Medical students face an academically rigorous road to graduation. Whether you're studying in the Ivy League or at a Caribbean medical program, you can expect to push yourself to personal, professional, and academic limits while in medical school.
When academic difficulties, personal issues, or circumstances beyond your control impede your progression, you may face the prospect of remediation. Here's everything you need to know about remediation, how you could avoid remediation, when remediation may be an acceptable process, and how an attorney-advisor can help.
What Does "Remediation" Mean?
For medical students, remediation is the opportunity (or mandate) to repeat coursework, clinical rotations, or other aspects of your medical education. Remediation generally becomes necessary when designated evaluators determine that your academics, adherence to professional standards, general behavior, or other aspects of your medical education are lacking.
Who Could Face Remediation in a Caribbean-Based Medical School?
While "remediation" often applies to students whose academic marks are lagging, a Caribbean medical program may recommend remediation to:
Students Having Academic Difficulty
Caribbean medical programs closely monitor students' academic progress, recommending or mandating remediation as soon as it becomes clear a student will not earn the grades necessary to progress.
St. George's University in Grenada explains that Credit Remediation (CR) allows the student to repeat a course that they are not likely to pass due to poor academic performance. A grade of D+, D, or F is considered non-passing at St. George's University.
Students Who Require a Leave of Absence
If a Caribbean medical student must leave school, they may have to remediate partially completed or wholly uncompleted coursework. There are several reasons why a medical student may need to leave school temporarily, including physical health problems, the loss of a loved one, and mental health difficulties.
Students Accused of Professional or Behavioral Misconduct
Medical education requires both satisfactory academic performance as well as adherence to professional and behavioral standards. If a medical program determines that you have not grasped or applied its behavioral or professional standards, it may require you to remediate some aspect of your training.
Is Remediation a Punishment?
Remediation does not fall into the category of punishment. A student who struggles with academic coursework should not be classified the same way as a student accused of overt misconduct, like cheating.
However, there are substantial drawbacks to remediation. In this sense, remediation can be punitive. This is especially true if you do not believe an order of remediation is just or necessary.
What Are the Potential Consequences of Remediation?
Though medical programs may be quick to assign remediation, you must weigh the potential consequences of remediation (especially when other options are available).
If you agree to complete remediation, you may:
- Delay your graduation date
- Have remediation on your permanent record
- Receive lesser residency offers due to the potential stigma of remediating coursework
- Receive lesser job offers upon completing residency
- Have lesser earning power due to diminished residency and job opportunities
Furthermore, you may have a limited number of remediation opportunities. Once you exhaust those opportunities (and there may only be one), the next consequence could be dismissal.
At least one study suggests that remediation can also have a psychologically adverse effect. Having to retake coursework can feel like a failure, and medical students do not always rebound from remediation.
Will Remediation Appear on My Permanent Record?
Remediation may be part of your academic record, though each Caribbean medical school may have its own policy on this matter. Generally, a medical program may preserve records and document every aspect of your performance, including remediation.
Associations like the Association of American Medical Colleges encourage medical programs to disclose "any record which contains information that is personally identifiable to a student, and is maintained by the university or by a party or organization acting on behalf of the school." Records of remediation would certainly qualify as "personally identifiable" information.
Even if your Caribbean medical program isn't mandated to maintain such records, don't be surprised if remediation is part of your permanent record.
Even If There Is No Formal Record of Your Remediation, You'll Have to Answer Difficult Questions If You Remediate
Residency programs, accreditation boards, and medical institutions know the standard timeframe for graduating from medical school. Even if your academic record or student profile does not explicitly state that you remediated coursework, you may face an obvious question from admissions boards, licensing bodies, and prospective employers: What is this gap in your record?
Because remediation will almost certainly delay your graduation date, it's likely that you'll have to address your remediation regardless of the details of your record.
Why Could Remediation Be Especially Problematic for a Student Attending a Caribbean Medical School?
Fair or not, medical students typically view Caribbean medical programs as a last resort. Often, students have been rejected from multiple American medical schools before enrolling in a Caribbean program. Considering the hyper-competitive nature of medical education, being a Caribbean medical student is nothing to be embarrassed by—far from it.
This being said, you must be realistic about your status in the medical student pecking order. It is possible for a Caribbean medical student to gain entrance to a top-tier residency program, but typically only after a stellar performance in medical school.
Your margin for error is simply thinner when you're attending a Caribbean medical program. Therefore, remediation could have a catastrophic effect on your residency and job prospects. If you can avoid further swaying the odds against your favor by avoiding remediation, you must do so.
What Kinds of General Academic Challenges Can Lead to Remediation?
Completing a Caribbean medical program typically requires you to complete academic coursework, training in the field, seminars, and other features of a multi-faceted educational gauntlet. Difficulties in any single area of your education could lead to remediation, and those challenges may include:
- Coping with the sheer volume of academic and training responsibilities that medical school requires
- Effective management of your time and energy between different academic and training responsibilities and concentrations
- A lack of tutors or advisors to assist you when academic or training difficulties arise
A study published by the U.S. Department of Education found that medical students are sometimes reluctant to ask for help when they're struggling academically. Not wanting to appear weak, underqualified, or problematic, students' determination to overcome their academic struggles without help can exacerbate those struggles.
Even if you did not ask for help with academic issues, now is the time to request assistance. If you are facing imminent or possible remediation, hire the Lento Law Firm's Student Defense Team to help you protect your reputation and find an optimal resolution.
How Can Personal Challenges Lead to Remediation?
Some personal challenges that could contribute to performance problems in medical school and ultimately lead to a remediation order include:
- Difficulty overcoming perceived failure, as medical students are often high achievers among their peers who may have little experience with academic adversity
- Difficulty acclimating to a new social structure within your medical program
- Mental health problems stemming from the stress that medical school imposes on students
- Homesickness
- The death of a loved one, may cause you to leave school and fall behind on studies or remain in school and struggle with the loss
Medical students are human, with the same vulnerability to pressure and hardship that every human has. When such personal challenges lead to remediation, it is important that decision-makers in your program understand the context of your struggles.
While the presence of personal difficulties alone won't prevent you from facing remediation, exceptional circumstances could afford you leniency. Administrators may be inclined to offer an alternative resolution in light of any personal struggles that led to a remediation order.
Are There Challenges Specific to Caribbean Medical Students That May Lead to Remediation?
In addition to the general academic and personal difficulties that any medical student may face, Caribbean medical students may have to overcome additional challenges. Specifically, students who are not from the Caribbean may experience some degree of culture shock upon enrolling in their medical program.
You may find it difficult to acclimate to:
- The native language on the island where you are studying
- Fewer dining options that you are used to
- Differences in the availability of water, air conditioning, and other amenities
- Different cultural norms
- Any time differences between the island where you're studying and your home
- The general unfamiliarity that comes with being in a foreign environment
Most Caribbean medical students find their professors and locals to be friendly and accommodating, but this does not stop the psychological and emotional difficulties of being in a new place for a prolonged period of time. Compounded with the stress you likely face from the demands of medical school, moving to the Caribbean can be a difficult adjustment.
These challenges can seep into your academic and professional performance. Understandable difficulty adapting to a new environment and culture could afford you leniency from those who are considering whether you should have to undergo remediation.
Attorney-Advisor Joseph Lento has helped many Caribbean medical students negotiate favorable resolutions, including those that helped the students avoid remediation. Lento and his Student Defense Team will communicate your story to administrators, make a detailed case for an alternative resolution, and fight hard to help you avoid remediation.
Are There Preferable Alternatives to Remediation?
The journal Perspectives on Medical Educationrecommends a continuum of remediation options rather than simply requiring students to retake an entire course when they struggle to comprehend specific concepts. Our firm adopts a similar outlook, believing that many solutions can help medical students avoid the stigma and adverse consequences of remediation.
Some alternative resolutions to remediation include:
- Enacting a grade change so that a failing mark becomes a passing mark
- Appealing a negative behavioral evaluation
- Negotiating academic probation (which is typically preferable to remediation)
- Explaining any absence that has led to the threat of remediation
- Exploring untraditional or undocumented resolutions to the problem that' lead to possible remediation
Each medical program has different problems, and each student facing remediation finds themselves in a unique circumstance. Attorney-Advisor Joseph Lento will work within your personal circumstances and your program's policies to seek a resolution that spares you from remediation.
If I Must Remediate Coursework at a Caribbean Medical Program, What Happens Afterward?
The specific way that your program handles remediation will depend on its grading scale and remediation-specific procedures. At Saba University School of Medicine (p.29), a student who fails to display necessary progress in a specific competency will receive a grade of "U" or Unsatisfactory. The student will then "require remediation."
Once remediation begins, there are two most likely outcomes:
- You successfully remediate the deficiencies
- You fail to successfully remediate coursework
The outcome that you (or any other Caribbean medical student) face will determine the following steps.
If You Successfully Remediate Coursework
Saba University School of Medicine notes two primary scenarios that can lead to remediation:
- You pass your course but fail the related competency exam
- You fail your course and fail the related competency exam
In the former scenario, the student will receive their course grade (a B, for example) with an asterisk next to it (B*). For the competency exam grade, the student receives a "U" for Unsatisfactory. The student can then remediate (retake) the competency exam. If they pass the second time, the student will receive a Satisfactory grade (S) with an asterisk (S*) for the exam grade. Then, the initial course grade will lose the asterisk (the B* will become a B).
In the latter scenario, the student who failed both the course and the competency exam will need to remediate both. The initial grade for the course will be an F*, while the competency exam grade will be a U. If the student successfully remediates the course, the F* will become an F (still a substantial blemish on the record), but the U will be replaced by the passing exam grade.
If You Fail to Remediate Coursework Successfully
When a student fails coursework or competency exams, they often face immediate academic probation. This probationary raises the stakes of failing further coursework or exams, including any work they remediate.
If you do not successfully remediate your coursework or exam, dismissal from the program is a realistic possibility. Your program's Promotions Committee will review your case and may recommend or demand that you leave the program.
When, Exactly, Can Failed Remediation Lead to Dismissal
Though each Caribbean medical program has its own rules and procedures, we will stick with the protocols set forth by Saba University School of Medicine. This school's handbook (p.36) explains several scenarios in which a medical student may face academic dismissal, including if they:
- Fail two (2) or more courses while on academic probation
- Fail one (1) course worth six (6) or more credits while on academic probation if any one of the course(s) failed or dropped resulting in academic probation was worth six (6) or more credits
- Fail one (1) clinical clerkship while on academic probation
- Fail the same course or the same competency (or sub-competency) a second time whether by remediation or otherwise (excluding Medical Knowledge 2a) while on probation
- Fail three (3) or more courses during the same semester
- Fail two (2) courses worth six (6) or more credits each, or two (2) clinical clerkships during the same semester
There are many avenues to potential dismissal as a medical student in the Caribbean.
What Is the Dismissal Process for Caribbean Medical Students Who Fail to Remediate Coursework?
Administrators (perhaps a Promotions Committee) will typically review your academic performance and determine whether to dismiss you. In cases where repeated academic struggles have triggered dismissal proceedings, your academic record may speak for itself.
In some cases, medical students have the opportunity for a hearing. If permitted, you should have Attorney-Advisor Joseph Lento represent you during all dismissal-related proceedings, including a hearing. An academic dismissal hearing may involve:
- A review of the student's academic record, including any failed remediation attempts
- The student's representative presenting relevant witnesses and evidence
- The presiding body asking questions of the student and their representative
- Closing arguments by the student's representative
The details of your circumstances will dictate our approach to a dismissal hearing. We may contest the facts that have led to dismissal proceedings. In some cases, we ask for leniency and explain any forgivable circumstances that contributed to academic hardship.
Whatever your defense entails, it is vital that you have a strong one. Failing to fight for your enrollment in a Caribbean medical program could mean giving up on your medical career altogether.
Can I Appeal a Remediation Ruling?
Your program's policies will determine whether you can appeal a remediation ruling. At the very least, you should have the opportunity to rectify any misunderstandings or errors that have led to the remediation order.
For example, Saba University School of Medicine requires that a student remediate a clinical clerkship if they fail to document all patient encounters. If the student had documented all patient encounters but had simply not submitted the documentation, an appeal could allow the student to share this information and avoid remediation.
Attorney-Advisor Joseph Lento and the Lento Law Firm Team will quickly determine your program's policies regarding appeals of remediation orders. Even if your program does not allow appeals, there may be ways to enact an appeal-like process (such as negotiating directly with the program's legal counselors).
What Are Valid Grounds for Appealing a Remediation Ruling?
Regardless of what type of decision a medical student is appealing (remediation, potential dismissal, or otherwise), appeal boards generally accept appeals based on:
- The emergence of new evidence that was not available at the time your medical program's administrators recommended (or mandated) remediation
- A violation of due process in the way that administrators determined you needed remediation
- Apparent bias in the way that administrators determined you needed remediation or in the circumstances that led to a remediation order (such as a biased professor grading you unfairly)
There may be other acceptable grounds to appeal a remediation order.
When Is Remediation an Acceptable Option for a Caribbean Medical Student?
American University of the Caribbean School of Medicine (AUCSOM) explains that students may face dismissal if they do not successfully remediate coursework. Without a doubt, dismissal is a more harmful outcome than remediation.
If you face a choice between remediation and dismissal, remediation is the preferable option. However, the choice is not always binary. Before you agree to remediation, ensure that you have no other options—like an appeal or grade change—that is preferable to both remediation and dismissal.
I've Been Informed That I'll Need to Remediate Coursework at a Caribbean Medical School. What Should I Do Now?
If you're facing possible or certain remediation, speak with the Lento Law Firm's Student Defense Team as soon as possible. Even if you believe you can rectify poor marks or evaluations by remediating work, there may be more favorable options.
Our legal team will review your case, listen to your account of events, and develop a sound strategy specific to you.
How Will Attorney-Advisor Joseph Lento Help Me Overcome a Remediation Issue at a Caribbean Medical School?
Our firm has assisted many medical students facing and undergoing the remediation process. We've also assisted those who failed remediation and are facing dismissal.
Depending on your unique circumstances, we will assist you by:
- Negotiating directly with your program's Office of General Counsel (OGC), as these attorneys may offer an acceptable resolution
- Helping you pursue a grade change or other course of action that may help you avoid remediation
- Accompany you in all remediation-related meetings and hearings
- Advise you of the most advantageous course of action
- Handle any necessary appeals process
We tailor our services to suit exactly what our clients need.
Contact the Lento Law Firm Today to Discuss How We'll Fight for Your Reputation and Medical Future
The value of the Lento Law Firm is clear. Your admission to residency programs, candidacy for future medical positions, and career in medicine may be at risk. Hire a law firm that has successfully represented countless students in the Caribbean medical school network.
Call the Lento Law Firm today at 888-535-3686 or contact us online. Let our experienced legal team fight for you.
