Academic Policies

Academic Progress

The Higher Education Amendments that govern Title IV Federal Financial Assistance Programs state a student shall be entitled to receive federal student assistance benefits only if that student is maintaining progress in the course of study he/she is pursuing, according to the standards and practices of the institution.

LSU Health Shreveport School of Medicine’s Policy Academic Progress requires a student to complete the medical curriculum by meeting both a qualitative (grade requirement) and a quantitative (work completed) requirement as prescribed by the faculty. All students must complete the curriculum of each year and receive a grade of “P” or better in all required courses before proceeding to the next year or graduating. Students also must complete the graduation requirements by the time of regular spring graduation during the sixth year following the first enrollment.

The student promotions committees makes the determination for Academic Progress. The committee is responsible for reviewing the progress of students at the end of each course or clerkship and at the end of an academic year. Continued enrollment, remedial work and/or repeat of one or more courses, must be approved by the student promotions committee.

Satisfactory Academic Progress

The Federal Student Financial Aid Satisfactory Academic Progress Policy differs from other institutional academic policies, but is consistent with the minimum graduation requirements in place prior to the start of the effective school year. The Financial Aid SAP policy considers only an “F” grade as a failing grade, whereas, the academic programs consider “D” and “F” grades as failing grades. The Financial Aid SAP policy does not monitor the number of “C” or “D” grades received by a student. The academic departments, however, limits the number of “C” and “D” grades that students can receive while enrolled in their current academic programs. Revisions to this policy and implementation, thereof, may not coincide with changes to mid-year academic program policy. A student who has an academic dismissal recommendation overridden by the Dean is not automatically eligible for financial aid. The student is still required to meet Financial Aid SAP requirements or appeal successfully to the Financial Aid Appeals Committee. It is possible for a student to be in good academic standing with their academic program and be ineligible for financial aid because of the student’s failure to meet the Financial Aid SAP requirements.

Aid applicants and recipients will be assigned one of the following statuses after SAP evaluations: Good Standing, Financial Aid Warning, Financial Aid Probation, Academic Plan, and Unsatisfactory. Refer to the Financial Aid Academic Requirements for more information.

Confidentiality of Student Education Records

Approved: 03-18-2021

1. Policy - Students may request in writing for any individual to be granted access to their student records. Access is provided by extracting and securely transmitting the requested records. Access is not granted directly to the electronic records system. The policy is designed to ensure that student educational records are available only to faculty and administration who are permitted to review them in accordance with FERPA and to outline the policy of disclosure of student records to a member of the faculty or administration who have legitimate educational interest.
2. Purpose - It is the purpose of this policy to provide reasonable interpretations of the Federal Family Educational Rights and Privacy Act and to protect the student’s right of privacy as guaranteed therein.
3. Scope - This policy applies to all School of Medicine students, faculty, staff, and administrators.
4. Procedure/Process - Faculty and Administrative Access to Student Information System

All students enrolled at the LSUHSC-S School of Medicine are protected by the Family Educational Rights and Privacy Act (FERPA).  Students’ rights include the right to consent to disclosure of personally identifiable information contained in education records, except to the extent that FERPA authorizes disclosure without consent.

At the School of Medicine, student education records are confidential and available only to those members of the faculty and administration with a legitimate educational interest, unless released by the student or as otherwise governed by laws concerning confidentiality.

The following medical school officials, based on a legitimate educational interest, have access to the education record without student consent.

• Dean
• Provost
• Associate Dean for Academic Affairs
• Associate Dean for Student Affairs
• Director for Academic Affairs
• Director for Student Affairs
• Office of the Registrar staff members
• Student promotions committees members
• Student Professionalism Committee members
• PhD and MD/PhD Program Director (for students in the PhD and MD/PhD Programs)
• Administrative Coordinator involved in preparation of the MSPE

The following medical school officials, based on a legitimate educational interest, have access without student consent only to the portion of the education record that contains grades.

• Module Directors
• Course and Clerkship Directors
• Learning Specialist
• Career Advisors
• Associate Dean for Diversity
• Office of Academic Affairs staff members
• Office of Information Technology staff members

Medical school officials and faculty members not listed above may request access to a student’s education record via the Student Academic Record Request form and are granted access to the record only with the student’s written permission. This request must contain the names of the parties who have requested access and the legitimate interest of the party requesting that information. The record of requests will be maintained by the Office of the Registrar and may be inspected by the student under the same procedures by which the record itself may be inspected.

References to Regulations and/or Other Related Policies:

Family Educational Rights and Privacy Act
LCME Element 11.5: Confidentiality of Student Educational Records

Attendance/Absence Policy

Grading System

1. Policy - Student performance is evaluated by the course director(s) and teaching faculty of each course.   Final grades are based on a composite score derived from written, oral, and practical examination scores, and the score from other required activities. The course director(s) is responsible for final determination of each student’s final grade.
2. Purpose - The purpose of this policy is to delineate how grades are determined for medical students.
3. Scope - This policy applies to all School of Medicine students.
4. Procedure/Process -

• The grading scale is:

• Pass for overall performance greater than or equal to 70%
• Fail for overall performance less than 70%

• The grading scale is:

• Honors for overall performance greater than, or equal to 89.5%,
• High Pass for overall performance greater than or equal to 79.5%, but less than 89.5%
• Pass for overall performance greater than or equal to 69.5%, but less than 79.5%
• Fail for overall performance less than 69.5%

• The grade in a MSIII Course is based on the student’s overall performance in the educational program objectives.
• A mid-course assessment for each student is required for all core courses (not elective courses).  The student’s performance must be reviewed in a face-to-face meeting with a clinical teacher, and the student and clinical teacher must sign the Mid-Course Assessment form prior to the course midpoint. The signed forms must be stored and available for review.
• The final grade will be determined based on a composite score derived from the clinical score, exam score, and the score from other required activities.
• The student will fail the course if he/she:

• receives a failing score on their clinical performance evaluation,
• receives a failing score on their professionalism performance evaluation
• fails the final exam retake, or
• receives a total course score of less than 70% (fail).

• Course Directors will report final grades to the Registrar within four (4) weeks of the end of the course.
• The Incomplete designation may be assigned by the Course Director if: 

• The student has not completed all required activities.
• The student has passed clinically but has failed the final examination and not yet completed the retake.

• A letter grade to replace an Incomplete will be posted within two (2) weeks after receipt of the following:

• Evaluation from the course preceptors.
• Completion of the required activities.
• Receipt of the score on the retake of the final exam.

• A student who retakes an examination due to failure on the first attempt is not eligible for a final Course grade of H (Honors) or HP (High Pass).
• A student who fails a course final exam on the first attempt must schedule a retake and successfully complete the exam within the semester of the failed attempt. A student will fail the course if he/she fails the final exam retake. 

Formative Assessment and Feedback

Approved: 09-18-2020

1. Policy - LSU Health Sciences Center Shreveport (LSUHSC-S) ensures that each medical student is assessed and provided with formative feedback that allows progress in learning to be monitored. Feedback must be provided early enough to allow sufficient time for remediation at the approximate midpoint of a module, course, or clerkship.
   Course and clerkship directors are responsible for ensuring that students receive formative assessment in each required course or clerkship.
   The Office of Academic Affairs is responsible for compliance oversight and non-compliance follow-up.
2. Purpose - The purpose of this policy is to outline the timeline for when formative assessment and feedback will occur and who will provide the feedback.
3. Scope - This policy applies to all School of Medicine students.
4. Procedure/Process -

Required Pre-clerkship Courses

• Students will receive formative assessment by at least the mid-point of each required pre-clerkship course.
• Students must have access to course or module directors (or their faculty designees) throughout the course or module to solicit additional feedback regarding their performance.
• Formative assessment includes, but is not limited to, quizzes, practice questions, and verbal feedback.

Required Clerkships

• A mid-clerkship review meeting must occur by approximately the midpoint of each required clerkship with the clerkship director (or their faculty designee).
• Each clerkship director (or faculty designee), will provide mid-clerkship feedback in person to each medical student on the rotation at the midpoint for that clerkship.
• A mid-clerkship evaluation form should be used for both student self-assessment prior to the meeting and by the clerkship/site director for formative evaluation incorporating feedback from faculty members and residents.
• In addition, the mid-clerkship review should include a review of the student’s clinical log to ensure that the student is on track to meet all required diagnoses and procedures for that clerkship. If deficiencies are found, a plan will be developed with the student to ensure all requirements are met by the end of the clerkship.
• The clerkship director (or faculty designee) and student will sign the mid-clerkship review form at the end of the meeting.
• Students must have access to clerkship directors (or their faculty designees) throughout the clerkship to solicit additional feedback regarding their performance.

Monitoring

Grade Notification Policy

Approved: 10-16-2020

1. Policy -

2. Purpose - Medical students should be provided with fair and timely assessment of their achievement in each course and clerkship. The purpose of this policy is to describe the procedures that should be followed to ensure that the final grades are available within six weeks of the end of a course of clerkship in accordance with the Liaison Committee on Medical Education (LCME) element 9.8.
   Given this requirement, departments are asked to report final grades for clerkships and electives within 4 weeks of the course ending and within 14 calendar days for pre-clerkship courses. The purpose of this policy is to ensure that no grade is delayed beyond 6 weeks from the end of the course/clerkship/elective/sub-internship, as mandated by our accrediting body.

3. Scope - This policy applies to all School of Medicine students, course, clerkship and elective directors, and the office of the Registrar.
4. Procedure/Process -

• If grades are not submitted by the 14th calendar day, the Medical School Registrar will notify the course director via email requesting grades within three calendar days or an explanation why grades cannot be submitted. The Associate Dean for Academic Affairs will be copied on this email.
• If the grades or an explanation is not received within three (3) calendar days, the Medical School Registrar will notify the Associate Dean for Academic Affairs, who will directly address the concern with the course director.
• For instances in which extenuating circumstances prevent the submission of grades within 14 calendar days, the Medical School Registrar will collaborate with the course director and the Associate Dean for Academic Affairs to determine an appropriate deadline and will ensure the grade is recorded in the learning management system within six weeks of the end of the course.

• If grades are not submitted by the end of the fourth week, the Medical School Registrar will notify the clerkship or elective director and the clerkship coordinator via email requesting grades within three (3) calendar days of notification or an explanation why the grades cannot be submitted. The Associate Dean for Academic Affairs will be copied on this email.
• If the grade or an explanation is not received within three (3) calendar days of notification, the Medical School Registrar will notify the Associate Dean for Academic Affairs, who will directly address the concern with the course or clerkship director.
• For instances in which extenuating circumstances prevent the submission of grades within four weeks, the Medical School Registrar will collaborate with the clerkship or elective director and the Associate Dean for Academic Affairs to determine an appropriate deadline and will ensure the grade is recorded in the learning management system within six weeks of the end of the course or clerkship.
• Course, clerkship or elective directors who fail to submit 100% of grades within six weeks of the end of a course, clerkship or elective will meet with the Associate Dean for Academic Affairs with notification to the relevant department chair or designee.

• The grade notification policy should be shared with course, clerkship and elective directors at least annually. All course, clerkship and elective directors should be encouraged to create a streamlined process for the completion and integration of student evaluations in order to meet grade submission deadlines.
• Central monitoring will occur in the office of the Medical School Registrar. Monitoring should include review of grade reports quarterly to identify missing grades as well as documentation extenuating circumstances, and trends of non-compliance. Data will be shared and made available to the Office of Academic Affairs for collaboration efforts and office function. Grade reporting data will be shared quarterly with the appropriate curriculum committee(s).

Remediation Policy

Approved: 09-18-2020

1. Policy - Students will be notified no later than one week after grades have been posted if remediation of a course or clerkship is deemed necessary.
2. Purpose - The purpose of this policy is to outline the process of remediation in pre-clerkship and clerkship courses.
3. Scope - This policy applies to all School of Medicine students.
4. Procedure/Process - The Course or Clerkship Director will notify students of their need to remediate a course no later than one (1) week after course/clerkship grades have been posted. This email will be cc’d to the Associate Dean for Academic Affairs and the Associate Dean for Student Affairs.

• The student must respond to the course director within one week after the notification. It is the responsibility of the student to schedule the remediation process with the course director.
• Students are required to make their first attempt at remediation prior to the next semester. Under certain circumstances, remediation may be delayed with prior permission from the Associate Dean for Academic Affairs.
• All remediations must be completed before a student may move on to the next semester.

• Students requiring remediation must meet with the director of the course to be remediated. If, during this conversation, the student identifies a non-academic contributor to their poor performance (i.e., something medical or social), this should be brought to the attention of the Associate Dean for Student Affairs.
• The process for remediation, as determined by the course director, should be tailored to the individual student through the identification and correction of specific areas of deficiency. Retaking the entire course should only be necessary if the student’s performance in all major content areas is unsatisfactory.
• The course director will provide the Associate Dean for Student Affairs, Associate Dean for Academic Affairs and the Registrar, a record of the remediation process for each student. This record will outline the format of the remediation, the dates on which it occurred, and whether the student successfully remediated on that date. If the student was unsuccessful on an attempt at remediation, the course director will briefly outline how they were unsuccessful. This will be part of the student’s record.
• Students may remediate the grade of F in one course; however, should a student earn two Fs (in spite of one being a successfully remediated F), he/she shall be dismissed.
• Likewise, a student who receives an F on attempted remediation of a failed course shall be considered to have received two Fs and be dismissed.

• If a student fails an end of clerkship NBME exam, the student will be required to remediate the exam. If a student successfully remediates the NBME exam on the second attempt, they will receive a grade of P (70%) in the clerkship. A student who receives an F on an attempted remediation of a failed exam will receive a grade of F in the clerkship.
• A student who fails a clerkship NBME exam in a second course BEFORE remediating the first failure must stop his/her academic progress and meet with the student promotions committee to agree upon a plan for the student to complete the Retake Exams.  If a student must schedule multiple Retake Exams, she/he must pass all of them before resuming his/her clinical training.  All retake examinations must be completed before the final day of the semester in which the initial failed exam was taken.
• A student who fails a final exam in a second course AFTER remediating the first failure must meet with the Associate Dean of Academic Affairs.
• A student who fails a final exam in a third course (even if the first two failed exams were successfully remediated) will be required to repeat the entire MSIII Year of medical school.
• All MSIII Courses must be successfully completed before progressing to the MSIV Year.

Final Grade Appeals

Promotions Committees

There is an Academic Success Council which considers the academic problems of students enrolled in years one and two of the curriculum. This committee consists of the faculty members of the Medical Curriculum Council and is chaired by the Associate Dean for Academic Affairs.

Individual MSIII and MSIV year promotions committees consider academic problems of students enrolled in years three and four. These committees consist of the course directors and representative faculty of each course in the year represented. The Associate Dean for Student Affairs may be present to act, if needed, as the student’s advocate.

Promotions committees have the responsibility for final action relating to student promotions. They also have an obligation to conduct a comprehensive review of the records of students who have acquired deficiencies, using all pertinent data available from any appropriate source, such as student files, and associated information from the Office of Student Affairs. In order to assure that the committee has adequate information for making a proper decision, it may be indicated to seek comments from a student’s faculty advisor, or any other faculty member designated by the student.

In reaching a decision on action to be taken in connection with a student who has incurred deficiencies, the committee shall give due consideration to the nature, extent, and significance of the deficiencies manifested. It shall take into account the relationship of the activity and time required for completion of the measures for removal of deficiency specified by the departments involved. It shall also evaluate the influence of other factors which relate to the best interest of the student and the School. The committee may designate an appropriate course of action as described below:

1. Promotion after removal of all deficiencies as specified.
2. Permission to repeat the year taking the entire course work of that year on probation
3. Dismissal for failure to meet the requirements in a satisfactory manner
4. Special procedure, which may be indicated in exceptional cases

In the event that a student fails to remove a deficiency, the committee shall decide which of the remaining alternatives stated above is to be followed. When a student is given permission to repeat a year, previously earned grades will not be changed.

Should a member of a promotions committee be the course or clerkship director who assigned a student’s failing course grade or be directly involved in the process leading to the student’s review by that promotions committee, that committee member may be present at the meeting to discuss the factors leading to the promotions committee review, but will recuse him or herself from the final vote. 

Calculation of Quintile Rank

Approved: 09-18-2020

1. Policy - Class rank for a given academic year (MSI, MSII, MSIII) is based on course scores received during that year. All course scores are included in the calculation of class rank.  When a course must be repeated due to a failing score, the initial score received, rather than the remediation score, is used in the calculation, to be fair to students who successfully completed all courses the first time.
   Cumulative class rank is based on performance in all courses of all years completed to date of calculation. As described above for yearly class rank, all course scores, including failing scores, are used in this calculation. To determine class rank, weighted score averages are calculated for each student. The averages are calculated by multiplying the credit hours for each course by the percentage score received in the course, and dividing the sum of the products for all courses by the total credit hours. Students accepted into Advanced Standing are not included in the final cumulative class ranking.
   Grades are recorded on a student’s official record (transcript) as P (Pass/ F (Fail) for MSI and MSII courses.  These grades are derived from numerical course scores, which will be used to generate quintile rank for each student at the completion of the MSI, MSII and MSIII academic years.
2. Purpose - This policy addresses the calculation of quintile rank for a given academic year and the cumulative class rank.
3. Scope - This policy applies to all School of Medicine students.

Leave of Absence

Approval: 09-18-2020

1. Policy - LSU Health students are expected to proceed through the medical school curriculum in a continuous, uninterrupted fashion. In the event of extenuating circumstances that necessitate a temporary period of non-enrollment, students may request a leave of absence (LOA). Requests for a leave may be granted by the Associate Dean for Academic Affairs or his/her designee or when recommended by a faculty committee. A leave may be granted, if deemed appropriate, for health, personal, or family reasons, or for special academic study. A leave of absence is granted for a finite period, not to exceed twelve (12) months.
   If for any reason the leave extends beyond one year, an extension may be granted for unusual circumstances if the student requests an extension in writing at least thirty days (30) before the expected reentry date.
   The School of Medicine reports all leaves/interruptions of medical education in the Medical Student Performance Evaluation (MSPE).
2. Purpose - The purpose of this policy is to define the process by which a student may take a leave of absence.
3. Scope - This policy applies to all School of Medicine students.
4. Procedure/Process -

• Complete and submit a signed Leave of Absence Request Form to the Office for Student Affairs.
• Meet with the Associate Dean for Student Affairs or his/her designee. The Associate Dean for Student Affairs will meet and advise the student regarding the request for a leave of absence. The Associate Dean for Student Affairs will make a recommendation on the student’s behalf to the Office of Academic Affairs who may approve or deny the request for a leave of absence. All decisions by the Associate Dean of Academic Affairs are final, subject to a student appeal to the Dean of the Medical School.
• Meet with the School of Medicine Registrar and Associate Director of Financial Aid and Scholarships (if the student receives financial aid), and
• Receive a letter from the Associate Dean for Academic Affairs or his/her designee approving the leave

Medical Student Supervision & Level of Responsibility

Approved: 04-16-2021

1. Policy - Medical students should be provided with appropriate levels of supervision as they progress through their education towards a career in patient care. A supervising preceptor will ensure that medical students are provided with opportunities to learn that are progressive and commensurate with the student’s level of learning.
2. Purpose - The purpose of this policy is to describe the procedures that should be followed by supervising physicians to ensure that the school adheres to expectations that protect patient and student safety in accordance with LCME Element 9.3:

A medical school ensures that medical students in clinical learning situations involving patient care are appropriately supervised at all times in order to ensure patient and student safety, that the level of responsibility delegated to the student is appropriate to his or her level of training, and that the activities supervised are within the scope of practice of the supervising health professional.

3. Scope - This policy applies to students in all courses at all training sites.
4. Procedure/Process -

DEFINITIONS 

• Supervising Physician - An attending physician with a LSUHSC-S faculty appointment; a resident or fellow physician training in a graduate medical education program at, or affiliated with, the School of Medicine.
• Healthcare Provider - Including but not limited to: anesthesia assistants, dieticians, emergency medical technicians, medical sonographers, medical technologists, nurse practitioners, nurses, occupational therapists, paramedics, pharmacologists, physical therapists, physician assistants, psychologists, radiographers, respiratory therapists, social workers, speech language pathologists, and surgical technicians.

POLICY

Medical students cannot provide unsupervised patient care. Clinical decisions and orders are never created or enacted by medical students without a supervising physician’s input and approval. A supervising physician has the medical and legal responsibility for patient care at all times. Student may be supervised at one of two broad levels as determined by the supervisor:

• Direct Supervision - the supervising physician is physically present with the medical student and patient.
• Indirect Supervision - the supervising physician is physically within the hospital or other site of patient care and is immediately available to provide direct supervision.

Students on duty must have rapid and reliable systems for communicating with their supervising faculty and resident physicians.

Determination of appropriate level of supervision is made by the supervisor, based on many factors, including:

• complexity of the situation or procedure
• acuity of activity and level of risk to patient
• medical student’s level of training, demonstrated competence, maturity, and responsibility.

The Course/clerkship director is responsible for determining the types of patient interactions and the clinical procedures that medical students can perform during patient care experiences and the levels of direct supervision required for these interactions and procedures.

The Clerkship director will provide faculty, resident physicians, and students with a list of the types of patient interactions and clinical procedures that students may perform, and the level of direct supervision required for each of them.

A supervising physician may delegate some medical student teaching and supervising responsibilities to non-physician care providers after ensuring the non-physician providers are appropriately credentialed and working within the scope of their practice. Medical students are expected to maintain self-awareness of their own competence and seek assistance/advice when clarification is needed; inform patients and/or family members of their status as a medical student and the name of the supervising physician under whom they are working; proactively inform the supervising physician or course director about concerns related to levels of supervision (excessive or sub-standard).

Reporting Concerns

Individuals who have experienced or witnessed a lapse in medical student supervision must report the incident to the course/clerkship director. Students are encouraged to relay instances in which they feel they have not received appropriate supervision as soon as possible to the course/clerkship director.

• Students will be asked at each mid-clerkship evaluation about any instances in which they were concerned about the level of their supervision.
• Students may also anonymously report lapses in medical student supervision in the course evaluation.

Expressions of concern will be held in strict confidence if possible. However, this may not be possible in situations where student or patient safety may be compromised, illegal activities may have occurred, or other situations needing immediate contact with reporting individuals.

Course directors are to inform the Associate Dean for Academic Affairs of instances in which student concerns are raised.

Monitoring

The Associate Dean for Academic Affairs reviews all reports of inappropriate supervision and ensures adequate and timely resolution in cooperation with the relevant clerkship director(s).

The Medical Curriculum Council receives a summary of all such occurrences annually to identify and act upon recurrent concerns. It also reviews the Annual Clerkship Director’s Report to ensure that adequate procedures are in place to ensure appropriate supervision.

Non-Involvement of Healthcare Provider in Student Assessment

Approved: 09-18-2020

1. Policy -

• Must not solicit that student as a patient in their clinical practice.
• May accept a student request for medical care with the understanding that they will adhere to the directives in the policy statement as described above.
• Faculty may not provide medical advice or care to their students while they are supervising that student.

• Must not serve in any academic supervisory role for that student. They must not supervise the student in the clinical setting, lead small group sessions involving the student, provide an academic assessment of the student, participate in assigning grades for that student or participate in making decisions about academic advancement or lack thereof for that student.
• May serve in a mentoring capacity for situations that do not formally contribute to decisions about academic progress.

2. Purpose -

• Maintain student’s right to confidentiality with treating providers.
• Avoid the potential that assignments, assessments, grading, and progress could be impacted by a faculty member’s knowledge of a student’s illness or disability status.
• Minimize concerns about favoritism related to special relationships between a faculty and a student.
• Ensure compliance with LCME standards, specifically standard 12.5: Non-Involvement of Providers of Student Health Services in Student Assessment/Location of Student Health Records

3. Scope - This policy applies to all School of Medicine students and faculty.
4. Procedure/Process -

• Students must complete a Disclosure of Potential Conflict of Interest to verify their understanding of this policy prior to starting their courses/clerkships. Student will be asked to disclose any prior clinical or familial/intimate relationship with LSUHSC-S faculty members.
• If a student realizes they have been assigned a role with an individual faculty member that is prohibited by a current or prior clinical or familial/intimate relationship with that faculty member, the student should notify the course or clerkship director and ask to be reassigned. The reason given for the reassignment is potential conflict of interest; the nature of the potential conflict of interest need not be identified. 
• In the event that a faculty member realizes that they have been assigned a role with an individual student that is prohibited by their current or prior clinical or familial/intimate relationship with that student, the course or clerkship director should be notified and reassignment requested. The reason given for the reassignment is conflict of interest; neither the specific conflict of interest situation need not be identified. 

5. Policy Limitations

Requesting Alternate Assignments

Approved: 09-18-2020

1. Policy - The School of Medicine manages students’ selection of and assignment to learning experiences. Medical students with appropriate rationale may request an alternative assignment when circumstances allow for it.
2. Purpose - To outline responsibility of and the process of assignment of students to learning experiences and responding to requests for change.

10.9 A medical school assumes ultimate responsibility for the selection and assignment of medical students to each location and/or parallel curriculum (i.e., alternative curricular track) and uses a centralized process to fulfill this responsibility. The medical school considers the preferences of students and uses a fair process in determining the initial placement. A process exists whereby a medical student with an appropriate rationale can request an alternative assignment when circumstances allow for it.

3. Scope - This policy applies to all School of Medicine students.
4. Procedure/Process -

• Assignment to learning experiences will be done consistently and fairly, allowing students to express preferences in the order and sites at which they complete their clerkships
• The School of Medicine is committed to ensuring a transparent approach to the assignment of medical students to geographically distributed sites and rotation assignments.
• LSUHSC-S medical students are given priority over visiting students’ requests.

• Any student who believes that he/she has circumstances that would warrant an alternate educational site or curriculum assignment during the clinical years can make a request directly to the Office of Academic Affairs prior to MSIII registration.
• Student requests can cover all or part of his/her schedule for an academic year and can include requests for course sequence, course sites, or both.
• Any individual making a request must provide the Office of Academic Affairs with an email narrative, outlining the specific reasons and details of the request.
• Each change request will be evaluated on the nature of the request, impact on other students, and available options. Requests based on conflicts of interest, accommodations, compliance issues, and mistreatment will be given priority.  All requests for changes will be reviewed by the Associate Dean for Academic Affairs (or his/her designee) with the final determination being made by the Associate Dean for Academic Affairs.

USMLE Step I Policy and Promotion to the MSIII Year

Approved: 08-27-2021

1. Policy - In order to support the success of medical students on the USMLE Step 1 examination, all second year medical students will take a National Board of Medical Examiners (NBME) Customized Exam in January and the NBME Comprehensive Basic Science Exam in May. 
2. Purpose - The intent of these examinations is to familiarize the students with the USMLE Step 1 Examination process by practicing a timed, proctored abbreviated version of the USMLE Step 1. The questions will be similar in type, length, and timing of questions. The scores will not be used as a formal grade but will allow students to assess their current study plans and test taking skills.
3. Scope - This policy applies to all School of Medicine students.
4. Procedure/Process -

• Microbiology-40 questions
• Cardiovascular System-40 questions
• Heme/Lymph System-20 questions
• Renal and Urinary System-20 questions
• Respiratory System-20 questions

• All students in the Class of 2024 must take USMLE Step I no later than June 11, 2022. Any MSII student that does not take USMLE Step 1 by the deadline date will not be registered for the Fall term.
• Any MSII student that does not take USMLE Step 1 by the deadline date will not be registered for the Fall term.

• Meet with the learning specialist and develop a structured learning plan.
• Have their Step I study timeline reviewed and approved by the Academic Success Council.
• Retake the CBSE after 3 additional weeks of intentional Step I preparation.

• A student who has shown readiness to sit for Step I cannot postpone any required clerkships.

• Meet with the promotions committee for discussion and approval of a revised Step I study timeline.
• Based on a student’s performance on the second CBSE and his/her completion of the structured learning plan requirements, the promotions committee may make one of the following recommendations:
  • Recommend that the student take USMLE Step I and establish a new deadline for taking the exam.
  • Recommend that the student attend academic counseling sessions with a Learning Specialist to review his/her study plans and readiness for USMLE Step I and establish a new deadline for taking the exam.
  • Recommend that the student be placed on an official leave of absence by the Associate Dean of Academic Affairs to allow additional time for the student to prepare for USMLE Step I.

1. Be enrolled in a Special Topics course for 6 credit hours and prepare to retake USMLE Step I. The student will still be officially enrolled in coursework and will therefore be responsible for paying all required tuition and fees as a part-time student. Students should contact the Financial Aid  Office to verify current and future aid eligibility. 
2. Request a Leave of Absence prepare to retake USMLE Step I.  The student must take Step 1 of the USMLE prior to November 21, 2022 or May 1, 2023 to ensure that the result will be received prior to the start of the next semester/academic year. A passing score on the repeated attempt must be received before a student can return to the MS III year and begin clinical work. The student will not be officially enrolled for the semester and may be eligible for a refund or partial refund of the required tuition and fees. The Leave of Absence will be reported on the student’s Medical Student Performance Evaluation (Dean’s Letter).

USMLE Step II Policy

1. Policy - All students are required to pass the USMLE Step 2 CK exam in order to graduate from the School of Medicine.
   
   May Graduates
   Students who intend to graduate in May must take the USMLE Step 2-CK examination no later than October 1 of the final year of the curriculum. In preparation for the exam, students must enroll in the Clinical Science Review course during the month/block immediately preceding their USMLE Step 2 CK date.
   
   December Graduates
   Students who intend to graduate in December must take the USMLE Step 2-CK examination no later than June 30 of the final year of the curriculum. In preparation for the exam, students must enroll in the Clinical Science Review course during the month/block immediately preceding their USMLE Step 2 CK date.

2. Purpose - This policy establishes the requirement to pass Step 2 of the United States Medical Licensing Examination to graduate. It establishes time limits and the number of attempts to pass, and the consequences of not passing.
3. Scope - This policy applies to all School of Medicine students.
4. Procedure/Process -

• Students may request an exception to the test dates required by this policy. This request should be made via e-mail to the Chair of the Academic Success Council. Request for an exception to the Step 2-CK deadlines must include an explanation of why the delay is requested as well as a proposed date for the completion of the Step 2 CK requirement. The Academic Success Council will review the request and make a final determination about whether or not the request will be approved.

• May graduates must submit the request by August 1 of the year in which they are required to take Step 2-CK.
• December graduates must submit their request by April 1 of the year in which they are required to take Step 2-CK.

• Students who do not meet the deadlines outlined in this policy, without prior written approval from the Academic Success Council, will be summoned to Academic Success Council to discuss the policy violation and to formulate a plan to complete USMLE Step 2CK in a timely manner.

Remediation

• Students who do not pass USMLE Step 2-CK must meet with the Learning Specialist to establish a plan for remediation, to monitor preparation, and to determine readiness for retake.

• Students who fail Step 2-CK on their first attempt have the option to complete coursework in progress or to withdraw immediately.

• Students who fail USMLE Step 2 CK on their second attempt must withdraw from future coursework. Students have the option to complete coursework in progress or to withdraw immediately.

• Students who fail USMLE Step 2 CK on the third attempt are immediately withdrawn from coursework and placed on school-initiated leave of absence pending decision by the Academic Success Council between dismissal and allowing a fourth attempt. In cases where the Academic Success Council allows a fourth attempt, the student will remain on leave until a passing score is reported.

Any variance from this policy must be approved in writing by the Academic Success Council.

Student Workload Policy

Approved: 05-14-2021

1. Policy -

• Students must be provided with 1 day in 7, free from all required educational activities and clinical responsibility averaged over a 4-week period, inclusive of call.
• Adequate time for rest and personal activities must be promoted. Students should have 10 hours free of duty between scheduled duty periods and after in-house call.
• Continuous on-site call duty should not exceed 24 consecutive hours; however, students may remain on duty for up to four additional hours to complete didactic activities and rounds with their assigned team to maintain continuity of medical and surgical care.
• Students cannot be scheduled for 24 hours continuous more than once in a 7-day period.

2. Purpose - The School of Medicine has the responsibility to develop and implement workload/duty hour policies for medical students in all phases of the curriculum, in accordance with LCME Element 8.8, Monitoring Student Workload. These policies should promote student health, maximize student learning time and opportunities for unstructured, independent, and self-directed learning.
3. Scope - This policy applies to all School of Medicine students.
4. Procedure/Process -

• Clerkship Directors and Coordinators are responsible for ensuring that individual student schedules adhere to the duty hour policy.
• Students must immediately communicate any deviation of the duty hour policy to their Clerkship Director, Clerkship Coordinator, and/or to their Attending Physician.  Students can report concerns anonymously by using the Grievance/Complaint Procedure.
• In addition, students are required to report on duty hours on Clerkship evaluations which are analyzed during regular clerkship reviews performed by the Curriculum Evaluation Committee. An annual report on levels of adherence to this policy will be presented to the Medical Curriculum Council.

Requirements for Graduation

Approved: 09-18-2020

1. Policy - Students must successfully complete all listed criteria to be eligible for graduation.

• Satisfactory completion of all coursework and requirements specified in the curriculum.
• Enrollment as a student in the School of Medicine while completing at least the final two academic years of course work unless extraordinary circumstances have arisen. Specifically, third and fourth-year rotations must be taken on campus or, with departmental approval, at affiliated institutions. The curricular requirements of the School of Medicine shall be adhered to in all cases.
• Approval by promotions committee and recommendation by the faculty of the School of Medicine for conferring of the degree, Doctor of Medicine.
• Satisfactory status concerning financial obligations to the institution.
• Certification that all materials issued as returnable items have been accounted for in an acceptable manner.
• Successfully complete Step 1 of USMLE.
• Health Sciences Center policy requires that all work toward a degree be completed within six calendar years. The time granted a student for a leave of absence will not be included in the maximum time period for completion of the program.
• Sit for the USMLE Step 2 Clinical Knowledge prior to graduation.
• Attend Commencement, unless excused in writing, by the Dean.

2. Scope - This policy applies to all School of Medicine students.

Technical Standards

Approved by Medical Curriculum Council: 07-16-2021

Approved by Admissions Committee: 09-03-2021

1. Policy - The following abilities and characteristics are defined as technical standards, which consist of certain minimum physical and cognitive abilities and emotional characteristics that candidates for admission, promotion, and graduation must possess to complete the entire course of study and participate fully in all aspects of medical training, with or without reasonable accommodation.The term “candidate” refers to candidates for admission to medical school as well as current medical students who are candidates for retention, promotion, or graduation.These standards are not intended to deter any candidate for whom reasonable accommodation will allow the fulfillment of the complete curriculum. Candidates who have questions regarding their ability to meet the school’s technical standards should contact the Associate Dean for Admissions (candidates for admission) or Associate Dean for Student Affairs (current medical students). Students who believe they may need to request reasonable accommodation(s) in order to meet the standards are encouraged to contact the Office of Student Affairs.

1. OBSERVATION: Candidates must be able to acquire information from demonstrations and participate in experiments of science, including but not limited to such things as dissection of cadavers; examination of specimens in anatomy, pathology, and neuroanatomy laboratories; and microscopic study of microorganisms and tissues in normal and pathologic states. Candidates must be able to accurately acquire information from patients and assess findings. They must be able to perform a complete physical examination in order to integrate findings based on this information and to develop an appropriate diagnostic and treatment plan. These skills require the use of vision, hearing, and touch or the functional equivalent.
2. COMMUNICATION: Candidates must be able to communicate effectively and efficiently with patients, their families, health care personnel, colleagues, faculty, staff, and all other individuals with whom they come in contact. Candidates must be able to obtain a medical history in a timely fashion, interpret non-verbal aspects of communication, and establish therapeutic relationships with patients. Candidates must be able to record information accurately and clearly; and communicate effectively and efficiently in English with other health care professionals in a variety of patient settings.
3. MOTOR FUNCTION: Candidates must, after a reasonable period of training, possess the capacity to perform physical examinations and diagnostic maneuvers. They must be able to respond to clinical situations in a timely manner and provide general and emergency care. These activities require some physical mobility, coordination of both gross and fine motor neuromuscular function and balance and equilibrium.
4. INTELLECTUAL-CONCEPTUAL, INTEGRATIVE, AND QUANTITATIVE ABILITIES: Candidates must be able to assimilate the detailed and complex information presented in the medical student curriculum. They must be able to learn through a variety of modalities including, but not limited to, classroom instruction; small group, team and collaborative activities; individual study; preparation and presentation of reports; simulations and use of computer technology. Candidates must be able to memorize, measure, calculate, reason, analyze, synthesize, and transmit information. They must recognize and draw conclusions about three- dimensional spatial relationships and logical sequential relationships among events. They must be able to formulate and test hypotheses that enable effective and timely problem-solving in diagnosis and treatment of patients in a variety of clinical settings and health care systems.
5. BEHAVIORAL AND SOCIAL ATTRIBUTES: Candidates must demonstrate the maturity and emotional stability required for full use of their intellectual abilities. They must accept responsibility for learning, exercising good judgment, and promptly complete all responsibilities attendant to their curriculum and to the diagnosis and care of patients. Candidates must display characteristics of integrity, honesty, attendance and conscientiousness, empathy, a sense of altruism, and a spirit of cooperation and teamwork. They must understand and demonstrate understanding of the legal and ethical aspects of the practice of medicine and function within both the law and ethical standards of the medical profession. Candidates must be able to interact with patients and their families, health care personnel, colleagues, faculty, staff, and all other individuals with whom they come in contact in a courteous, professional, and respectful manner. The candidate for the MD degree must accept responsibility for learning, and exercise good judgment. Candidates must be able to contribute to collaborative, constructive learning environments; accept constructive feedback from others; and take personal responsibility for making appropriate positive changes. Candidates must have the physical and emotional stamina and resilience to tolerate physically taxing workloads and function in a competent and professional manner under highly stressful situations, adapt to changing environments, display flexibility, and manage the uncertainty inherent in the care of patients and the health care system.
6. ETHICAL AND LEGAL STANDARDS: Students must be of the highest ethical and moral behavior. Candidates must meet the legal standards to be licensed to practice medicine.  Candidates for admission must acknowledge and provide written explanation to the School of Medicine of any felony offense(s), misdemeanor offense(s), and institutional action(s) taken against them prior to matriculation at the School of Medicine. This disclosure is required of all charges and convictions, including expunged and diverted offenses. This includes, but is not limited to, violent misdemeanors and substance use violations. Institutional actions include, but are not limited to, Title IX or Title VII violations. In addition, students who are enrolled in the School of Medicine must immediately notify the Associate Dean of Student Affairs of any arrest, charge, conviction or institutional investigation or action occurring thereafter. Felony conviction or failure to disclose prior or new offenses can lead to disciplinary action by the school that may include dismissal.

Equal Access to the School of Medicine’s Educational Program
The Louisiana State University Health Sciences Center at Shreveport (LSUHSC-S) School of Medicine provides reasonable accommodations for all qualified individuals with disabilities who apply for admission to the MD degree program and who are enrolled as medical students. Otherwise qualified individuals will not be excluded from admission or participation in the School of Medicine’s educational programs and activities based solely on their status as a person with a disability.

Should a candidate’s or student’s existing or acquired disability (despite reasonable accommodation whether the candidate chooses to use the accommodation or not), interfere with patient or peer safety, or otherwise impede the ability to complete LSUHSC-S School of Medicine’s MD program and advance to graduation, residency, training, or licensure, the candidate or student may be denied admission or may be separated, discontinued, or dismissed from the program.

It is the responsibility of a candidate or student with a disability, or a candidate or student who develops a disability, who requires accommodations in order to meet these technical standards, to self-disclose to the Office of Student Affairs and request accommodations. Candidates must provide documentation of the disability and the specific functional limitations during the registration process with the Office of Student Affairs. Candidates who fail to register with the Office of Student Affairs or who fail to provide necessary documentation shall not be considered to be claiming or receiving accommodations under the federal or state disability laws. Students are held to their performance, with or without accommodation. No candidate will be assumed to have a disability based on poor performance alone. Accommodations are not applied retroactively, and a disability-related explanation will not negate poor performance.

2. Purpose - This policy specifies certain minimum physical and cognitive abilities and emotional characteristics needed to successfully complete the entire course of study of the MD program and participate fully in all aspects of medical training, with or without reasonable accommodation.
3. Scope - This policy applies to MD degree candidates for admission, promotion, and graduation.
4. Procedure -
   1. Admitted students attest to these Technical Standards prior to matriculation.
   2. LSUHSC-S School of Medicine is committed to the full and meaningful inclusion of students with disabilities. Students with disabilities should contact the Office of Student Affairs to request accommodations. The Office of Student Affairs will engage in a confidential, collaborative, and interactive process with the student, learning specialists, and/or other faculty members as needed to determine reasonable accommodations.  Timely disclosure and requests by students are essential and encouraged as accommodations are not applied retroactively.
5. Related Policies/Forms
   • Non-Involvement of Healthcare Provider in Student Assessment Policy
   • Disclosure of Potential Conflict of Interest Policy
   • Student Policy for Requesting Accommodations

Narrative Assessment

Approved: 09-17-2021

1. Policy - A written narrative description of a medical student’s performance, including his or her noncognitive achievement, will be included as a component of the assessment in each required course and clerkship of the medical education program whenever teacher-student interaction permits this form of assessment. 
2. Purpose - Narrative assessment is necessary for students to acquire a full understanding of their achievement of course and clerkship objectives, especially in non-cognitive areas (e.g., professionalism, communication skills, leadership, conscientiousness, critical thinking, time management, and interpersonal skills). Narrative comments are intended to provide students with additional information about their strengths and opportunities for improvement beyond numeric data. Narrative assessment can be formative and/or summative:  

• Formative (“feedback”)-comments provided to students intended for formative purposes only and not included as a part of a graded assessment 

• Summative (“assessment”)-comments that are part of a graded assessment 

3. Scope - This policy applies to all required courses and clerkships where teacher-student interaction permits this form of assessment. 
4. Procedure/Process  

Written narrative feedback is required on all clerkship evaluation forms and is used as part of the formative midpoint assessment and as part of the final grade in all required clinical clerkships. The clerkship evaluations offer faculty the opportunity to provide narrative comments to the student, give specific directions for improvement, or encouragement to continue excellent behavior. In addition, faculty provide a more global written narrative evaluation of the student’s performance for inclusion in the student’s MSPE.  

In the pre-clerkship curriculum, written narrative feedback is provided in a course where teacher-student interaction permits it to occur.  Narrative feedback can include comments regarding students’ performance on history taking skills, counseling skills, physical exam skills, and on other presentations or small group interactions.  

Written narrative feedback is not required in laboratory sessions. Faculty provide verbal feedback to students as often as possible in the lab.  

All courses have objectives related to medical professionalism, and written feedback is provided to students exhibiting behavior that is unprofessional and in need of improvement. 

NBME Grading System Module II & Remediation Policy

Approved: 11-19-2021

1. Policy - Students must successfully pass the NBME exam to progress towards successful completion of the M.D. degree. 
2. Purpose - To outline the criteria for successful completion of the NBME exams and the steps to take to successfully remediate NBME exams and/or Module II courses.  
3. Scope - all School of Medicine students 
4. Procedure/Process 

Student performance is evaluated by the course director(s) and teaching faculty of each course. Final grades are based on a composite score derived from written, oral, and practical examination scores, along with scores from other required activities. The course director(s) is responsible for determination of each student’s final grade.  

Recorded grades for all Module 2 courses within the MSI and MSII academic years will be P (Pass)/F(Fail).  

• The grading scale is:  

  • Pass for overall performance greater than or equal to 70%  

  • Fail for overall performance less than 70%.  

• HOWEVER, if a student scores more than 2 standard deviations below the class mean on the NBME final exam, he/she will be required to remediate the NBME exam regardless of overall performance in the course.  

  • The student will receive an Incomplete grade in the course until the NBME exam has been remediated.

  • If a student successfully remediates the NBME exam by scoring within 1 standard deviation of the class mean on the second attempt, he/she will receive a pass (P) in the course and keep the original overall percentage score earned in the course.  

  • If a student’s score falls more than 1 standard deviation below the class mean on the second attempt, he/she will receive a grade of F in the course and will be required to remediate the course. See policy on Course Remediation.  

  • A student who fails an end of course NBME final exam in a second course BEFORE remediating the first failure must meet with the student promotions committee to agree upon a plan for the student to complete the Retake Exams.  

  • If a student must schedule multiple Retake Exams, she/he must pass all of them before progressing to the next semester. All retake examinations must be completed before the first day of the semester that follows the semester in which the initial failed exam was taken.  

  • A student who fails an end of course NBME final exam in three courses during an academic year will be required to repeat the entire academic year.  

A passing grade or the successful remediation of a failing grade must be earned in all courses for a student to be promoted and to graduate. 

Remediation Policy for Module 2 Courses  

If a student scores more than 2 standard deviations below the class mean on an NBME final exam or earns a final course grade of less than 70%, the Course or Module Director will notify the student of their need to remediate the NBME final exam or the course in writing.  

Students may remediate the grade of F in one course; however, should a student fail two courses (in spite of one being a successfully remediated F), he/she shall be dismissed.  

Schedule:  

• The student must respond to the course director within one week after the notification. It is the responsibility of the student to schedule the remediation process with the course director.  

• Students are required to make their first attempt at remediation prior to the first day of the next semester. Under certain circumstances, remediation may be delayed with prior permission from the Associate Dean for Academic Affairs.  

• All remediations must be completed before a student may move on to the next semester. 

• To more readily identify students in academic difficulty and offer them additional support services in a timely fashion, students who need to remediate a course will be provided with information on receiving a learning assessment, the results of which may trigger further support services that may help the student avoid the need to remediate additional courses.  

Process:  

• Students requiring remediation must meet with the director of the course to be remediated. If, during this conversation, the student identifies a non-academic contributor to their poor performance (i.e., something medical or social), this should be brought to the attention of the Associate Dean for Student Affairs.  

• The process for a course remediation, as determined by the course director, should be tailored to the individual student through the identification and correction of specific areas of deficiency. Retaking the entire course should only be necessary if the student’s performance in all major content areas is unsatisfactory.  

• The course director will provide the Associate Dean for Student Affairs, Associate Dean for Academic Affairs, and the Registrar, a record of the remediation process for each student.  

• If the student is successful on the course remediation attempt, the earned grade of F is not removed from the transcript or calculation of class rank, although successful remediation is noted.  

• If the student is unsuccessful course remediation attempt, he/she shall be considered to have received two Fs and be dismissed. 

MS2 Comprehensive Physical Exam Policy

Approved: 10-15-2021

1. Policy - At the end of the second year, MS2 students are required to complete a comprehensive physical exam on a standardized patient and must achieve a score of 90% or better to demonstrate proficiency.  Students that fail to achieve 90% are required to re-take the exam until they are able to demonstrate proficiency.  
2. Purpose - Completion of this exam ensures that students are proficient in the minimum physical exam skills necessary for their clerkships. 
3. Scope - This policy applies to all School of Medicine students 
4. Procedure/Process - At the end of the second year, MS2 complete an objective structured clinical exam. Students are assessed on their physical exam skills through checklist items graded by Clinical Skills Center staff.   

Medical School Performance Evaluation Policy (MSPE)

Approved: 11-19-2021

1. Policy - A medical school provides an MSPE, which is required for a residency application of a medical student, only on or after the date required by ERAS, ACGME, and AAMC of the student’s final year of the medical education program.
2. Purpose - To describe how the Medical School Performance Evaluation (MSPE) is generated for each graduating medical student.
3. Scope - This policy applies to all medical students.
4. Procedure/Process -
   1. The MSPE (or Dean’s Letter) is the official medical school record for graduating medical students and is generated by the Office of Student Affairs in conjunction with the Office of the Registrar. It includes a description of the student (identifying information), noteworthy characteristics, academic history, description of academic progress (including preclinical coursework, clinical rotation summaries and grades, completion of dual degrees, and professional performance), and a summary statement on overall academic performance.
   2. The MSPE also reports all Leaves of Absence, adverse actions, and repetition of course work that extends graduation.
   3. The MSPE may be updated with an addendum to reflect new information about student performance that occurs after the initial release.
   4. The MSPE is generated and compiled with oversight from the Associate Dean for Student Affairs; it is finalized and signed by the Dean of Student Affairs.
   5. Students may request another MSPE writer through a formal request to the Associate Dean for Student Affairs.
   6. Students have an opportunity to review their MSPE before it is transmitted to residency programs, to address any errors.
5. Responsibility - 

Associate Dean for Student Affairs