Professionalism Policy | UC Davis School of Medicine

PURPOSE
To outline processes for students to become aware of and abide by the UC Davis School of Medicine’s commitment to professional behavior, steps in addressing lapses in professional behavior by students, and the consequences of such lapses.

AUDIENCE
All medical students

LCME STANDARD
3.5 Learning Environment/Professionalism

POLICY
The Professionalism Statement reads: The practice of medicine requires the highest standards of personal and social responsibility. These standards should be fostered during medical training as well as throughout practice.

Professionalism is a core competency for UC Davis medical students and is fundamental to the practice of medicine. Students are expected to demonstrate professional behavior both within and outside the boundaries of a course or clerkship, including when they are representing themselves as a UC Davis medical student in any activity (such as volunteering in health-care activities, participating in media presentations including social media, and posting messages on list servs, etc.). Professionalism includes: behaving in an ethical manner; familiarizing oneself with, and abiding by the regulations that govern this institution and which govern one’s position as a student in the School; fulfilling educational roles and expectations for each course/learning activity as detailed in the respective course syllabus; timely completion and adherence to administrative and health requirements; taking responsibility for one’s actions; working towards the highest level of competence and treating all those with whom one interacts with in a collegial and respectful manner.

Student behaviors that are of concern and may indicate a lapse in professionalism may be referred to the Honor and Professionalism Council (HPC); lapses are opportunities for student learning and professional development; they may also help inform structural changes to the learning environment. Based on the seriousness and frequency of occurrence of the lapse, disciplinary action may also result.

Honor and Professionalism Council (HPC): The UC Davis School of Medicine HPC is charged with implementing strategies to promote the development of professionalism in medical students, as outlined in the School's I-EXPLORE Graduation Competencies and to help address student lapses in professional behavior.

The HPC shall be comprised of the following members:

A minimum of two student representatives from each class (initial appointment by the Associate Dean of Students and the Director of Medical Student Professionalism-DMSP); once the initial HPC is formed, future appointments will be decided on by the HPC members. Volunteers will be solicited from each School of Medicine class. The appointment process will attempt to ensure that the membership matches the diversity of the School of Medicine student population.
Associate Dean of Students
Associate Dean representing the Office of Student and Resident Diversity
Vice Dean for Medical Education
Director of Medical Student Professionalism
A minimum of four faculty members with educational roles/experience in the School, appointed by the Associate Dean of Students and the DMSP.
A minimum of two staff members representing the Office of Medical Education (OME), appointed by the Vice Dean of Medical Education and the Assistant Dean of Medical Education.

The HPC shall meet at least quarterly on a scheduled basis; additional ad hoc meetings are anticipated to address concerns pertaining to lapses, as they arise, in a timely manner. For voting purposes, a quorum of at least 50% of the HPC members must be present. Voting will be anonymous. Members who have a perceived conflict of interest will be asked to declare that and recuse themselves from the discussion and voting

PROCEDURE

Students will be required to sign the Professionalism Statement annually and meet professional standards, as described in that statement and in the School's Graduation competencies.
For minor and isolated professionalism lapses by students, it is expected that a course/clerkship director, peer, faculty member or staff member who is concerned about the behavior will give direct feedback to the student and make suggestions for improvement. Members of the HPC and the DMSP are available as resources for guidance to the observer of the lapse as well as to meet with the student and observer together (based on the observer’s comfort level); the UC Davis Physicianship Form can serve as another helpful resource. The purpose of such a meeting is to discuss ways in which performance can be improved, allowing the student adequate opportunity to make appropriate changes.
If the lapse is serious from the perspective of the observer; or attempts to give the student feedback about a lapse are unsuccessful; or the behavior is repeated, the staff member, peer or faculty member should notify the course/clerkship director or appropriate curriculum manager (if the behavior occurs in the context of a course/clerkship) or the Associate Dean of Students (if the behavior is noted outside of a course/clerkship, but during School educational or sponsored activities, or on School grounds).
A course/clerkship director, staff manager or the Associate Dean of Students to whom a report has been made, must complete a UC Davis Physicianship Form and meet with the student to review the form and discuss feedback with the student. The form should be filed as close in time to the incident of concern as is practical. As part of this process, the student can respond to the concerns noted by providing additional information on the form, which they should then sign and date.
The completed form will be submitted to the DMSP for tracking purpose and will also be sent to the student’s Academic Coach.
All subsequent Physicianship Forms received on a given student will result in a referral to the HPC. In such cases, a subset of the student members and at least one faculty member of the HPC will perform an intake process, by meeting with the student and, when necessary, with the person completing the form, and present the details of the event to the HPC.
If the HPC agrees by a 2/3^rd majority vote of the members present (voting requires a quorum) that the behavior represents a professional behavior lapse, the student will meet with the DMSP and a peer member of the HPC, along with the student’s Academic Coach. If the student’s Academic Coach is unable to be present, the student will have the option of bringing one School of Medicine faculty member to the meeting as an advocate. The goal of the meeting will be to review the issue(s) of concern and address the lapse(s), with a view to promoting professional identify formation and preventing future lapses.
If the HPC does not feel that the concern(s) represents a lapse in professional behavior (i.e., less than a 2/3^rd vote), no further action will be taken and the student will be notified of this decision.
For all subsequent submissions of a Physicianship Form that are determined by vote of the HPC to represent professional lapses, based on the nature and pattern of lapses and the receptivity of the student to change, possible actions will include any combination of the following:
1. Continued work with the HPC or external resources to promote self-awareness and professional growth.
2. Continued work with the HPC to promote self-awareness and professional growth and reporting of the lapse(s) to the Vice Dean of Education for inclusion in the Medical Student Performance Evaluation (MSPE).
3. Continued work with the HPC to promote self-awareness and professional growth, reporting of the lapse(s) to the Vice Dean of Education for inclusion in the MSPE, and referral to the Committee on Student Promotions (CSP) for the development of a remediation plan.
  
  A decision to report the lapse on the MSPE and/or to refer a student to CSP will be made by a vote of HPC. All students referred to CSP for Professionalism lapses will have mention of the referral and the lapse in their MSPE.
As described in the Regulation of the School of Medicine, for lapses that have occurred in the context of a course, course directors may choose to give an ‘I’ mark or a Y grade for the course, based on the course grading policy.
Students may also be placed on Academic Warning or Probation or face a dismissal recommendation from CSP as outlined the School’s Regulations and CSP policies.
Students on whom a Physicianship Form is submitted, who do not feel that its issuance was merited, can ask for clarification or review from the person who submitted the form.
1. The student cannot appeal the Physicianship Form unless
  1. the student feels that it was based on discrimination (i.e, that bias or wrongdoing on the part of the observer or reporter has occurred), or
  2. the student feels there was an infringement on the student’s academic freedom.
2. A student with a grievance regarding an alleged act of discrimination as expressed through a Physicianship Form may contact the Vice Dean of Education, who will investigate and make a final determination.

RESPONSIBILITY
Associate Dean of Students
Committee on Student Promotions (CSP)
Honor and Professionalism Council

REFERENCES
UC Davis School of Medicine, Professionalism Graduation Competency
UC Davis School of Medicine Bylaws and Regulations, Regulation 60 (A) (4)

POLICY OWNER
Vice Dean for Medical Education

REVIEWED BY
Committee on Educational Policy (CEP)
Committee on Student Promotions (CSP)
Honor and Professionalism Council
Associate Dean of Students
Vice Dean for Medical Education*

REVIEWED DATE and REVIEW CYCLE
July 25, 2023; 1-year cycle

*indicates the policy owner