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 (the School) commitment to professional behavior, steps in addressing lapses in professional behavior, and the consequences of such lapses.

AUDIENCE
All medical students, and faculty and staff working with medical students

LCME STANDARD
3.5 Learning Environment/Professionalism

POLICY

DEFINITIONS

Professionalism Statement (as associated with undergraduate medical education within the School): The practice of medicine requires highest standards of personal and social responsibility within the practice of medicine. These standards should be fostered during medical training as well as throughout practice.
Honor and Professionalism Council (HPC): A group 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.

Professionalism is a core competency for the School's medical students and is fundamental to the practice of medicine.
Students will be required to sign the Professionalism Statement annually.
Students must demonstrate professional behavior both within and outside the boundaries of a course or clerkship, including when they represent themselves as a UC Davis medical student in any activity. Activities might include volunteering in health-care associated activities, participating in media presentations, including social media and posting messages on listservs, etc.
Professionalism includes:
1. Behaving in an ethical manner
2. Abiding by the regulations that govern this institution and which govern one’s position as a student in the School
3. Fulfilling educational roles and expectations for each course/learning activity as detailed in the respective course syllabus
4. Timely completion and adherence to administrative and health requirements
5. Taking responsibility for one’s actions
6. Working towards the highest level of competence
7. 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 HPC.
1. Lapses result in opportunities for student learning and professional development; they may also help inform structural changes to the learning environment.
2. Based on the seriousness and frequency of the lapse, disciplinary action may result.
The HPC membership aims to match the diversity of the School's student population and is comprised of the following members:
- A minimum of two student representatives from each matriculating cohort
- Associate Dean for 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 for Students and the DMSP
- A minimum of two staff members representing the Office of Medical Education appointed by the Vice Dean for Medical Education and the Assistant Dean for Medical Education
The HPC meets on a quarterly basis.
1. Additional ad hoc meetings are scheduled in a timely manner to address concerns pertaining to lapses as they arise.
2. A quorum of at least 51% of the members must be present for voting on motions; voting will be anonymous.
3. Members who have a perceived conflict of interest will be asked to declare that and recuse themselves from the discussion and voting.

PROCEDURE

Students are expected to meet the professional standards as described in the Professionalism Statement and in the School’s Graduation competencies.
For minor and isolated professional behavior lapses by students, it is expected that a course/clerkship director, peer, faculty, or staff member who is concerned about the behavior will give direct feedback to the student, discuss ways in which performance can be improved and allow the student adequate opportunity to make appropriate changes.
1. 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.
2. The UC Davis Physicianship Form can serve as a helpful resource for the feedback session.
If the lapse is 1) serious from the perspective of the observer, or 2) the observer's attempt to give the student feedback about a lapse are unsuccessful, or 3) the behavior is repeated, the peer, faculty, or staff member should notify one of the following.
1. The course/clerkship director and appropriate curriculum manager if the behavior occurs in the context of a course/clerkship.
2. The Associate Dean for Students if the behavior is noted outside of a course/clerkship but during School educational or sponsored activities, or on School grounds.
3. (Lapses in administrative requirements that are addressed in the Medical Student Compliance with Administrative Tasks Policy are addressed according to the policy.)
A course/clerkship director, staff manager, or the Associate Dean for 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.
1. The form should be filed as close in time to the incident of concern as is practical.
2. The student can respond to the concerns noted by providing additional information on the form
3. Student are expected to sign and date the form.
The completed form will be submitted to the DMSP and will also be sent to the student’s Academic Coach. The DMSP will reach out to the student to set up an information meeting to discuss the event(s) leading to the lapse.
All subsequent Physicianship Forms received on a given student will result in a referral to the HPC.
1. 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. Those doing the intake will present the details of the event to the HPC.
2. If the HPC agrees by a 2/3^rd majority vote of the quorum that the behavior represents a professionalism lapse, the student will meet with the DMSP, a peer member of the HPC, and 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.
3. The goal of the meeting will be to review the issue(s) of concern and address the lapse(s) while promoting professional identify formation and preventing future lapses.
4. 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.
Additional subsequent submissions of a Physicianship Form that are voted on by the HPC to represent professional behavior lapses, based on the nature and pattern of lapses and the receptivity of the student to change, will include any combination of the following actions.
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 for Medical 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 for Medical Education for inclusion in the MSPE, and referral to the Committee on Student Promotions (CSP) for the development of a remediation plan.
  1. 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.
  2. All students referred to CSP for Professionalism lapses will have the referral and the lapse mentioned in their MSPE.
As described in the School of Medicine's Bylaws and Regulations, lapses that have occurred in the context of a course, course directors may choose to give an ‘I’ grade or a Y mark 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 other M.D. Program related policies.
CSP may also request the support of the HPC to work with students on remediation related to professionalism lapses. HPC will report back to CSP after working with the student. (A CSP referral to the HPC will be considered equivalent to a Physicianship Form).
Students on whom a Physicianship Form is submitted to the DMSP 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, bias or wrongdoing on the part of the observer or reporter has occurred).
  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 for Medical Education for an investigation and final determination on the lapse.

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

REVIEWED DATE and REVIEW CYCLE
July 2024; 1-year cycle

* Indicates the Policy Owner