Medical Student Issues

In order to become a doctor, most students have to complete a four-year undergraduate degree, go through the competitive process of getting into medical school, complete four years of medical school, then go through residency. With so much time, money, and effort invested in medical school, it can be devastating for a student to be accused of disciplinary measures in med school. 

An adverse disciplinary hearing or loss of medical student appeals can potentially put an end to your career path. With so much at stake, it is important to speak with an attorney-adviser when facing a medical school misconduct investigation, disciplinary charges, or any medical school issue that can negatively impact your academic and professional career 

Student Disciplinary Issues for Medical Students and Other Fundamental Concerns

Medical students can face any number of issues throughout the medical school process, from the application and interview process through graduation. Issues can range from academic problems to Title IX and sexual harassment claims to professionalism and dismissal concerns. Some of the medical student issues of concern for prospective doctors include: 

Medical schools across the United States at times have similarities in terms of how such concerns will be addressed and adjudicated, but there will also be fundamental differences.  Understanding how your medical school's process is critical to understanding prospective steps forward and also how to best protect your rights and interests.  The following link provides information about individual medical schools' policies regarding how concerns that can negatively impact students will be handled:

Academic Misconduct

The consequences of an adverse academic misconduct finding can be drastic. The penalties and disciplinary measures for academic misconduct can include probation, suspension, or dismissal. An adverse academic misconduct finding can also prevent a student from attending another medical school, essentially putting an end to their medical career. 

Academic misconduct or dishonesty can refer to a number of actions or inactions by students in a medical school. Some examples of academic misconduct include: 

  • Plagiarism
  • Unauthorized collaboration, 
  • Deceitful educational software
  • Blackmail,
  • Cheating, 
  • Reusing assignments or exams, 
  • Forgery, 
  • Fabrication, 
  • Bribery, 
  • Failing to report violations,
  • Impersonation, or 
  • Sabotage. 

Some students see other students engaging in academic misconduct, are frustrated by others seemingly getting it away with it, make the poor decision to do so themselves.  Other medical students have engaged in some form of academic misconduct from high school, through college, even on the MCAT, or in their medical school classes. This can make it more tempting to engage in cheating or plagiarism when so many others may be doing so.

Other students may be having a difficult time dealing with the stress of their first year of medical school, or be dealing with a family emergency or mental health issue. Cheating, copying, or other misconduct may be a way for them to continue through med school until their personal situation has improved. 

Unfortunately, many medical students are falsely accused of academic dishonesty. Competition between students, jealousy, or even anger over personal relationships may cause another student or teacher to make false claims of academic misconduct. For example, one student who copies another student's work may then claim the other student copied them to try and take the spotlight off their own misconduct. 

Challenging academic misconduct claims may depend on the evidence available and the strength of the claims against the student. In many situations, the med student accused of misconduct faces weak evidence against them. The school may try and give the student an opportunity to “admit” to the misconduct in exchange for reduced disciplinary measures. It can be tempting, even for an innocent student, to admit to misconduct rather than face more serious penalties. 

Medical students generally have the option to consult with an attorney or counsel when facing disciplinary accusations. Unfortunately, many students avoid calling a lawyer because they think it will make them look guilty. However, contacting an academic misconduct attorney and adviser is a way to protect your rights and make sure you are not taken advantage of by the unequal process of a med school disciplinary proceeding. 

Academic Misconduct Hearings

Academic misconduct can result in serious consequences for a medical student, especially when the student has not availed themselves of their right to counsel or an attorney-adviser. After an initial report of misconduct or other medical student issues, the school may conduct a disciplinary proceeding through an administrative hearing or panel hearing. The type of hearing may depend on factors, including the nature of the misconduct, penalties, and prior history of the student.

An administrative hearing generally involves a meeting between a school official and the med student. The school official may review the allegations, the evidence, and meet with others involved in the alleged misconduct. The student will then be given an opportunity to respond. The school official may then make a determination based on the evidence of whether the student should be subject to discipline. 

A panel hearing is generally a more structured administrative process. A panel hearing may consist of a few med school faculty, staff, deans, or other administrators. The panel will hear the evidence, hear from any witnesses, and allow the student to respond. The panel would then make a decision based on the evidence whether the student's actions constitute a violation of the school's policy and what sanctions to apply. 

Disciplinary Violations for Medical Students

The hope would be that most medical students, even if having matriculated directly from college, would be mature enough to avoid potential improprieties that can result in disciplinary charges under the medical school's code of conduct.  This is not always the case, however.

Disciplinary concerns are different than concerns involving professionalism for example, but due in part to the nature of youth, the social dynamics of a medical school campus, and the best-laid plans going awry, medical students can at times find themselves subject to being charged under the school's code.

Disciplinary charges can vary in nature, but charges can include, for example:

Medical students can also, unfortunately, find themselves subject to Title IX allegations and charges involving sexual harassment and sexual misconduct.  Although there can be interplay between a medical school's code of conduct and its Title IX policies, Title IX will control how such allegations and charges are addressed and adjudicated.    Title IX charges can include, for example:

Lastly, criminal charges filed against a medical student by law enforcement can impact the medical student's future, even if the incident happened outside of school or the student was never convicted of a crime. Violations of the law often constitute violations of the medical school's Code of Conduct or Disciplinary Code. Unfortunately for the student, although the criminal case has a higher burden of “beyond a reasonable doubt,” but the medical school can apply their own standard of proof and will often address such off-campus criminal acts through the medical school's disciplinary process. 

It may seem like a person's right to avoid double jeopardy may be being violated in such an instance, but medical schools generally have wide latitude to enforce their own code of conduct policies and medical schools almost always also have expansive policies regarding their "jurisdiction" over alleged acts committed off-campus by a medical student.

Although medical students may still be young, make mistakes, or make poor decisions under the pressures of medical school, school administrators and others strongly frown upon any inappropriate behavior on the part of a medical student, perceived or otherwise. Minor offenses, like a traffic offense, will most often not trigger a disciplinary measure, unless severe in nature. Common criminal charges affecting medical students both independent of medical school and also through the school's disciplinary processes may include: 

  • Drunk driving, 
  • Driving under the influence of drugs, 
  • Assault, 
  • Domestic violence,
  • Prescription fraud, 
  • Drug possession, 
  • Theft, 
  • Trespassing, or
  • Weapons offenses. 

Fair or not, when a medical student is arrested on suspicion of a crime, the medical school will often conduct its own disciplinary hearing. Unfortunately for the student, the laws of evidence and constitutional protections do not offer the same rights under the school hearing. 

Medical Student Academic Issues

Academic issues may impact the medical student's academic progress. Medical students may be able to appeal an academic issue to address unfairness, unequal treatment, or other problems. Common issues for academic appeals include: 

Faculty and educators should be expected to clearly establish course requirements along with the standard of academic performance students must meet to pass a class. Faculty should also apply their criteria equally for medical students. Unfortunately, med school requirements and academic guidelines may have been incorrectly or unequally applied. 

Mistakes and errors can have a significant impact on a student's exams, grades, and standing in the class. Unfortunately, the school may not be so straightforward about mistakes that were made. It may be up to the student to bring up the matter with the advice of a legal professional who can help steer the student in the right direction.

In some cases, problems may have been intentional and not just the result of a mistake. Professors may use arbitrary and inconsistent guidelines in the evaluation of a student's performance. A grade may be based on reasons other than the academic performance of a student, including personal bias. In some cases, the overall grade may be based on discrimination, harassment, or malice.

Academic Appeals Process

Each school will have its own policies and procedures for academic appeals. Many schools provide a limited time to challenge a grade or score, such as 45 days after the grade was officially recorded. Each school will have its own policies, the med student may submit an appeal to the dean with substantive evidence of the grounds for the appeal. Talk to your student rights attorney about your rights and options for appealing a medical school grade or academic decision.

Professionalism Concerns

Medical students are held to a very high standard of professionalism and professionalism concerns can lead to severe consequences. The principles of professionalism in medical school may include: 

  • The Primacy of Patient Welfare: Altruism, trust, and patient interest that must not be compromised by market forces, societal pressures, and administrative exigencies.
  • Patient Autonomy: Honesty with patients and the need to educate and empower them to make appropriate medical decisions.
  • Social Justice: A physicians' societal commitment to the healthcare needs of the society. 

A medical school's curriculum and professionalism program may educate the students in professionalism, values, and responsibilities of a medical student in: 

  • Setting expectations,
  • Performing assessments,
  • Remediating inappropriate behaviors,
  • Preventing inappropriate behaviors, and
  • Implementing a cultural change. 

As a college student, a lack of maturity, responsibility, or communication skills may not have resulted in any disciplinary action. However, these issues in medical school can lead to further inquiry and assessment of the student's professional capacity, and if not successfully resolved, can result in disciplinary consequences up to and including dismissal.

Medical students are expected to maintain professional standards involving responsibility, maturity, communication skills, and respect. If an instructor or professor identifies a potential issue with professionalism, the teacher may address the issue with the student or report the issue. 

Once a professionalism issue is identified and the student is made aware, remediation may be a way to help the student address the problem. Professionalism can be as important as other forms of medical school evaluation. Professionalism could affect a med student's ability to obtain residencies. Professionalism concerns may also be reported on a Medical Student Performance Evaluation (MPSE), also known as the "Dean's Letter".

Medical Student Remediation

Despite being high-achieving over the course of their academic careers, and in cases involving non-traditional medical students, over the course of their academic and professional careers, medical students can face a learning curve unlike in past endeavors.  It is not always first-year medical students who struggle at times either, as challenges can arise at any point during a medical student's career. 

Medical schools, when they properly and effectively respond to such concerns, understand that such challenges can also be viewed as an opportunity for medical students.  As such, schools have established remediation programs to, in theory, help struggling students before adverse action would need to be taken be the school – action that can result in negative consequences up to and including dismissal. 

Remediation itself can encompass various forms.  For example, a student can be asked to remediate a course, a curriculum level assessment (NBME progress exams, gateway OSCEs, lab practicals), a semester, or even an entire academic year.

The potential issue with medical school remediation, however, is that what may be well-intended may also have unexpected consequences for a struggling medical student.  Having to remediate can result in additional time being required to complete medical school, and consequently, additional expense being incurred by the student and often his or her family.  Remediation can also result in diminished residency and employment opportunities if such action is viewed as a concern to prospective residencies and employers.

The above concerns are significant potential negatives to medical school remediation.  It is also recognized that remediation programs require substantial resources of medical schools.  The positive, however, is that studies indicate that remediation was successful for 90 percent of students who undergo remediation. Studies also indicate that not only did the remediation work, but that students also reported that the program helped them as individuals.

Successful remediation programs at medical schools across the United States are intended to help students referred (or self-referred) to the program by diagnosing areas of deficiency and creating strategies for remediation based on the individual student. 

Successful remediation programs are: 1) designed with the student as a whole in mind, coordinating academic resources with other applicable resources, such as communication coaches, mental health services, and more; and 2) implemented in timely manner so as to help a struggling student avoid adverse disciplinary action by the medical school as a result of ongoing concerns with grades which do not pass muster, professionalism issues, and other potential concerns which can negatively impact medical students.

Analysis of the issues impacting medical students and leading to remediation, or potential disciplinary action when not properly or effectively addressed by the medical school, reflects as follows:

  • Most learners had more than one deficit.
  • The most common deficits were related to medical knowledge, clinical reasoning and professionalism.
  • Medical students (as opposed to residents and fellows) were more likely to have mental well-being issues
  • Men struggled with communication and mental well-being more than women.
  • Poor professionalism was the only predictor of probationary status. Faculty on the remediation team spent significantly more time with learners requiring remediation of clinical reasoning and mental well-being. Per hour, faculty face time reduced the odds of probation by 3.1 percent and all negative outcomes by 2.6 percent.
Concerns with Medical School Remediation Programs

Although well-intended, several concerns arise regarding medical student remediation. 

Is it the student's or the medical school's obligation to be proactive in seeking help and resources to allow a struggling medical student to overcome such struggles?  If it is the student's obligations, is such help and resources readily known and available to the struggling student?   If it is the medical school's obligation, did the school act in a timely manner in addressing the concerns or did the school allow the concerns to reach the point where they may not be rectifiable and the student potentially faces adverse consequences including the prospect of dismissal? 

The opposite of the above concerns are when a medical school prematurely imposes remediation upon a student.  Although not limited to instances where the medical student may have disabilities, this is a common theme.  For example, a medical student may have documented (or not yet diagnosed) disabilities such as ADHD.  In instances, where the diagnosis is documented, the student often would have reasonable accommodations provided by the medical school.

Despite these accommodations, professors, instructors, and the school in general may not be cognizant of their obligation under the Americans with Disabilities Act (ADA) and may not provide the student with the necessary accommodations.  It may not be a pattern of such oversight on the school or applicable party's part, but one instance of not providing an approved accommodation can severely impact a medical student.  For example, if a medical student is allotted additional time to take an exam or a private setting to do so, it is not an uncommon occurrence where the school or applicable party failed to provide as such, resulting in consequences that, even a limited instance, can have profound consequences for a medical student.

Just as every medical student has his or her own story, characterized by the path they traveled to reach medical school, itself influenced by the student's strengths and weaknesses, the potential scenarios are endless for medical students who may struggle at times. 

As well-intended as remediation may be, because of what is at stake, from the standpoint of the potential additional time and expense involved for a medical student when facing remediation, in addition to the potential related concerns as to how residency programs and employers will regard a student's remediation, one cannot necessarily depend on their school to do what is best for a struggling student. 

When facing remediation, having an experienced attorney review and assess your circumstances can allow an independent professional opinion as to what is appropriate and best for a medical student facing such concerns, and when action is necessary to address remediation concerns, an experienced attorney can help in this regard also.

Medical Student Dismissals

Medical schools can take swift action in imposing dismissal proceedings.  Each school will have its own policies regarding when a medical student can fact dismissal, but a student at risk for dismissal cannot depend on the school to have the student's interests at heart. 

Taking the necessary steps as early as possible, preferably before, but especially once confronted with the prospect of dismissal will best position a medical student to avoid such an outcome.  If, upon realizing that the prospect of a dismissal has become an unfortunate reality, a dismissed medical student will in most instances be able to appeal such an outcome.

In order to have any prospect of success, there generally need to be grounds for filing a dismissal appeal, however.  Depending on the medical school and individual situation, an appeal may require a showing of improper conduct, factual error, or extenuating circumstances. 

It is unfortunate that a medical student's career can be ended because of a factual error or mistake. When a student does not challenge their dismissal or seek the advice of an experienced attorney and adviser, a factual error could result in dismissal from medical school. 

Extenuating circumstances can cause a major disruption to your life. Unpredictable events can occur in the life of a medical student that could impact academic progression. This could involve:

  • Family crisis or unexpected death in the family: If a parent or close member of your immediate family has fallen ill or has passed away, you may feel the need to take care of them. This may take away from the time allocated to study.
  • Psychological or medical issues: A serious accident, illness, or mental illness can have a major impact on your ability to study. Depression and anxiety are common mental health issues that medical students have to address.
  • By the nature of being accepted into medical school, students are obviously high-achieving.  Despite years of academic success, students often struggle due to the steep learning curve, especially as a first-year medical student.  A respectable number of students have struggled once reaching medical school only to be surprised to learn that they in fact have had lifelong learning disabilities such as Attention Deficit Hyperactivity Disorder (ADHD).  Such struggles can lead to a medical student facing dismissal and must be effectively addressed so as to allow the school to have a better understanding of the reasons leading up to dismissal proceedings and why such circumstances should be considered in allowing the student to continue forward with their medical studies.   
  • Financial issues: Even with financial aid and scholarships, going to medical school will likely leave you with a heavy financial burden. During medical school, a sudden emergency or loss of income can leave you trying to figure out how to pay your bills and tuition. Worrying about providing for you and your family can be a major distraction.

When an unexpected event keeps the student from attending school or has an adverse effect on the student's academic performance, it may be considered an extenuating circumstance.

Improper conduct or extenuating circumstances can have a serious impact on a medical student's grades or academic record. After investing so much time and money into your higher education, when your medical school makes a decision that you believe is wrong, you have every right to appeal that decision. 

Medical Schools in the U.S. by State

Attorney Joseph D. Lento and the Lento Law Firm have helped medical students through misconduct hearings, dismissal proceedings, and with any concern impacting students at medical schools across the country.  He has also represented many clients who are studying at Caribbean medical schools, and students involved with overseas programs. 

Our medical schools by state page has links for medical students going to medical school in all 50 states, Washington D.C., and the Caribbean.

Medical Student Discipline Defense and Student Rights - Helping Clients Nationwide

When medical school professors or administrators make a mistake, they may not be willing to admit they did something wrong. Medical students may need to take action to protect their rights, ensure due process, and challenge any unfair results. Attorney Joseph D. Lento has a firm understanding of the consequences and has helped countless medical students with such concerns. Contact attorney Joseph D. Lento and the Lento Law Firm at (888) 535-3686 today for help.

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If you, or your student, are facing any kind of disciplinary action, or other negative academic sanction, and are having feelings of uncertainty and anxiety for what the future may hold, contact our offices today, and let us help secure your academic career.

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