I. PURPOSE
The purpose of this policy is to provide consistent guidelines for professionalism and professional behaviors, their assessment, and remediation in the New York Medical College, School of Medicine (“NYMC SOM”). In accordance with the NYMC Student Code of Academic Integrity and Professionalism, this policy makes explicit the attitudes and behaviors described by the term professionalism, which serve as the foundation of the expectations that society has for members of the medical and health sciences community.
II. POLICY
A. It is the policy of NYMC SOM that parameters be defined regarding the expectations for medical students’, as physicians in training, professional behaviors and the procedures for promoting and assessing professional behaviors.
B. Medical students, as physicians in training, are expected to demonstrate attitudes, behaviors and habits expected of healthcare professionals, a commitment to carrying out professional responsibilities in a responsive and compassionate manner, as well as in adherence to ethical principles.
C. As stated in the Professionalism Graduation Competency and Program Objectives, medical students, as physicians in training must:
1. Demonstrate responsiveness to patient needs and advocate for those needs over one’s own interests and beliefs
2. Relate to others with respect, care, and compassion
3. Respond to colleagues’ needs, expectations, and concerns, including solicitation of other clinical opinions
4. Demonstrate cultural sensitivity and responsiveness to a diverse patient population
5. Demonstrate honesty, integrity and trustworthiness
6. Demonstrate respect for patient privacy and autonomy
7. Demonstrate responsibility, leadership, and accountability
8. Demonstrate excellence and scholarship
9. Demonstrate a commitment to ethical principles
10. Demonstrate understanding of the importance of personal wellness in one’s professional responsibilities and demonstrate appropriate self-care
11. Demonstrate a commitment to reflection, self-improvement and responsiveness to feedback
D. Expectations for Medical Students’ Professional Behaviors include but are not limited to:
1. Attending all mandatory academic sessions
2. Requesting an excused absence by notifying appropriate individuals in accordance with the NYMC Policy on Attendance and Absence
3. Arriving to all academic and clinical sessions and meetings on time and prepared to participate and remaining until the session is over (Tardiness of greater than 30 minutes or leaving early without permission will be considered an unexcused absence.)
4. Submitting all assignments and meeting all responsibilities in stated time frames
5. Engaging in supportive and appropriate behavior with faculty, staff, all members of the NYMC/Touro community, and other students during in-person, virtual, or email discussions
6. Responding to communications from NYMC peer, staff, faculty, or administration within 48 business hours or after two attempts
7. Communicate in a manner that supports relationship-building to ensure common understanding when conflicts occur
8. Completion of one or more required evaluations by deadline
9. Adhering to all procedures and expectations for behavior
10. Maintaining appropriate dress to sessions as outlined on the learning management system.
11. Maintaining business casual attire for all clinical, standardized patient, and non-classroom educational settings
12. Demonstrating respect for faculty and peers (e.g., cameras on for virtual small group sessions, participate in all teaching sessions without distractions)
13. Consistent and visible wearing of the NYMC identification badge
14. Seeking support when student is struggling and/or not meeting medical knowledge, professionalism, or patient care expectations.
E. Additional Expectations of Medical Students’ Professional Behaviors in Phase 2 & 3.
The behaviors listed below are considered disruptions to the professional environment and therefore, lapses in professionalism. The contribution of the professionalism domain to the clerkship grade is outlined in the clerkship syllabi.
1. Recurrent tardiness to rounds, sign-out, small group, didactic lecture, activities at the Clinical Skills Center, other required activities, etc. (NOTE: Tardiness of greater than 30 minutes will be considered an unexcused absence.)
2. Leaving clinical shifts before the shift has concluded or you are dismissed by your supervisor
3. Unexcused absence for a clinical assignment or an academic session
4. Lack of timely completion of patient care responsibilities
5. Late or missing assignments or patient care logs
6. Assignments not submitted by the end of the clerkship will result in an automatic failure of the professionalism domain.
7. Lack of completion of one or more required evaluations by deadline
8. Lack of adherence to professional dress code as per NYMC policy and the affiliate site policy
F. NYMC SOM expects and will encourage the development of professionalism as a unique competency and will remediate medical students, as physicians in training, as necessary.
III. SCOPE
This policy applies to medical students, faculty, staff, and administrators who contribute to the M.D. Program curriculum of the NYMC SOM.
IV. PROCEDURES
A. Grading and Tracking of Professionalism in Phase 1
1. Medical students will receive formative feedback in the domain of professionalism at the end of each module.
2. Medical students will receive summative feedback at the end of each course which will translate into a Pass/Fail professionalism grade that will be combined with the medical knowledge and patient care domains to create the final course grade. The details of professional assessment and the contribution of the professionalism domain to the course grade are outlined in the relevant syllabi.
3. Medical students are encouraged to utilize program resources (e.g., Academic Support, Student Affairs, Student Mental Health Services) to address any potential patterns of behavior that might impede their success as a physician in training.
4. Medical students who are not present at the start of a clinical skills session without having reached out to faculty/staff, will fail on professionalism and will not be permitted to participate in the activity, which may result in a failure of the experience
5. Should a module director deem that a medical student has demonstrated a lapse in professionalism, or should a medical student receive a negative Professional Accolades and Incidents Reporting (P.A.I.R) report, the medical student will receive a warning which will be documented by the Office of Undergraduate Medical Education (UME).
6. Should a medical student receive two warnings regarding lapses in professional behavior within a course, the student will receive written warning documenting the lapses and will be reported to the Office Student Affairs (OSA) and will be discussed during regularly scheduled Student Academic Success Team (SAST) meetings.
7. Should a medical student receive more than two warnings in a course, the student will be reported to the Professionalism and Integrity Committee (PIC).
8. Medical students who receive more than two professionalism warnings in the M.D. Program, will be automatically referred to the PIC and will be subject to additional remediation and/or dismissal.
B. Grading and Tracking of Professionalism in Phase 2 and 3
1. Medical students will receive formative feedback in the domain of professionalism as part of mid-clerkship feedback
2. Medical students will receive summative feedback at the end of each clerkship which is incorporated as part of the Professionalism competency.
3. Lapses of professional behavior outlined above will be noted and tracked longitudinally across clerkships.
4. Should a clerkship director deem that a medical student has demonstrated a lapse in professionalism, or should a medical student receive a negative P.A.I.R report, the physician in training will receive a warning which will be documented by UME and will be reported to both the OSA and to the PIC for remediation.
5. Recurrent lapses in professional behavior or one egregious lapse in behavior will result in failure of the Professionalism competency, which may result in failure of the clerkship or dismissal from the SOM.
C. Procedures for Remediation of Recurrent or Significant Lapses of Professional Behaviors
1. The PIC is the main body responsible for working with medical students at risk in the domain of professionalism. It will create a remediation plan appropriate to the specific situation.
2. Any medical student identified as at risk in the domain of professionalism will be discussed during regularly scheduled SAST meetings, where additional recommendations and resources to address concerns may be identified.
3. If a medical student does not achieve the minimum requirements for the professionalism domain for a course or clerkship as outlined in the course or clerkship syllabi, the physician in training will fail the professionalism domain for that course or clerkship. Failure of the professionalism domain will result in failure of the course or clerkship.
4. A medical student who fails the professionalism domain or demonstrates either a pattern of lapses of professional behaviors or a one-time, significant lapse of professional behavior (outlined in the Student Code of Academic Integrity and Professionalism), will be reported to OSA and the PIC for inquiry and remediation, using the P.A.I.R. system.
5. In the case of a failure in the professionalism domain, remediation may include:
a. Reflective/educational assignment
b. Development of a personalized learning plan
c. Other activities based on the nature of the professionalism lapse(s)
6. Recurrent or significant lapses of professional behavior will be documented in the medical students’ formal educational record and/or in the MSPE by description of the behavior(s) and curriculum phase in which they occurred. Medical students will be advised in advance of such documentation.
7. Recurrent or significant lapses of professional behavior may result in dismissal from the SOM.
8. Recurrent and/or significant lapses of professional behavior will also be considered in selection for honor societies, awards/scholarships, and other institutional honors.
V. DEFINITIONS
A. Medical student: a person enrolled in an educational program of NYMC SOM
B. Staff: NYMC SOM personnel
C. Faculty: Formal designation for a person involved in teaching, supervising, and assessing students enrolled in a NYMC SOM educational program, whether M.D., Ph.D., nurse, allied health professional, resident, fellow, or other.
D. Learning management system: a web-based system for curriculum management in the medical education program.
VI. EFFECTIVE DATE
This policy is effective immediately.
VII. POLICY MANAGEMENT
Executive Stakeholder: Dean, School of Medicine
Oversight Office: School of Medicine
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.
