Dismissals Over Academic Progression—Medical Students

To become a doctor requires a considerable commitment of time, energy, and money. You'll need excellent grades as an undergrad student, plus score well on the MCAT, just to be considered for most medical schools. You will spend at least eight or more total years in study plus tens of thousands of dollars in tuition. And medical school itself is so challenging that even the most dedicated students often have trouble keeping pace or maintaining good grades. If you can't maintain acceptable grades in medical school, you may be dismissed due to poor academic progression—and for the medical student, this is a serious problem that can have a devastating effect on their career prospects, not to mention cause untold financial losses.

If you're a medical student facing the prospect of dismissal, you may be naturally apprehensive as to what the future holds and how to protect your career. Hiring an attorney-advisor to help might be the best decision you could make at this critical time. Attorney Joseph D. Lento has many years of proven experience assisting medical students facing academic dismissal and other school disciplinary issues across the country. To help you be better prepared, the Lento Law Firm has the following answers to some of the most common questions about medical school dismissal.

What Are the Academic Expectations for Medical Students?

Just to be accepted into medical school, a person's academic performance in undergraduate studies must be nearly impeccable. While most medical schools are vague about the minimum GPA thresholds they expect, the average GPA threshold for acceptance in medical schools nationwide is usually between 3.5 and 3.7.

In medical school, the academic expectations are just as high, if not higher—and yet, many times, the standards of performance are still not always clear. Med students must balance grueling coursework schedules with many hours of clinical experience—and in many cases, the courses are pass/fail. Medical students who can't keep pace or whose grades fall short may be subject to academic probation, remediation, and sometimes a leave of absence. The school may recommend dismissal for students who have consistently low grades that do not improve with remediation.

How Do Medical Schools Track Academic Progress?

While colleges and universities may have their own systems for tracking academic progress (including technologies like tracking algorithms), medical schools will typically have their own systems in place to monitor their students' progress. This usually includes a committee of faculty and/or students (called a “Student Progress Committee” or something to that effect). This committee will evaluate student performance and recommend corrective solutions for those who fall behind. If a medical student consistently fails to perform academically, the Student Progress Committee will usually recommend suspension or dismissal.

What Are Some of the Most Common Reasons Why Medical Students Fail To Make Sufficient Academic Progress?

The short answer is “bad grades,” but as with most of life, that answer doesn't usually tell the whole story. The key to resolving an academic deficiency with the medical school is understanding why the student is getting bad grades or underperforming. Those answers are often quite complicated, and very often, it's more than just one thing. Let's look at some of the common reasons, including some extenuating circumstances, why medical students may fall behind—and most importantly, why medical schools need to be willing to take these matters under advisement before recommending dismissal for the student.

Learning Curve

The format for medical school is often much different than anything the student encountered in their undergraduate studies. Instead of just taking courses, doing assignments, taking tests, and getting grades, medical students usually have to endure a grueling schedule that combines intensive courses and practical application. Likewise, where progress in undergraduate courses is represented by letter grades and a grade point average, a significant number of medical schools and/or med school courses are simply pass/fail. This means that a student may not even realize they are underperforming until they get the failing grade!

All this to say that sometimes medical students underperform because they are on a steep learning curve to understand how medical school works. For most medical students who struggle in the first year, it's a good bet that they have been thrown into a learning situation they don't understand, and they don't know the rules for survival—let alone success.

Time management

Sometimes, the student's problem isn't academic-related at all, but rather an issue of time management. Medical students are extremely busy and have many responsibilities to juggle all at once. If a student hasn't been properly acclimated to this type of schedule or hasn't learned time management skills, they could easily run into trouble—not affording themselves enough time to do sufficient research, running out of time to study for exams, and so on. If a student begins getting bad grades or losing pace due to these issues, the Student Progress Committee might incorrectly view the shortfalls as a failure to grasp the material and attempt to recommend probation or remediation.

Pace of academic progression

While colleges and universities do have some flexibility about how many courses students take in a semester, the fact is that you cannot stay in medical school for as long as you like or “as long as it takes” to earn your degree. There is no taking a course here or there and working your way through the program at your own pace. Each school has its own policies on this issue, but most medical schools require students to get through a minimum course load each term and graduate within a specified window of time. Thus, a medical student may be getting good grades but still end up on academic probation simply because they aren't progressing quickly enough through the coursework.

Mental or physical health issues

Sometimes, a medical student may have an underlying mental or physical health issue that they ignore or don't realize is interfering with their academic progress. Physical ailments are easy enough to spot or diagnose, but mental health problems sometimes fly under the radar. Some examples include depression, behavioral issues such as attention deficit disorder (ADD), PTSD, anxiety disorders, and drug/alcohol abuse. Sometimes the sheer stress of keeping up with their studies can cause a student to experience crippling anxiety. These physical or mental health problems could make it very difficult to stay focused on the task at hand and cause the student to underperform.

Even as students become more aware of mental health issues and are getting better at seeking help, there is still a stigma associated with mental health disorders, making it difficult for some students to realize they need help. When and if the problem is identified, the school should be notified so they can take the matter into account when evaluating the student's academic progress and hopefully offer solutions to keep the student on track.

Injuries and accidents

Sometimes the cause of a medical student's academic struggles is an accident or injury that either prevents them from showing up to class or distracts them from their studies. Occasionally, the injury might occur during a clinical rotation as the student tries to gain practical experience. A student who has an awful semester after injuring themselves may be reluctant to tell the school about it for fear of being put on a leave of absence, opting instead to risk poor performance and academic probation without accepting help.

Family crises

Sometimes medical students may be dealing with a significant family issue that they don't feel comfortable discussing. In these cases, the stress of the situation could cause them either to miss classes or to do poorly in school. Examples include ill or aging parents, young children who get sick or hurt and need attention from their student-parent, siblings suffering from illness or other trauma, an incarcerated spouse, parents going through a bitter divorce, or the medical student going through a divorce.

Any family issue that consumes so much attention and requires constant involvement that students cannot dedicate themselves to their studies could lead to poor grades, academic probation, or even dismissal.

Loss of a loved one

Unfortunately, the death of a loved one is always difficult to cope with and can often lead to emotional distress and poor academic performance. A medical student may feel like they should be able to compartmentalize these traumatic events while continuing with their studies. Still, that kind of denial usually results in more problems down the road. The student should notify the school so the student can seek counseling or other support services.

Domestic abuse

Domestic abuse can happen to anyone, and sometimes a medical student may find themselves in an abusive relationship. This can be highly disruptive to a student who needs to focus. A student who is being abused might fall behind because they are too afraid or depressed to go to class or clinical rotation. Because domestic abuse generally includes a cycle of shame, the victim might avoid talking about it with their professors and classmates for fear that the exposure could cause further repercussions with their abuser.

Any of the above issues could easily cause a medical student to struggle with grades or fail to move forward academically—and any of them could cause a student to face dismissal if the issues aren't addressed. A good attorney-advisor will be able to offer guidance for medical students who are falling behind in their work due to extenuating issues such as these.

What Does Remediation Look Like for Medical Students?

Because medical school is so challenging even for dedicated students, remediation programs are typically an integral part of any school of medicine. Many medical schools, if not all, will offer some form of remediation to avert outright dismissal, especially the issue is academic-related. Although remediation is preferable to dismissal, it can also have its disadvantages. Schools frequently recommend or even mandate remediation when it might not be necessary or when other solutions might be better.

Remediation for medical students is, in most cases, a repetition of material that you have already studied. It could be a single course or a lab or repeating a semester or year of school. For the privilege of remediation, you will need to spend more time and pay extra tuition. If you are already familiar with the material, this may be a waste of time and money. A successful appeal of your grade may allow you to avoid dismissal or remediation if you have academic deficiencies or poor grades. We recommend consulting an attorney-advisor before you accept any offer of remediation. This will ensure that you get the best outcome possible.

Do I Have To Accept Remediation When the Medical School Committee Recommends It—Even if I Think It Isn't a Good Fit for Me?

No, you don't. While remediation is always a better option than dismissal, there are instances when remediation may be unhelpful or counterproductive. Here are some examples:

• The school may be too quick to recommend remediation when there are less intrusive options to resolve the deficiencies.
• Some programs for remediation are too generalized for the needs of the medical student, and as a result, may add undue strain to an already grueling schedule.
• Sometimes student grades can be incorrectly calculated or biased in such a way as to identify the student incorrectly as a candidate for remediation. You may be able to appeal the grade in these cases.
• Some schools see remediation as little more than a precursor to justify dismissal, so the program isn't tailored to help students academically.

Before you agree to a school's remediation plan, it is a good idea to consult an experienced attorney-advisor. You may be able to negotiate with the school to offer other options or modify the remediation to make it more beneficial.

Can Remediation Hurt Me Academically And/or Career-Wise?

Yes, it can. Although remediation is supposed to be beneficial for the student academically, it may also do some damage. For example:

You may be required to spend too much energy and time on remediation, which could leave you less time to concentrate on your other studies.

Many medical schools require the student to qualify for a degree within a set period of time. Remediation can cause delays in academic progress that could lead to you being disqualified from graduation.

To take remediation classes or repeat a year, you will most likely need to pay more tuition and/or take on more debt.

Remediation may result in a notation placed on your permanent academic record. This could impact your ability to compete for internships, residencies, or other job openings.

Do not accept remediation without considering all the pros and cons. While remediation may prevent dismissal, it can also cause more harm than good if not specifically tailored to your actual needs.

Can I Appeal a Negative Grade or a Course Failure?

Yes, you can. Medical schools have procedures that allow students to appeal a grade that is not satisfactory. You can successfully appeal a grade change if you prove that the grade was unfairly calculated or administered. This could boost your GPA and keep you from being placed on probation or remediation.

Any of the following grounds might be enough to overturn a bad grade:

• The grade was affected by instructor bias
• An error calculating the grade
• The instructor did not assign the grade according to established school or course guidelines
• Your instructor did not inform you about the criteria used in determining your grade
• Your overall performance assessment was not based on school policies
• Your grade is based on other factors than your performance (e.g., spite, retribution, harassment)

To appeal a bad grade, you will need to consult the school's policies and procedures, which usually involves filling out forms or meeting with committees to demonstrate why your grade should be changed.

What Is the Procedure for Academic Dismissal?

Every medical school will have its own procedures in place to address academic underperformance, and you can usually find this information in the school's published Policies and Procedures. In most cases, the process will look something like this:

• Review. An appointed committee will review your academic history to determine if further action is required.
• Notification. The school will inform you about your possible dismissal and the next steps so that you can prepare a response.
• Hearing. The committee will usually schedule a formal hearing where you can share your side of the story and give a reason why you should not be dismissed.
• Final determination. The committee/board will decide whether or not to recommend dismissal.
• Appeal. Any adverse decision can be appealed before it becomes final.

What Are the Possible Consequences if I Am Dropped From Medical School?

Being dismissed from medical school can have devastating consequences for the student with regard to continuing their education—and possibly fatal for their career in medicine. A dismissal can create a cascade effect of complications, which may include the following:

• Getting re-enrolled in medical school will be difficult. Many medical schools only accept a very small number of applications. They have high admissions standards, and medical students previously dismissed for any reason are not usually considered high up on the priority list.
• Ineligibility for the USMLE exams. If you don't re-enroll in an approved program, you won't be eligible to take the USMLEs required to obtain your medical license.
• Loss of academic progress. Assuming you can resume your medical education, you'll probably be starting from the beginning. Academic dismissal typically erases all prior academic progress.
• A permanent notation of dismissal on your academic record may make it more challenging to be considered for residencies or open positions in the medical field.
• Excessive student debt. If you've taken out student loans to pay for school, you'll still have to repay those loans even without the benefit of a physician's salary. It's not uncommon for medical students to accrue student debts of $100,000 or more—and if you re-enroll in medical school, the debt sheet goes even higher.

Given all that is at stake and all the potential complications, you want to do all you can to avoid dismissal from medical school. Having an experienced attorney-advisor in your corner can make a huge difference in the outcome.

If I Have Been Dismissed From Medical School, Can I Reapply?

It depends on the school's policies. Many medical schools will be more accommodating or lenient with academic dismissals than if you were dismissed for other reasons. In many cases, they will allow you to reapply after a certain period. For some medical schools, dismissal means a permanent separation, and you will not be permitted to reapply.

Can I Appeal My Dismissal From Medical School?

Yes, you can. Most medical schools give you the right to appeal any adverse action (including dismissal) before it becomes final.

How Much Time Do I Have to File My Appeal?

The window of time for appealing a dismissal is usually very short. Most schools only allow 5-15 days after the decision to dismiss before the dismissal is final. It can be very challenging to prepare a compelling argument within this short time frame. Yet, it is critical to your future because this is usually your last line of defense before your dismissal is finalized. A good attorney-advisor can be extremely helpful in circumstances such as these.

What Grounds Are Acceptable for an Appeal?

Each school has its own criteria under which it will consider an appeal. To find out the specific policies of your medical school, consult your Student Handbook.

Most medical schools allow you to appeal your dismissal on one or more of the following grounds:

• Introduction of new evidence. If new evidence has come to light that was not available during the investigation/hearing but could have changed the committee's decision, you may be able to bring that evidence forward at your appeal.
• Procedural errors. You may be able to demonstrate that the school, the investigator, and/or the hearing board did not follow school policies in conducting their review or the hearing, resulting in an unfavorable decision.
• Bias. If you can show that your academic performance was unfairly judged due to bias of the committee or instructors and that this led to your dismissal, you may be able to overturn the decision.

What Happens During an Appeal?

The medical school will have procedures set in place by which they consider an appeal. For most medical schools, it looks something like this:

• You submit a request for appeal. For some schools, this step simply means you are informing them of your intent to appeal, in which case you may have the opportunity to appear at a separate appeals hearing. The written request itself constitutes the appeal for other schools, and you'll need to submit all your supporting documentation and arguments in writing.
• The school considers the appeal. School authorities will review your appeal and your supporting arguments. This may take the form of an informal meeting with a Dean or a formal meeting with the appeals committee. Sometimes, the consideration stage is just the appeals committee meeting behind closed doors to examine your written request.
• The school renders a final decision. At this point, you can expect one of three outcomes: 1) The decision to dismiss will be reversed; 2) The dismissal will be reversed on condition of your fulfilling specific requirements; 3) The decision to dismiss will stand.

Do I Have the Right To Have an Attorney Represent Me When the School Is Considering My Dismissal?

Most colleges, universities, and medical schools do not allow students to have an attorney representing them in an official capacity. This is because it's not considered a legal matter, and they don't bring in lawyers. However, you are permitted to hire an attorney in an advisory capacity, especially when the school is considering any kind of disciplinary action or dismissal for any reason.

What Can an Attorney-Advisor Do To Help Me Avoid Being Dismissed From Medical School?

Hiring an attorney-advisor gives you a much better chance at averting dismissal from medical school. Here's how an attorney-advisor can help you:

• Evaluate your academic status in light of school policies, so you know what is at stake.
• Identify any issues that would unfairly affect the way your grades and performance were assessed.
• Evaluate remediation plans to make sure they will actually help improve your grades without adding to your academic burden unnecessarily.
• Provide guidance on how to negotiate with the Student Progress Committee on terms of remediation.
• Assist you in successfully appealing bad grades.
• Help you with gathering evidence and preparing a compelling argument against dismissal.
• Help you appeal your dismissal.

In addition to these benefits, having an attorney-advisor helps ensure the medical school stays accountable to its own policies and procedures so your rights are protected.

What Are the Benefits of Hiring an Attorney-Advisor?

An attorney-advisor can significantly increase your chances of a better outcome when trying to avoid being dismissed from medical school. Here's why you should consider hiring one.

• It makes the process fairer. As a medical school student, no matter how fair the school claims its process to be, you're at an automatic disadvantage when considered for academic dismissal. An attorney-advisor will have a keen understanding of the school's policies regarding academic progression, giving you a better footing with your defense.
• You bear the burden of proof. This is not “innocent until proven guilty.” If the Student Progress Committee believes you're not meeting their standards of academic excellence, it's up to you to prove them wrong to avoid dismissal. Having a student defense expert in your corner can make a huge difference when the stakes are this high.

Is There Anything an Attorney-Advisor Can Do After I've Exhausted Standard Channels?

Yes, a skilled national academic attorney has two other potential ways to help you if you still face dismissal after exhausting your school's standard process. Colleges and universities typically have an Office of General Counsel (OGC). The school's OGC ensures that the school applies policies and procedures fairly in individual cases. A national academic attorney can advocate with your school's OGC for your reinstatement, despite that the school's standard processes resulted in dismissal. Strong advocacy from a national academic attorney with your school's OGC could potentially save your enormous investment in your medical education. But even if OGC review doesn't change your dismissal, you may still have constitutional and contractual rights your national academic attorney can pursue in the civil courts. You should prefer straightforward OGC relief, but a lawsuit might be an appropriate and necessary last resort.

I Have Just Been Alerted by the Medical School That My Academic Progress Is Insufficient, and I Am Being Considered for Dismissal. How Soon Should I Consult an Attorney-Advisor?

The sooner you act, the better. In fact, if you wait until you're facing immediate dismissal, you're at a much worse disadvantage than if you hire outside help early in the process. Hiring an attorney-advisor at the first sign of trouble may help you avoid serious repercussions or a major crisis later.

If you are a medical student accused of wrongdoing or facing dismissal over academic or other issues, there is simply too much at stake to risk facing the disciplinary process on your own. With his many years of experience with student defense cases, attorney Joseph D. Lento is considered a nationwide expert and has successfully helped countless students across the country to avoid dismissal from medical school and rescue their careers. Why risk your future by facing a disciplinary process alone that is naturally skewed against you? Take steps now to avoid the worst and secure your future. Contact the Lento Law Firm at (888) 535-3686 today to see how we can help.