By the time a student completes higher education, they, and sometimes their parents, have invested an enormous amount of time and resources in their professional ambitions. The average medical school student owes over $240,000 in student loans by the time they graduate. The key to paying back that overwhelming debt is in building a successful career with that medical degree you worked so hard for. While any number of life events can get in the way of ultimate career success, few of those events are more frustrating than the scrutiny of your medical school's student progress committee before you even graduate.
Medical student progress committees are meant to help ensure a student's fitness to continue through the program, graduate, and then transition into the professional world as a representative alumni of their school. All too often, though, student progress committees wield their power with too heavy a hand, and students well on their way to achieving their professional goals find they're suddenly thrown to the curb after an unfavorable committee decision.
If you are required to face a student progress committee vote, you need to consult with an experienced attorney who can help you defend all that is at stake.
What is a Medical School Student Progress Committee?
A student progress committee is a group of voting and non-voting individuals affiliated with the school who review student progress and determine whether a student is fit to be promoted to the next stage of their program.
While medical schools across the country have their own student progress committee policies, they all share a common goal. As an example, the UW School of Medicine provides “The Student Progress Committee (SPC) exists to monitor medical students' progress toward graduation and to determine if the standards of the University of Washington School of Medicine (UWSOM) are being met in individual cases.”
In making its evaluation, UWSOM's SPC tracks and implements:
- Leaves of absence
- Licensing exam performances
The school's SPC also considers promotions and may recommend that deserving students receive various honors. While review by the SPC can be a positive event, it is more often a point of significant anxiety for students.
What Role Does the Medical School Student Progress Committee Play?
The SPC is not an investigatory body. When misconduct or disconcerting behavior is brought to the SPC's attention, the SPC will review the allegations in the context of the medical school's policies. Certain behaviors may trigger a vote on dismissal, but the SPC does not conduct hearings or investigations at most schools.
The way the process works is an important takeaway for medical students facing disciplinary action. You may feel like you're part of a close-knit community within your medical school and that you're surrounded by familiar faces who will understand your situation. This is a false sense of security, however. Ultimately, any formal complaint lodged against you as a student will be investigated by the larger university body and not by the familiar faces of your medical school.
As soon as you become aware that a formal complaint has been made against you for improper behavior, you should contact a student defense attorney who can help you assert mitigating circumstances that can serve as a defense.
What Does the Medical School Student Progress Committee Review?
There are certain benchmarks all students are expected to meet during the course of their program. If these benchmarks aren't met, then the SPC may hold a vote on how to proceed with the student—potentially requiring the student to remediate the issue or dismissing them altogether.
Students who receive failing grades in coursework, internships, externships will be reviewed by the SPC. They may be given the opportunity to remediate their grades during a probationary period.
Competency is a requirement of graduation in medical school, and as such, a determination of “Competency Not Achieved” or other similar attribution will prompt an SPC review.
Failure of Exams
Although failing an exam in undergraduate school is almost a rite of passage into the rigor of higher education, it is not acceptable in medical school. If a student fails an exam during their post-graduate coursework, then the SPC will review the circumstances surrounding the failing grade and may dismiss the student or require remediation.
Failure of Step Exams
Medical students who fail to take and pass their step exams within the expected timeframe, usually within one year for Step 1, will be reviewed by the SPC for fitness.
Student evaluations occur throughout the course of a medical student's educational career, and when an evaluator voices a concern within the evaluation, the SPC will review the matter. Notably, these concerns are not always included in the Medical Student Performance Evaluations that accompany a student's permanent record, but after a review, the SPC may decide that the information does belong in the student's permanent record.
Occasionally students must take an incomplete in a course or clerkship program due to illness or other personal situations. Although these circumstances may be outside of the student's control, the SPC will still review the incomplete.
In some cases, a student will need to drop a class for reasons beyond their control. Generally, dropping a class must be approved by the school's dean. Medical schools will often allow a dropped class so long as the student isn't attempting to bail out before they're issued a failing grade. Unsurprisingly, the SPC will review all dropped classes.
Professional and Ethical Conduct
Medical students can be accused of a variety of professional misconduct issues. These allegations may come as a surprise to many, especially those who are performing well academically. Post-graduation, though, professionalism is a key tenet of a medical provider, and thus, your medical school will monitor any assertations of unprofessional behavior.
Professional Issues May Prompt a Vote by Medical School Student Progress Committee
While SPCs will regularly assess students throughout the course of their program, in some cases, they may be called to vote on issues outside of their regular reviews.
The student progress committee review may be prompted when an individual initiates a complaint against you for professional or ethical misconduct. Under the University of Oklahoma's committee guidelines, such complaints may come from:
- Rotation site authorities
Essentially, almost anyone may lodge a complaint against you for professional misconduct. In the high-pressure scenarios that often accompany medical programs, these complaints are often unjustified or mischaracterized.
Professional misconduct can manifest in a variety of ways, and a claim against you can be made by anyone. Patients you've interacted with may disapprove of your bedside manner, or perhaps classmates or peers have witnessed behavior from you that they deem improper. Sometimes, claims of unprofessional conduct stem from disagreements or even jealousy.
Unprofessional conduct for medical students includes:
- Chronic tardiness
- Lack of follow-through
- Refusal to accept blame when appropriate
- Inappropriate bedside manner
- Improper communication
- Alcohol or drug abuse
In addition to the general professionalism standards of any higher education system, Medical schools in the United States focus on three pillars of professionalism in their programs that focus on:
- Patient welfare
- Patient autonomy
- Social justice
Professionalism for medical students must include the tenets of these pillars, which are designed to emphasize patient care over market forces and pressures from society. Behavior that jeopardizes the three pillars also jeopardizes a medical student's standing within his or her medical school.
The SPC will monitor a medical student's demonstration of professionalism throughout the student's tenure in an academic setting.
Medical Student Misconduct Issues May Prompt a Vote by Student Progress Committee
While the SPC doesn't generally investigate issues of student misconduct, leaving that process instead to the applicable parties at the university, the committee will take the findings of the university into consideration when determining whether a student is fit to continue within the medical program.
Title IX Misconduct
Title IX violations are especially egregious and occur when a student attending a school that receives federal funding commits an act of discrimination on the basis of sex. This manifests as sexual assault, rape, or discrimination. A student who's been accused of sexual misconduct will have a difficult time asserting why they deserve to remain in their medical program, and in fact, the university may decide through separate disciplinary action to expel the student.
Other Student Misconduct
There are other types of student misconduct that may be more suitable for remediation in the eyes of both the university and the SPC than Title IX violations are. Instances of theft, vandalism, or academic misconduct (like cheating) are examples of this type of misconduct. With appropriate remediation measures, like professional psychological treatment, a student could be allowed to continue through their program.
Both professional misconduct and conduct that violates a university's student conduct code may trigger a formal review. Even when an allegation made against you or your loved one seems completely ridiculous, it's important that you take steps to protect yourself from the negative implications associated with a formal review by the student progress committee.
Who is On the Medical School Student Progress Committee?
Medical schools generally have several members on their student progress committees. Some of the members vote, while others are non-voting members and are present to provide insight and context into situations on a case-by-case basis. Members may include vice deans and department heads, and select faculty approved by the dean of the medical school.
How do Medical School Student Progress Committees Make Decisions?
Student Progress Committees make decisions by voting. Each school is different in both the number of voting members on the committee and how large the majority must be in order to sway the vote one way or another. Often a two-thirds majority vote is required for dismissal.
On some occasions, the SPC chair may make decisions on behalf of the entire committee, however, there is usually some limitation on this power, and only a quorum of SPC voting members can make a decision when it comes to suspension or dismissal of a student.
A simple majority vote may be sufficient when determining whether a student should be considered for promotion or if they need to complete remediation before they can move on to the next level of their education.
The Medical School Student Progress Committee and Confidentiality Issues
Those facing an SPC review should be concerned about confidentiality. Importantly, the SPC is tasked with ensuring that all reviews surrounding a medical student's grades and their overall progress are confidential.
That said, the circle of individuals who are entitled to the information can be a large one and, for example, at UWSOM, individuals may include:
- SPC chair
- SPC voting members
- SPC non-voting members
- Student mentors
- “Relevant staff members who schedule appointments with deans, schedule students in courses and clerkships, write letters of good standing, maintain academic files, Block, thread, course, and clerkship directors (or designees) who present or provide information to SPC about students having difficulty in their curricular component, and who need to manage remediation”
- Relevant faculty
- Academic support directors
- “Anyone with legitimate need to know as defined by the federal Family Educational Rights and Privacy Act (FERPA).”
While the SPC owes students a duty of confidentiality in theory, in practice, it may be difficult to ensure. A breach of confidentiality can have serious consequences, however. Many medical students rely on letters of recommendation from faculty, and the stigma of prior progress issues can outlast the issues themselves. A breach of confidentiality is unfair to students who've effectively remediated their progress issues and who have successfully moved on.
Conflicts of Interest on the Medical School Student Progress Committee
Unsurprisingly, medical students and SPC members often have existing relationships—after all, the SPC is comprised of individuals who may be mentors, instructors, and other staff who are ever-present in the daily lives of medical students.
So, what happens when a preexisting relationship hinders the ability of the SPC to vote fairly? SPC members are required to disclose their conflicts of interest prior to any review. Examples of the types of relationships that may trigger a conflict of interest include:
- Mentor/Mentee relationships
- Familial relationships to student
- Friendly relationships with students or their family
- Students have been medically treated by the SPC member
Some may be quick to assume that these relationships would benefit the student under review, but the opposite is just as likely to be true. Students facing a review by the SPC may be facing a life-altering decision to be made by a member who holds a grudge or exhibits discriminatory behavior. This situation is more likely to fly under the radar of the SPC chair's oversight, and if you suspect this is happening or will happen to you, you need to contact an attorney. An experienced medical student defense attorney will ensure your rights are protected in front of the SPC committee.
Risks Associated with Medical School Student Progress Committee Reviews
Every student must move through the SPC review process to ultimately graduate from medical school. For many, the process will go smoothly, and they will graduate and move onto their residency programs. Still, for many others, their experience in front of the SPC will forever tarnish their reputations and hinder their ability to move forward to the next step in their medical educations.
Although there is an appeal process available to students who receive unfavorable SPC reviews, it is always easier to mount a defense before a decision has been made. Students that go before the SPC are given formal notice and the opportunity to appear. It's wise to show up to the meeting, even when you're a busy medical student. The committee members may ask you questions that are intended to give context and clarity to your behaviors.
When you find yourself on the cusp of an SPC review, you should contact an attorney. Sometimes the meetings happen with little time to search for and hire an attorney to help you with your case, but students quite often have an inkling of their standing within the school. They know that they didn't make the grade or that they acted in a way not becoming of them. When this is the case, it's smart to reach out to an attorney as soon as possible.
If, however, the SPC review feels completely out of the blue, then that could be a sign that something is amiss, and you'll need an attorney to help you get to the bottom of it.
The worst outcome that could result from the SPC review is dismissal. Most of the time, a student will have an opportunity to correct their grades or their behavior, and they won't be dismissed upon the first review unless there has been egregious misconduct.
Sometimes a student will face dismissal even though they've tried to remediate their behavior. Remember that even when the SPC votes to dismiss you, you will have an opportunity to appeal the decision.
In some cases, the SPC will issue a warning to students it deems in violation of certain codes of conduct, whether for professional, academic, or other misconduct. The student could be placed on probation until they've remediated the issues that gave rise to the SPC vote to begin with.
For those accused of professional misconduct, remediation may require a probationary period in which the student demonstrates that they can go above and beyond in improving their behavior. It's critically important that students conduct themselves politely, professionally, and ethically on campus and off-campus if they're remediating any type of behavioral issues.
Sometimes remediation misses the mark of its intended goals and isn't the effective second chance many students hope it will be. This can result when the real issue is attributable to poor faculty behavior, ambiguous policy guidelines, or undiagnosed medical conditions of students. If your remediation plan isn't working for you, then you need to speak up. If your school's administrators won't listen or don't want to help you figure out a better plan of action, then contact a student defense attorney who will advocate for you.
Appealing Adverse Medical School Student Progress Committee Decisions
When an SPC committee votes to dismiss you from your medical school, you can and should appeal the decision. It can be difficult to organize your thoughts into an effective appeal request after such a devastating vote, but you only have a short amount of time to appeal the decision. Your appeal needs to clearly and concisely articulate every possible reason that the decision made was wrong.
Many schools require a showing of the following before they will grant an appeal:
- New facts have come to light that weren't readily accessible at your hearing, and these facts would change the outcome of the vote.
- The SPC incorrectly interpreted and applied school policy, and this mistake would have impacted the way the members voted on your case.
- A conflict of interest or a discriminatory bias affected the outcome of the vote.
The committee that decides on and hears your appeal is comprised of different individuals than the SPC is, and the appeal committee should provide you with an unbiased opportunity to make your case.
When You Should Seek Legal Help
Whether you're facing the student progress committee or the appeal committee, you shouldn't have to face them alone nor should you because too much is stake. Because of what is at stake and also because of the dynamics and considerations involved, you should have an attorney experienced with medical student progress issues involved as soon as you learn of any medical school concern, or even the prospect of such a concern. When you hire an experienced student progress defense attorney, you're hiring someone who's done this before. This experience levels the playing field in an important way. While it may be your first time in front of a committee, it is not the committee's first time evaluating a student. When you bring in your own advocate, you're adding someone to your team with the same level of experience as the committee who will be deciding your fate.
Hiring a Medical School Student Progress Committee Defense Attorney
Attorney Joseph D. Lento has helped countless medical students across the nation present their defenses and mitigating circumstances to student progress committees. Attorney Lento believes that every medical student deserves an advocate who's willing to leave it all out on the field in defense of their rights.
If you or your loved one is facing a student progress committee decision that could dramatically alter the course of your future, call the Lento Law Firm at 888-535-3686 today.