and reliably. The student must consent to allow their medical provider to provide relevant medical information to a health care provider designated by the medical school to ad-vise the Associate Dean of Student Affairs and the SEPC.

If the circumstances suggest that the student is unfit, the SEPC or Disciplinary Committee may, based on the situation, ask the student to do any or all of the following:

• Take a LOA for a specified duration.
• Receive treatment as appropriate during the LOA.
• Enter a treatment program and monitoring program, (e.g. Physician Health Services).
• Withdraw from the School of Medicine if remediation of unfitness is unavailable as an option, or has been reasonably tried without success.
• Dismiss from the school of medicine

If, at any time, the student refuses or materially fails to comply with a request made by the Associate Dean of Student Affairs in conformity with this Section of the policy, the Associate Dean may proceed according to the Medical Student Code of Academic and Professional Conduct. The student will have the rights of hearing and appeal provided under that Code.

If the student agrees to take a LOA at the request of the Associate Dean and/or to enter a treatment or monitoring program, then the Associate Dean of Student Affairs in conjunction with the SEPC and/or with Physician Health Services may require continued medical monitoring and reporting to the Associate Dean as a condition of re-entering and continuing in the curriculum. In addition, if the student has been or will be out of the curriculum for a significant period of time, the SEPC will establish any necessary academic requirements for return to the curriculum.

Continued or repeated non-compliance with monitoring required in accordance with this policy or continued or repeated lack of medical fitness may lead to a determination by the Associate Dean, in conjunction with the SEPC and/or the Physician Health Services, that underlying causes of unfitness cannot be remediated. The Associate Dean may then recommend to the SEPC that the student be Suspended or Dismissed from the curriculum for repeated lack of fitness. If a student requests an accommodation for a disability, the student’s request will be evaluated in consultation with the Boston University Office of Disability Ser-vices and the Dean of the School of Medicine.

6.2 Other LOAs
A student’s petition must include the reason for requesting a non-medical LOA, the expected duration of the LOA, and should describe the student’s plan to address any current academic difficulties or those that might result from an extended period away from the curriculum.

The Associate Dean of Student Affairs may approve a LOA for a student in good academic standing and will notify the SEPC Chair and Registrar of any LOA approval. A petition for a non-medical LOA from a student who is not in good academic standing must be submitted to the SEPC for review, unless the SEPC Chair authorizes the Associate Dean of Student Affairs to act on the student’s petition.

Any student who takes a LOA will be reviewed by SEIC at the next meeting and if identified as at academic risk based on performance to date, SEPC will be notified and will be provided with recommendations which may include additional expectations upon return such as required clinical coaching, tutoring, required meetings with the Associate Dean of Medical Education.

6.3 Excused Absences
A request for an excused absence of less than one semester is not considered a request for a LOA. A student can be placed on an emergency short-term leave for up to 14 days without any curricular modifications in curricular time within the first 2 years. After 14 days, students may need to modify their curriculum and needs to petition the SEPC. The Associate Dean of Student Affairs may grant emergency absences from the curriculum and will notify the SEPC Chair, the Registrar, and the ADME. The SEPC may bring a student who is not in good academic standing or who has more than one emergency absence before the Commit-tee for further discussion. A student who has modified their curriculum due to one period of absence must submit a new petition for subsequent modifications.

6.4 Delays in the Curriculum for USMLE Step 1
Rising M3 students who have not shown readiness to pass the USMLE Step 1 exam, may be permitted, via written petition to the SEPC for a delay to the start of clerkship for further preparation. The Associate Dean of Student Affairs, after consultation with the Academic Enhancement Office, may provide administrative approval petitions that result in delay of up to 10 weeks. A student who requires a clerkship delay of 12 weeks or more will be required to come before the SEPC. A student who takes greater than 12 weeks of additional preparation may be required to take a LOA for the remainder of the year.

Each proposed change to schedule and/or enrollment requires written petition to the SEPC.

Postponing the start of the third-year curriculum by more than 4 weeks may result in delay of graduation, as students may not be able to fit all requirements for residency application into the allotted fourth-year schedule. A student approved to enter the curriculum after delaying 12 weeks will be enrolled as part-time for that semester, and will have expected graduation date delayed by one year.

If a student requires a year-long LOA to prepare for Step 1, they must have a passing Step 1 score documented within one year of the ISP end-date to continue in the program. To participate in the 3rd Year schedule selection process, a student must be registered for Step 1, and have scheduled a test date prior to the opening of the scheduling process. If a student has not taken Step 1 by the time the 3rd year scheduling process opens, but has sat and passed by the end of ISP, they will be given a schedule for the year based on available rotations and sites. A student who has a documented passing Step 1 score prior to the end of the Fall semester may also request to participate in the Research Semester at BU for the Spring semester, in-stead of continuing in LOA.

All delays to the start of the 3rd year are reported to the SEPC. Postponing the start of the third-year curriculum by more than 4 weeks may result in delay of graduation, as students may not be able to fit all of the requirements for residency application into the allotted 4th year schedule. A student approved to enter the curriculum after delaying 12 weeks will be enrolled as part-time for that semester, and will have expected graduation date delayed by one year.

All students are required to take the Transitional Clerkship if they plan to enroll in the 3rd year at any time during that academic year.

6.4.1 Failure of Step 1
A student who fails the USMLE Step 1 must meet with a dean in the Student Affairs Office to develop a plan to retake Step 1 and may not begin the next third year block until Step 1 has been retaken.

Any student who fails USMLE Step 1 for the first time may finish their current rotation, but may elect to de-fer the shelf exam and will receive an Incomplete grade. The student’s course of study will stop until Step 1 has been re-taken, after which, the student may re-enter the curriculum. If the student fails Step 1 a second time, the student must leave the curriculum and may not re-enter until the student passes Step 1 and may be placed on probation. A student who has failed Step 1 must repeat the exam and achieve a passing score within 6 months of receiving the failed Step 1 score. If a student fails USMLE Step 1 three times, the SEPC may dismiss the student.

6.5 Petition for Return from a LOA
For reinstatement to the curriculum after any LOA, a student must file a written petition with the SEPC. The Associate Dean of Student Affairs may approve routine petitions to return to the curriculum for students in good academic standing. The SEPC must review petitions from a student whose absence was related to academic or professionalism issues, and from students who are not in good standing.

When requesting to return from a medical LOA, the student must be evaluated by BU’s Student Health Ser-vices (SHS). All students returning from a medical LOA (including those related to mental health) must begin the return process by submitting the paperwork entitled “Return from LOA” accessible at the Student Health Services site (http://www.bu.edu/shs/resources/forms/).

SHS may either determine that a student has been satisfactorily reviewed, and thus able to return to the curriculum, or may deem “further review required” and refer a student to Physician Health Services prior to allowing the student to re-enter the medical curriculum. Students reviewed by SHS will receive a letter from SHS outlining its assessment. Medical details are not shared with the SEPC members, except by the student or at the student’s request. Confidentiality of the student’s medical information will be protected to the extent possible, consistent with the needs of the University.

6.6 Two-Year Limit on Absences from Curriculum
The maximum time allowable for completion of the medical degree is six (6) years. Time taken for LOAs (whether a single leave or multiple leaves) counts towards the six year period.

6.7 Withdrawal
A student who seeks to leave Chobanian & Avedisian School of Medicine permanently should prepare a re-quest to withdraw in consultation with the Associate Dean of Student Affairs. The withdrawal is effective on the date the statement of intention to withdraw is received by the Office of the Registrar.

To facilitate communication concerning student performance, the medical school employs the following means of communication:

7.1 Administration-Student Communication
Communication is via Boston University email. All students are expected to maintain and regularly access their BU email accounts. Checking email, at least daily, is strongly recommended. Students who do not re-spond to emails after repeated requests from any member of the administration will be sent a profession-alism notification from an Associate Dean or the Registrar after consultation with SEIC. Any student with continued communication concerns will be referred to SEPC for professionalism

In addition, the school requires students to comply with all Boston University requirements and with all hospital compliance requirements in a timely fashion. Failure to maintain current contact information may result in disciplinary action, including but not limited to, removal from the curriculum.

7.2 Family Educational Rights and Privacy Act
All access to information within student records is governed by the policies of the University Registrar in compliance with the Family Educational Rights and Privacy Act (FERPA), found at https://www.bu.edu/reg/general-information/ferpa/.