Progress, Promotion and Graduation

Satisfactory Academic Progress

Students must achieve satisfactory academic progress in order to receive federal financial aid. The Financial Aid Department’s satisfactory academic progress standards mirror the academic progress policies of each individual college. Students found to not be making academic progress by their college are not eligible for federal financial aid. This rule may also apply to state, institutional, and private funds. For more information refer to CenterScope, Satisfactory Academic Progress, http://catalog.uthsc.edu/index.php?catoid=8.

Progress & Promotion Requirements

A Progress and Promotions Committee (P&P) is appointed for each matriculating class. The committee is charged by the Executive Dean of the College of Medicine with monitoring and making recommendations concerning the results of individual student performance in the curriculum until graduation.

The following are the minimum standards for student promotion to the next year of the curriculum and for graduation as set by the College. No student may be promoted to the next year of the curriculum or certified for graduation without having met all of these standards, unless a recommendation for an exception is justified in writing by the appropriate Progress and Promotions Committee (P&P) and accepted by the Executive Dean. An exception to any minimum standard is made only under extremely extenuating circumstances. The statements following the minimum standards are potential recommendations for the disposition of marginal or failing performance regarding that minimum standard.

Any student not having met the minimum standards may be allowed to repeat the curriculum in lieu of regular progress only under extremely extenuating circumstances. The P&P should recommend that a student repeat the curriculum in lieu of regular progress only in those situations in which the following three criteria are met:

• Committee identification of a specific circumstance(s) judged as having had a probable adverse effect on the student’s academic performance;
• Committee judgment that the identified specific circumstance(s) shows probability of resolution in a reasonable period of time;
• Committee expectation that resolution of the identified specific circumstance(s) will result in subsequent satisfactory student performance in the curriculum.

The cumulative grade point average recorded on the transcript from the Registrar is used by the P&P, in part, to make recommendations about the promotion and continuation of students in the curriculum. For students who must retake either courses or clerkships to remove academic deficiencies, the cumulative grade point average is calculated by averaging the final grades attained in all programs in which they have been enrolled for academic credit, including those repeated at UTHSC and those taken in approved summer programs. GPAs are calculated to two decimal places

First Year - Preclinical Courses

Each student must obtain a passing grade in each course.
The Progress and Promotions Committee (P&P), after consideration of all available information including academic performance to date, may make one of the following recommendations concerning student failure of a course(s) within the first year:

• Re-evaluation in the failed course(s).
• Repeat all or part of the first year.
• Academic dismissal from the College.

Each student must achieve a grade point average (GPA) of 2.0 (on a 4.0 scale). The P&P, after consideration of all available information including academic performance to date, may make one of the following recommendations concerning student failure to achieve an overall GPA of 2.0 by the end of the first year:

• Re-evaluation in specified course(s).
• Repeat all or part of the first year.
• Academic dismissal from the College.

Second Year - Preclinical Courses

Each student must obtain a passing grade in each course.
The P&P, after consideration of all available information including performance to date, may make one of the following recommendations concerning student failure of a course(s) within the second year:

• Re-evaluation in the failed course(s).
• Repeat part or all of the first and/or second year.
• Academic dismissal from the College.

Each student must achieve an overall GPA of 2.0.
The P&P, after consideration of all available information including academic performance to date, may make one of the following recommendations concerning student failure to achieve an overall GPA of 2.0 by the end of the second year:

• Re-evaluation in specified courses.
• Repeat part or all of the second year.
• Academic dismissal from the College.

Each student must obtain a passing score at the national standard on the United States Medical Licensing Examination (USMLE) Step 1.
All students must take the USMLE Step 1 examination and pass at the national standard in order to be officially promoted to the Clinical Sciences portion of the curriculum. This examination must be taken by all students in April following their second year unless deferred by the the Senior Associate Dean for Medical Education. Students who are approved for deferment will not begin clerkships until a passing score is submitted.

The P&P will review the total academic performance to date of any student failing to achieve a passing score on the USMLE Step 1 examination. Any student failing to submit a passing score on the first attempt will be withdrawn from the Clinical Sciences portion of the curriculum and will not be scheduled for clerkships until a passing score is submitted. For students who fail the exam a second time, the P&P will review the student’s academic record and recommend a program for the student to follow while preparing to take the examination for a third time. Any student failing to submit a passing score after three attempts will be academically dismissed from the College. Any recommendation for an exception to the College of Medicine policy concerning the USMLE Step 1 examination will be justified in writing to the Executive Dean by the Progress and Promotions Committee. Any student who cannot begin and continue the curriculum as planned will be returned to clinical rotations on a space and place available basis. Students are responsible for working with the Assistant Dean for Clinical Curriculum to understand and minimize the impact on their fourth year schedules.

Third Year - Clinical Rotations

Each student must obtain a passing grade in each core clerkship.
The Progress and Promotions Committee (P&P), after consideration of all available information including academic performance to date, may make one of the following recommendations concerning a grade of “F” in a clerkship within the junior year:

• Re-evaluation in the clerkship in which an “F” was made.
• Repeat the clerkship in which an “F” was made and obtain a grade of “C” or better.
• Repeat all of the core clerkships.
• Academic dismissal from the College

Fourth Year - Clinical Rotations

Each student must obtain a passing grade in each clerkship, selective, or elective program.
The Progress and Promotions Committee (P&P), after consideration of all available information including academic performance to date, may make one of the following recommendations concerning a grade of “F” in a clerkship, selective or elective:

• Re-evaluation in the program in which an “F” was made.
• Repeat the program in which an “F” was made and obtain a grade of “C” or better.
• Academic dismissal from the College

Each student must obtain a passing score at the national standard on the United States Medical Licensing Examinations Step 2CK (Clinical Knowledge) and Step 2CS (Clinical Skills).
All students must take the USMLE Step 2CK and Step 2 CS examinations and pass at the national standard in order to be certified for graduation. All required core clerkships must be completed before the student is eligible to sit for these examinations. Students should take the Step 2 CK and the Step 2 CS examinations no later than December 31st of their senior year. Any student failing to submit a passing score on the first attempt will be allowed to retake the exam. Any student failing to submit a passing score on the second attempt may be allowed to retake it again after consultation with the P&P Committee. Any student failing to submit a passing score after three attempts will be academically dismissed from the College. Any student sponsored for a second or third attempt may be required to remain enrolled in a Special Topics course until the examination has been retaken, regardless of whether or not all other academic requirements have been met. Any recommendation for an exception to the College of Medicine policy concerning the USMLE Step 2CK and Step 2CS examinations will be justified in writing to the Executive Dean by the P&P. Students must work with the Office of Financial Aid to understand the ramifications of these delays on their federal financial aid.

Progress and Promotions Process and Roles

The Progress and Promotions Committee (P&P)
The Progress and Promotions Committee is charged by the Executive Dean of the College of Medicine with monitoring and making recommendations concerning the results of student performance in each academic year and certification of students for graduation. A committee is appointed for each academic class and will remain with that class through graduation. Each Committee is composed of faculty members, including a voting chair. The Executive Dean of the College of Medicine appoints all members, including the chair. The Senior Associate Dean for Medical Education appoints ex-officio non-voting members to the Committee. The Office of Medical Education and/or the Office of Student Affairs provides each Committee with all pertinent information available from the Registrar’s Office and College of Medicine student records for those students under consideration. The deliberations of a Committee are confidential. A recommendation by the P&P to the Executive Dean requires a majority vote of the members present. The meetings are called by the Senior Associate Dean for Medical Education or the Committee Chair as necessary. The Committee maintains written records of the recommendations made to the Executive Dean. Summaries of Committee proceedings are on file in the Office of Medical Education.

The Progress and Promotions Committee only makes recommendations to the Dean.  P&P recommendations only become effective if accepted by the student or finalized on appeal to the Dean.  A student who does not accept the recommendation may appeal and will continue in the curriculum in most cases until the Dean makes a final decision.

Role of Course Directors Concerning Progress and Promotions
Each Course Director is responsible for the evaluation of students and the assignment of student grades in the course(s) for which he/she is responsible, and for presenting to the appropriate Committee all pertinent data collected on any student during a course in which a student earned an “F” (failing) or “I” (incomplete) grade. In addition, each Course Director reports to the Committee the method, if any exists, by which any grade can be modified or changed.

Role of the Student When Recommended for Committee Consideration
A student has the right to appear before the P&P when his/her academic standing is initially discussed and after an adverse recommendation has been reported by the P&P.  It is the responsibility of the student requesting consideration by a Progress and Promotions Committee (P&P) to obtain and submit any information or documentation to support an alternative to an adverse recommendation by the P&P. This includes any academic, psychiatric, personal, financial or physical information the student wishes to release to the P&P and the Associate and Assistant Deans. The Office of Medical Education and the Office of Student Affairs are responsible for assisting the student in obtaining this information.

Appeal of Progress and Promotions Committee Recommendations
In the case of an adverse recommendation, the student has the right to reconsideration by the Progress and Promotions Committee (P&P) that made the original recommendation. The student must make a request to the Office of Medical Education within five (5) working days of receipt of written notification of the P&P recommendation. The student will meet with the P&P and have the opportunity to bring with him/her any person(s), excluding legal counsel, whom the student feels  can contribute to  his/her presentation to the P&P. Committee reconsideration is conducted without the presence of legal counsel. Should the original adverse recommendations be sustained by the P&P, the student may then appeal to the Office of Medical Education and subsequently to the Executive Dean of the College of Medicine.

Role of the Senior Associate Dean for Medical Education Concerning Student Progress and Promotions
The Senior Associate Dean for Medical Education reviews all recommendations made by the Progress and Promotions Committee (P&P) and, after all Committee considerations have taken place, submits these to the Executive Dean for consideration and decision. At that time, the Senior Associate Dean for Medical Education either concurs in the recommendation(s) of the P&P or makes alternative recommendation(s) to the Executive Dean. The recommendation(s) of the P&P, as well as the position of the Senior Associate Dean for Medical Education, are communicated to the student in writing by the Senior Associate Dean or designee. The position of the Senior Associate Dean for Medical Education and the decision of the Executive Dean will be reported to the P&P.

Role of the Executive Dean Concerning Student Progress and Promotions
The Executive Dean may receive recommendations from the Progress and Promotions Committee, the Senior Associate Dean for Medical Education, and other sources concerning the result(s) of individual student performance in the curriculum. W ithin the College, only the Executive Dean makes decisions concerning the result(s) of individual student academic performance. Any student wishing to appeal to the Executive Dean concerning recommendation(s) made in his/her case must make a written request to the Executive Dean within five working days of receipt of written notification of the recommendation(s) concerning his/her case from the Senior Associate Dean for Medical Education. The Executive Dean will review all documentation supplied by the P&P, the Senior Associate Dean for Medical Education, and the student. At the sole discretion of the Executive Dean, there may be a meeting with the student. The student is considered to have been dismissed from the College of Medicine at the time of the Executive Dean’s action. Any appeal to a higher level is an appeal for reinstatement.

Readmission Process
Any student dismissed for academic reasons may apply for readmission, but must follow all procedures required of new applicants. If readmitted, exceptions to state or federal licensing regulations may be needed to allow successful completion of the program.

Pre-clinical Courses Evaluation

Biomedical Science (Years One and Two - Preclinical courses)
Examinations are given at periodic intervals during this portion of the curriculum. The content of each examination is established by the course director. The questions are generally multiple choice and computer graded. Each student’s individual examination score report is returned promptly online through the exam system. Scores are usually recorded in the course learning management system site for student access.

It is the responsibility of each course director to establish the criteria for awarding course grades and the role of examinations in the determination of those grades. Any concerns relative to individual examination questions, criteria for course evaluation, or final grades should be directed to the appropriate course director. Laboratory performance, participation in small group activities, special projects, etc., may also influence the final grade in each course. Each course director is responsible for communicating this information on the first day of class.

Students are expected to take examinations as scheduled. Those unable to take a scheduled examination because of illness or emergency situations must notify the Assistant Dean for Basic Science Education and the appropriate course director prior to the examination.

All students must take the United States Medical Licensing Examination(USMLE) Step 1 and pass at the national standard in order to be officially promoted to the clinical portion of the curriculum. This examination is taken by all students following the successful completion of all components of the Biomedical Sciences curriculum. Delay in taking this examination must be approved by the Senior Associate Dean for Medical Education.

M1 and M2 Remediation Policy

The integrated courses of the revised curriculum present remediation challenges. W ith the exception of gross anatomy (covered in the Structural Basis of Normal Body Function), there are no summer courses that are inclusive of the content in our revised courses. Even in the case of SBNBF, histology and embryology may not be adequately represented in a summer course.

Course remediation will only be offered to students who fail a course with a final percentage in the range of 63-68%. These students will receive an  “I” (incomplete) for the course, which will be converted to a letter grade upon completion of remediation. Students who perform satisfactorily in remediation will receive a “C” grade (and no higher) for the course. Failure to pass remediation will result in an “F” grade for the course. Students who earn a final score below 63% will receive an “F” grade for the course.

Only one course per year may be remediated by students. If a student receives more than one “I” grade or a combination of “I” and “F” grades, the student will be required to withdraw from all classes upon receipt of the second deficient grade and will be referred to the standing Progress and Promotions Committee. The student may be allowed to attempt remediation of one “I” grade while all others will be converted to an “F” grade. Choice of which “I” grade to remediate will be made by the student after consultation with the Progress and Promotions Committee.

Remediation of a first year course will occur during the summer break between the first and second years. Remediation of a second year course will occur after the end of the second year curriculum but prior to sitting for Step 1. Students will not be allowed to sit for Step 1 until all courses are successfully completed. Students who fail a course will be reviewed by the standing Progress & Promotions committee and allowed all current standards of appeal for continuation in the curriculum.

Repeating First- and Second-Year Courses

A student withdrawing from courses in the first or second year will receive a “W”, “WP”, or “WF” grade, as appropriate, on his/her official transcript. When a student does not complete a first- or second-year course at UTHSC, he/she must repeat the course at UTHSC. The Progress and Promotions Committee has the option of recommending that a student who completes but fails first- or second-year courses, or a cumulative GPA less than 2.0 at the end of the first or second academic years, may correct the academic deficiency or unacceptable cumulative GPA requirement by successfully completing courses taken at other institutions, courses repeated at UTHSC, or both. All courses taken for academic credit are recorded on the official transcript and computed in the GPA.

Clerkship Evaluations

Clinical Clerkships (Years Three and Four - Clinical rotations)
Student evaluation in the clerkships portion of the curriculum includes written examinations as well as an increased emphasis on other forms of evaluation. Clerkship examinations are normally multiple choice formats and most are obtained from the National Board of Medical Examiners (NBME). Oral examinations are utilized in some clerkships and are administered by faculty and house staff. In addition, clinical performance is evaluated by attending faculty and house staff in such areas as:

• history taking and physical exam
• progress notes and oral presentations
• fund of knowledge and understanding of disease mechanisms
• clinical application
• problem solving
• professional attributes and responsibilities
• self-improvement and adaptability
• information management
• relationships with patients
• interpersonal relationships.

The methods of evaluation are established by each clerkship director and communicated to students during clerkship orientations. Student evaluation reports are filed in the Office of Student Affairs and are available for review by the student. Student evaluations are also maintained by departmental offices. A student unable to take a clerkship examination due to illness or other emergency situation must notify the director of that clerkship at the earliest possible time. Concerns affecting individual examination questions or other forms  of evaluation, as well as final grades, should be directed to the appropriate clerkship director. This must be done within one block of notification of the award of the final course grade. Evaluation of students in selectives and electives does not normally include a written examination. The evaluation method is established by the course director and available to the student on the first day of the rotation.

Completion of the Degree of Doctor of Medicine

The College of Medicine offers an educational program leading to the Doctor of Medicine (M.D.) degree. The M.D. degree is awarded after completion of degree requirements in May, August or December. UTHSC holds two commencement exercises annually, in May and December. Only those students who will complete all requirements on time will be allowed to participate in commencement activities. Degrees are also conferred in August without an official commencement ceremony. The August conferral date is available to students who complete their degree requirements after the May graduation date and prior to September 1. For other students completing requirements for the Doctor of Medicine degree out of phase, the transcript will be posted with the date of completion of all degree requirements.The diploma, as well as each student’s official transcript, reflects the awarding of the M.D. degree. Those who do not complete their requirements in time for the May commencement ceremony will not receive their degree, and they are therefore ineligible to begin post-graduate training.

Health Science Center policy allows for the awarding of degrees at times other than the official conferral dates in cases such as when residency positions or national board examinations require an official diploma..

Time for Completion of the Medical Degree
The College of Medicine curriculum is designed and coordinated for students to complete the requirements for the M.D. degree in four years. In the event that students feel they cannot continue in the regular curriculum, they may choose to take a leave of absence (LOA), working with the Senior Associate Dean for Medical Education. Similarly, as a passing score on USMLE Step 1 is required to enter the clinical portion of the curriculum and a passing score on Step 2CK and Step 2CS is required for graduation, students may need to delay entry into the clerkships or residency while completing the USMLE requirements.

Students will have six consecutive years to complete the COM curriculum, including time spent on LOA or out of the regular curriculum to complete the USMLE requirements. Failure to meet graduation requirements by the end of the sixth year following initial COM matriculation will result in dismissal. The limit of six total years applies to all medical students, but excludes time spent in other curricula for students in dual degree programs or other approved educational programs.

If for any reason students choose to delay normal progression through the curriculum, they must meet with the Senior Associate Dean for Medical Education and acknowledge in writing that they understand the delay may jeopardize their ability to complete the course of study in the required number of years. Any appeal to extend the number of years beyond six years must be approved by the Progress and Promotions Committee and by the Senior Associate Dean for Medical Education or designee.

Commencement Activities

Commencement activities are held in May and December of each year. An aspect of the May commencement is the Deans’ Convocation in honor of the graduating class and their families. This ceremony includes an address by the Executive Dean of the College of Medicine, presentation of doctoral hoods, recognition of honors and award recipients, administration of the Oath of Hippocrates, and addresses by faculty and student representatives.

The UTHSC Office of Student Affairs provides information concerning commencement activities. Attendance at the commencement ceremony is required of all students. Graduation in absentia may be permitted by the Executive Dean after a petition for graduation in absentia is submitted to the College of Medicine’s Office of Student Affairs at least two months before graduation. Students should contact the Office of Student Affairs for further information.

United States Medical Licensure Examinations (USMLE)

Each individual state determines requirements for licensure to practice medicine in that state and maintains the standards of medical practice in accordance with its own rules and regulations. To this end, each state has a medical licensure board charged with maintaining the standards for licensure in that state and in evaluating credentials submitted to them for licensure. Regulations of state licensing boards are subject to change without notice and each board should be contacted concerning the specific requirements for licensure in that state.

The Federation of State Medical Boards of the United States (FSMB) and the National Board of Medical Examiners (NBME) have established a single common uniform examination for medical licensure in the United States, the United States Medical Licensing Examination (USMLE). The USMLE is a single examination program with three complementary steps. Step 1 assesses whether an examinee understands and can apply key concepts of basic biomedical science, with an emphasis on principles and mechanisms of health, disease, and modes of therapy. The USMLE Step 2 has two components. Step 2CK (Clinical Knowledge) assesses whether an examinee possesses the medical knowledge and understanding of clinical science considered essential for the provision of patient care under supervision, including emphasis on health promotion and disease prevention. The Step 2CS (Clinical Skills) assures that examinees have the data gathering and communication skills necessary to enter supervised postgraduate education and for subsequent licensure.

A passing score on the Step 1, 2CK, and 2CS examinations is a requirement for the M.D. degree at the UTHSC College of Medicine. A student will normally sit for the Step 1 examination at the end of the M2 year and will sit for the Step 2 examinations by December 31st of the M4 year. USMLE Step 3 assesses whether an examinee possesses the medical knowledge and understanding of biomedical and clinical science considered essential for the unsupervised practice of medicine, and is taken during residency training. To be eligible for the Step 3 Examination, an individual must obtain the M.D. degree and must have completed successfully Step 1, Step 2 CK, and Step 2 CS examinations.

The USMLE Step 1 and Step 2 exams are administered by the National Board of Medical Examiners (NBME) for all eligible examinees. Further information can be found at http://www.nbme.org/. The Step 3 examination is administered by licensing authorities for the state in which the learner is completing post-graduate training. Information can be obtained from the National Board of Medical Examiners.

Taking USMLE Step 2 Exams During the Required Clerkships

All students must take the United States Medical Licensing Examinations, Step 2CK and 2CS, and pass at the national standard in order to be certified for graduation. The Step 2CK and Step 2CS exams should be taken no later than December 31 of the M4 year. Students must declare, in writing to the appropriate clerkship director, if they have registered to take the USMLE Step 2 exams during a required clerkship. Students are not permitted to schedule the USMLE Step 2 exams at times conflicting with the scheduled administration of any end-of-clerkship examinations.

The declaration must be done as soon as possible, but no later than two weeks prior to the orientation to the appropriate clerkship and be on file in the clerkship director’s office. A student who is registered to take Step 2, and who has properly indicated such, will be provided with an excused absence from all clerkship activities to sit for the USMLE. The course director has the discretion to allow, on a case-by- case basis, an appropriate number of days with the excused absence prior to the examination date. If not notified properly, the clerkship director reserves the right to refuse a student’s request for excused absence from the scheduled activities.