I. PURPOSE
Professionalism is a core competency expected of all physicians. Physicians are expected to demonstrate attitudes, behavior, and habits that are responsible, accountable, self-directed, ethical, help-seeking, and professional. The New York Medical College (“NYMC” or the “College”) School of Medicine (“SOM”) expects all students to adhere to the high standards of behavior expected of physicians during all professional and patient care activities at the school, its academic affiliates, and in the community. This includes, but is not limited to, being respectful of their peers, faculty, administration, staff, patients, the institution, and the community, being aware of the ways in which their conduct may affect others, and conducting themselves with honesty, compassion, integrity, and adherence to ethical principles in all interactions.
The purpose of this policy is to provide consistent guidelines for professionalism and professional behaviors in academic and clinical settings in the NYMC SOM, including procedures for assessing and addressing any lapses in professionalism.
II. POLICY
A. Consistent with the Graduation Competencies and Medical Education Program Objectives and SOM Technical Standards for Admissions and Continued Enrollment, medical students must demonstrate attitudes, behaviors, and habits expected of healthcare professionals, as well as a commitment to carrying out professional responsibilities in a responsive and compassionate manner and in adherence to ethical principles.
B. As stated in the Professionalism Graduation Competencies and Medical Education Program Objectives, medical students are expected to:
i. Demonstrate responsiveness to patient needs and advocate for those needs over one’s own interests and beliefs;
ii. Relate to others with respect, care, and compassion;
iii. Demonstrate cultural sensitivity and responsiveness to a diverse patient population;
iv. Demonstrate honesty, integrity, responsibility, accountability, and leadership;
v. Demonstrate a commitment to scholarship; and
vi. Demonstrate a commitment to ethical principles, including patient privacy and autonomy.
C. Specific professional expectations may include, but are not limited to:
i. Attending all mandatory academic sessions;
ii. Requesting an absence, in advance, by notifying appropriate individuals in accordance with the NYMC Policy on Attendance and Absence;
iii. Arriving to all academic and clinical sessions and meetings on time and prepared to participate, and remaining until the session is over;
iv. Submitting all assignments and meeting all responsibilities in stated time frames;
v. Engaging in supportive and appropriate behavior with faculty, staff, other students, and all members of the NYMC community during in-person, virtual, or online encounters and communications encounters;
vi. Responding to communications from peers, staff, faculty, or administration within two business days or after two attempts;
vii. Communicating in a manner that supports relationship-building to ensure common understanding when conflicts occur;
viii. Completing all required evaluations by the stated deadline;
ix. Maintaining appropriate dress to sessions as outlined on the learning management system (e.g., LEO);
x. Maintaining business casual attire or hospital-approved uniform for all clinical, standardized patient, and non-classroom educational settings (white coats are expected in patient encounters unless otherwise specified);
xi. Demonstrating respect for faculty and peers (e.g., participating in all teaching sessions without distractions, including having cameras on for virtual small group sessions); and
xii. Consistently and visibly wearing the NYMC identification badge when on campus or at clinical sites.
D. Behaviors that are considered lapses in academic professionalism may include, but are not limited to:
i. Recurrent tardiness to rounds, sign-out, small group, didactic lecture, activities at the Clinical Skills Center, other required activities during Pre-Clinical or Clinical years, etc. (NOTE: Tardiness of greater than 30 minutes will be considered an unexcused absence.)
ii. Noticeable disengagement and/or rude commentary.
iii. Leaving clinical shifts or sessions before the shift or session has concluded or dismissal by the supervisor.
iv. Unexcused absence for an academic session or clinical assignment.
v. Lack of timely completion of academic or patient care responsibilities.
vi. Late or missing assignments.
vii. Lack of completion of one or more required evaluations by the deadline.
viii. Lack of adherence to professional dress code as per NYMC policy and the affiliate site policy.
III. SCOPE
This policy applies to all medical students in the NYMC SOM.
This policy does not govern academic integrity issues, such as allegations of cheating or plagiarism; such issues are governed by the Touro University System Academic Integrity Policy and the SOM Policy on Student Conduct.
IV. DEFINITIONS
- MSPE – Medical Student Performance Evaluation
- SAPRC – Student Advancement, Promotions, and Review Committee
- SAST – Student Academic Success Team
- Course Director – Module, Clerkship, or Course Director
V. PROCEDURES
A. Grading of Professionalism
i. Although professionalism is not graded during Phase 1 of the curriculum, it is nonetheless an expectation of all students, as set forth in this Policy.
ii. Professionalism is a component of grading during Phases 2 and 3, as set forth in the clerkship syllabi and SOM Grading Policy for Phase 2 and Phase 3.
1. Medical students will receive formative feedback in the Professionalism competency as part of mid-clerkship feedback, with recommendations for improvement as necessary. Medical students will receive summative feedback at the end of each clerkship as part of the Professionalism competency.
2. Assignments not submitted by the end of the clerkship will result in an automatic failure of the Professionalism competency.
3. Recurrent lapses in professional behavior or one egregious lapse in behavior will result in failure of the Professionalism competency.
4. Failure of the Professionalism competency results in failure of the clerkship.
B. Procedures for Documenting and Remediating Lapses in Professionalism
i. When a Course Director determines that a student has demonstrated a lapse in academic professionalism as described in the Policy, the Course Director shall issue the student a written warning with recommendations for improvements. A copy of the written warning shall be sent to the Dean of Students and the Dean of Ethics and Professionalism.
ii. If unprofessional behaviors continue, the Course Director, in consultation with the Dean of Ethics and Professionalism, may develop a remediation plan for the student. The Course Director, in consultation with the Dean of Ethics and Professionalism, determines if/when the student has successfully completed a required remediation. All remediation plans will be documented and sent to the Dean of Students and the relevant Phase Administrator.
iii. Written warnings and remediation plans related to lapses in professional behavior, as described above, will be included in the student’s record.
iv. Lapses in professionalism will be tracked longitudinally across the student’s academic career by the Dean of Students and the Dean of Ethics and Professionalism.
1. Professionalism lapses will be discussed during regularly scheduled SAST meetings to identify areas where support may be needed.
2. Professionalism lapses may be considered in decisions for selection for honor societies, awards/scholarships, and other institutional honors.
C. Procedures for Addressing Recurrent or Significant Lapses of Professional Behaviors
i. A pattern of lapses in academic professionalism behavior, or one serious lapse in professional behavior, may be referred to the SAPRC at the discretion of the Dean of Students and/or the Dean of Ethics and Professionalism. Written warnings and remediations with the Course Director, as described in Section V, are not required before referral to SAPRC.
ii. All referrals to SAPRC will be documented in the student’s record and/or in the MSPE by description of the behavior(s) and curriculum phase in which they occurred. Medical students are able to review their MSPE as per theMedical Student Performance Evaluation Policy.
iii. Procedures governing SAPRC meetings are set forth in the SOM Policy on Student Promotions.
iv. Following a SAPRC’s review of professionalism issues referred to it, SAPRC may:
1. Determine that no further action is necessary.
2. Determine that the student requires remediation.
a. If SAPRC requires remediation, it shall refer the student to the Dean of Ethics and Professionalism to create a remediation plan appropriate to the specific situation. Such remediation may include:
i. Reflective/educational assignment
ii. Development of a personalized learning plan
iii. Other activities based on the nature of the professionalism lapse(s)
b. The Dean of Ethics and Professionalism shall determine, in their sole discretion, whether the student has successfully remediated and shall share this information with SAPRC for further action, if appropriate.
3. Determine that a student requires a leave of absence to address professionalism issues.
4. Determine that a student cannot meet the professionalism requirements set forth in the Graduation Competencies and Medical Education Program Objectives and SOM Technical Standards for Admissions and Continued Enrollment and dismiss the student.
5. Take any other action it deems appropriate.
v. Students may appeal adverse action decisions (i.e., related to advancement, graduation, or dismissal) of SAPRC as per the SOM Policy on Adverse Actions. All other decisions of SAPRC are final.
VI. EFFECTIVE DATE
This policy is effective immediately.
VII. POLICY MANAGEMENT
Executive Stakeholder: Dean, School of Medicine
Oversight Office: Office of Student Affairs
VIII. RELATED ACCREDITATION STANDARDS AND ELEMENTS
A. 3.5 Learning Environment/Professionalism: A medical school ensures that the learning environment of its medical education program is conducive to the ongoing development of explicit and appropriate professional behaviors in its medical students, faculty, and staff at all locations. The medical school and its clinical affiliates share the responsibility for periodic evaluation of the learning environment in order to identify positive and negative influences on the maintenance of professional standards, develop and conduct appropriate strategies to enhance positive and mitigate negative influences, and identify and promptly correct violations of professional standards.
