An academic unit composed of a combination of clinics may be taken for elective credit. This must include at least nine clinic meetings per

Article V Summer Honor Council

M. D./Div.andD./T.S

4. An academic unit composed of a combination of clinics may be taken for elective credit. This must include at least nine clinic meetings per

week. Signatures for each clinic must be obtained through an add card at least one month prior to the beginning of the chosen unit.

The Department of Medicine offers a four-week unit for senior med- ical students to work in subspecialty clinics in the Department. Students work one-on-one with faculty members or fellows in at least nine clinic meetings per week. Students may choose from a variety of clinics includ- ing Allergy/Pulmonary, Cardiology, Endocrinology, Gastroenterology, Hematology/Oncology, Infectious Disease, Nephrology, Pharmacology, and Rheumatology. Students may spend all of their time in one or two clinics or elect to work in a variety of clinics. Students arrange their sched- ule with attendings in various clinics, then obtain a signature for the course from Dr. Spickard III through an add card at least two weeks prior to the beginning of the chosen unit.

5. Important: Most selectives and electives are available in all units. Excep- tions are noted with individual listings. Most of these have strict enroll- ment limitations that are indicated under each course listing.

NOTE: REQUIREMENTS ARE SUBJECT TO CHANGE. STUDENTS WILL BE NOTIFIED.

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Fourth Year Clerkships with No Prerequisites 2004/2005

Department Course Number Course Title

Medicine 504-5617 Clerkship in Alcohol & Drug Dependence 504-5622 Clerkship in Hepatology

504-5645 Nutrition Support 504-5710 Arthritis Center 504-5735 Palliative Care

504-5760 Clerkship in Rheumatology 504-5930 Health Promotion Clerkship 504-5940 Rheumatology Clinical Research

**(Requires Consent of Instructor) 504-5950 Seminar in Clinical Electrocardiography

and Electrophysiology

*(Requires Consent of Instructor) 504-5980 Elective Rotation in Clinical Ethics

Neurology 506-5616 Neurology Research

*(Requires Consent of Instructor) Pathology 510-5610 Clerkship in Autopsy Pathology

510-5620 Surgical Pathology 510-5630 Clinical Pathology

510-5640 Clerkship in Laboratory Medicine 510-5650 Clinical Microbiology

510-5670 Clerkship in Neuropathology

*(Requires Arrangement with Sponsor) Pediatrics 511-5650 Clerkship in Child Behavior & Development

511-5800 Genetics Clerkship

*(Requires Interview with Sponsor) 511-5920 Pediatric Rehabilitation

Preventive Medicine 514-5720 Clerkship in Epidemiology at the CDC

Surgery 517-5810 Laboratory Research in Surgery

Advanced Training

In addition to its primary responsibility of educating medical students, the School of Medicine has active programs for graduate students in the preclinical sciences, for postdoctoral interns and residents, and for post- doctoral research trainees.

School of Medicine / The Academic Program 87

Residency Training

Students preparing for the practice of medicine usually spend three or more years in house staff training. Such experiences at Vanderbilt are par- ticularly varied and well supervised. Applicants for positions are care- fully chosen because of the competition for positions. As a result, the house staff makes up a competent and stimulating group, with consider- able responsibility in medical student teaching.

The faculty of the School of Medicine has professional responsibilities at Vanderbilt, Veterans, Saint Thomas, and Baptist hospitals. Patients in these hospitals are cared for by members of the medical staff, assisted by the intern and resident staff.

Vanderbilt University Hospital is a referral center and consequently has a patient population with complex medical and surgical problems. The Veterans Administration Hospital, adjacent to the Vanderbilt Medical Center, serves veterans and their families from throughout the mid-south and is an important component of the teaching program. All physicians at the VA Hospital are full-time faculty members of the School of Medicine.

Post-Residency Fellowships

Postdoctoral training programs have as their goal the training of physi- cians for practice and certification in a medical subspecialty. Fellows ad- mitted to these programs must have completed an approved residency program. The fellow is expected to participate in departmental activities related to teaching, clinical services, and research.

Continuing Medical Education

Vanderbilt University School of Medicine and Vanderbilt University Medical Center recognize a major commitment to the continuing educa- tion of physicians and others in the health professions. The School of Medicine views medical education as a continuum initiated in the under- graduate phase, progressing through graduate medical education, and maturing in ongoing continuing medical education. The professional life of the physician and all health professionals should include activities en- compassing this view, with the goal of improving health care for patients.

Under the auspices of the Division of Continuing Medical Education, the School of Medicine offers a broad spectrum of courses throughout the year to meet the needs of physicians in practice and other health profes- sionals. Inquiries should be directed to the Division of Continuing Med- ical Education.

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Academic Policies

V ANDERBILT students are bound by the Honor System inaugu- rated in 1875 when the University opened its doors. Fundamental responsibility for the preservation of the system inevitably falls on the individual student. It is assumed that students will demand of them- selves and their fellow students complete respect for the Honor System.

All work submitted as a part of course requirements is presumed to be the product of the student submitting it unless credit is given by the student in the manner prescribed by the course instructor. Cheating, plagiarizing, or otherwise falsifying results of study are specifically prohibited under the Honor System. The system applies not only to examinations but also to written work and computer programs submitted to instructors. The student, by registration, acknowledges the authority of the Student Honor Council of the School of Medicine.

The University’s Graduate Student Conduct Council has original juris- diction in all cases of non-academic misconduct involving graduate and professional students.

The Student Handbook, available at the time of registration, contains the constitution and bylaws of the Honor System and the Honor Code, as well as an explanation of the functions of the Honor System.

Requirements for M.D. Degree

Candidates for the Doctor of Medicine degree must be mature and of good moral character. They must have spent at least four years of study or its equivalent as matriculated medical students at an accredited medical school. Students accepted with advanced standing must complete at least the last two years in the Vanderbilt University School of Medicine. All stu- dents must have satisfactorily completed the medical curriculum, have passed all prescribed examinations, and have no outstanding unpaid bal- ances with the University other than sanctioned educational loans. Stu- dents fulfilling these requirements will be recommended for the degree Doctor of Medicine.

Advisers

The Vanderbilt Medical School has one of the lowest attrition rates in the country. The faculty and administration take an active interest in as- suring that each student achieves to maximum capability. Advisers, both student and faculty, and staff members of the office of the Dean are avail- able to assist students toward successful development of their plans.

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Licensure

It is the policy of Vanderbilt University School of Medicine that all medical students will take Step 1 and Step 2 (both Clinical Knowledge and Clinical Skills) of the United States Medical Licensing Examination prior to graduation, although passage of these examinations will not be a degree requirement.

Standards of Behavior for Interactions with Medical Students¹

Statement of Standards

In practice, physicians are held to high standards of professionalism and patient care. The medical learning environment is expected to facili- tate students’ acquisition of the professional and collegial attitudes neces- sary for effective, caring, and compassionate health care. The development and nurturing of these attitudes requires mutual respect between teachers (including faculty, residents, and staff) and students, and between each student and his or her fellow students.

²

Mutual respect between student and teacher, and between fellow students, may be expressed in many ways but all interactions shall include honesty, fairness, and evenhanded treatment. Behavior which is inimical to the development of mutual re- spect shall be prohibited. Such behavior may include but is not limited to:

(1) Harassment of a sexual nature;

(2) Discrimination or harassment based on race, sex, religion, color, na- tional or ethnic origin, age, disability, military service, or being or being perceived as homosexual, heterosexual, or bisexual.

(3) Grading, promoting, or otherwise evaluating any student on any basis other than that student’s performance or merit.

Comments

The following delineates more clearly the behavior enumerated above which may be inimical to the development of mutual respect between stu- dents and teacher and between fellow students. For purposes of these Comments, the term “person” shall refer to a student in interactions be- tween fellow students or, in student-teacher interactions, to the student or teacher, as appropriate.

(1) Harassment of a sexual nature may include:

a. Denying the opportunity for training or rewards because of a stu- dent’s gender;

b. Requesting sexual favors in exchange for grades or other awards;

1 All Vanderbilt University policies concerning medical student interactions with faculty and staff as set forth in the Vanderbilt University Student Handbook, the Faculty Manual, and the Staff Manual remain in full force and effect.

2 By their express terms, these Standards apply only to interactions which involve one or more medical students;

however, it is hoped that these Standards will serve as a guide to all members of the Vanderbilt University Medical Center community. The reporting procedure outlined herein shall apply only to allegations of the violation of these Standards in in- teractions involving medical student(s).

c. Making unwanted sexual advances;

d. Unreasonable and inappropriate sexual or sexist conduct directed towards any person;

e. Displaying in an unreasonable and inappropriate manner sexually suggestive or pornographic materials; or

f. Grading or evaluating a student based upon gender rather than per- formance and merit.

(2) Discrimination and harassment may include:

a. Denying the opportunity for training or rewards because of a stu- dent’s age, race, religious affiliation, or any other attribute of the student other than merit or performance;

b. Unreasonable and inappropriate conduct directed towards any per- son which is intended to insult or stigmatize that person;

c. Exclusion of a student from any usual and reasonable expected edu- cational opportunity for any reason other than as a reasonable response to that student’s performance or merit;

d. Requiring a student to perform personal services such as shopping or babysitting;

e. Showing favoritism among students based upon any attribute of the student(s) other than performance or merit and thereby reducing educa- tional opportunities available to the nonfavored student(s); or

f. Grading or evaluating a student based upon any attribute of a stu- dent other than that student’s performance and merit;

g. Any physical mistreatment, such as hitting, slapping or kicking, or threatening such physical mistreatment;

h. Requiring a student to perform menial tasks with the intent to hu- miliate the student.

Any perceived violation of these Standards of Behavior (“Standards”) may be reported in accordance with the following procedure. Violations of these Standards may subject the offender to disciplinary action. These Standards may be amended at any time by the Executive Faculty. The Standards Committee shall be composed of such members as the Dean shall appoint from time to time.

Reporting Procedure

Prior to filing a formal report as outlined below, the individual consid- ering making a report should first, if at all possible, attempt to resolve the matter directly with the alleged offender. In addition, the reporting indi- vidual may consult informally with any member of the Standards Com- mittee for information and assistance. Any such informal consultation will be confidential if so requested. The only written record of any such confidential consultation shall consist of a confidential memorandum re- tained in the files of the Chair of the Standards Committee.

School of Medicine / Academic Policies 91

To make a formal report of an alleged violation of these Standards, a written description of the alleged violation, signed by the individual mak- ing the report, shall be delivered to any individual on the Standards Com- mittee. The Standards Committee shall conduct a preliminary investigation, giving the reporting individual, the alleged offender and any other persons as the Standards Committee shall determine a fair op- portunity to express their views on the matter. Further, the Standards Committee shall make, in accordance with commonly held standards of conduct, any necessary preliminary determination of what does or does not constitute reasonable or appropriate conduct and behavior. Thereafter, the Standards Committee shall issue a written statement of their prelimi- nary findings to the individual making the report, to the alleged offender, and to the Dean. The Dean shall then take such further action on the mat- ter as the Dean shall deem appropriate, consistent with Vanderbilt Univer- sity policy on disciplinary actions as set forth in the Vanderbilt University Faculty Manual, Student Handbook, or Staff Manual, as applicable.

Alternatively, a student alleging sexual harassment or unlawful dis- crimination may make a complaint to Vanderbilt’s Opportunity Develop- ment Center in accordance with the procedure outlined in the Student Handbook. If the complaint to the Opportunity Development Center does not resolve the matter to the satisfaction of the individual making the complaint, a formal grievance may be filed with the Office of the Chancel- lor in accordance with the procedure in the Student Handbook.

Grading and Promotions

Successful completion of the courses of the medical curriculum and scholastic standing are determined by the character of the student’s daily work; the results of examinations, which may be written, oral, or practi- cal; and observation of the student in action. The medical school curricu- lum builds progressively on the course work of each previous academic year. The courses of each subsequent year require increasing levels of co- ordination and integration of the material previously presented. Thor- ough knowledge and understanding of each subject and an appropriate level of skills are therefore required for satisfactory progress to be main- tained in the medical curriculum.

Grades

The summative evaluation of academic performance for each course is reported on the following basis:

Honors (H): superior or outstanding work in all aspects (second, third, and fourth years).

High Pass (HP): completely satisfactory performance in all aspects, with some elements of superior work (third and fourth years).

Pass (P): completely satisfactory performance in all aspects (all years).

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Marginal Pass (P*): marginal performance, to be reviewed by the Pro- motion Committee and course directors. Not to be recorded on the official transcript. After discussion and/or remedy, the grade will be changed to either Pass or Fail.

Fail (F): unsatisfactory performance (all years).

Electives in the first and second year are graded on a Pass or Fail basis.

Exemplary or inadequate performance in these electives will be docu- mented by supporting narrative evaluations. Electives and selectives in the third and fourth years are graded on the same basis as required courses.

Student Grievances Concerning Grades

Students should seek redress of a problem with a grade as soon as pos- sible after receiving the grade and in no case later than six months after the event. Students with a problem should confer directly with the course director. Every effort should be made to resolve the problem fairly and promptly at this level.

If the student cannot resolve the problem through discussion with the course director, he or she should bring the problem, within two weeks of talking with the course director, to the attention of the Associate Dean for Medical Students, who will seek to resolve the problem. If resolution is still not achieved, the Associate Dean will make a recommendation to the Dean, which will be accompanied by commentary on the recommendation by the relevant department chair. The Dean will make the final decision.

Promotion

Promotion Committees of the faculty, in consultation with representa- tives of the departments responsible for instruction, are charged with making recommendations to the Dean, and the Executive Faculty regard- ing progress and promotions of students in each class. The Executive Fac- ulty of the School of Medicine has final responsibility for the determination of medical student progress in the school. Decisions on the progress of students during the first two years are ordinarily made at the end of each academic year. In view of the integrated nature of the curricu- lum in the final two years, no specific decisions on promotion from the third to the fourth year are made. Decisions on the progress of students during these final two years, however, may be made at any time as acade- mic performance may dictate. Ordinarily, decisions for graduation will be made shortly before Commencement in the final year.

The committees recommend for promotion those students who have demonstrated appropriate personal behavior and the knowledge, under- standing, and skills consistent with faculty expectations at their particular stage of professional development.

School of Medicine / Academic Policies 93

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The school’s academic program is predicated upon providing students an academic environment conducive to successful achievement. Occa- sionally, however, the outcome is unsuccessful. The Promotion Commit- tees will review the performance of students with deficiencies and make recommendations concerning their progress.

Students who have marginal grades in two or more courses in a single academic year will undergo special review by their Promotion Commit- tee. In light of the student’s complete academic record, the committee may recommend promotion, promotion on probation, repetition of all or part of the academic year, or withdrawal from school. Ordinarily, a stu- dent with marginal performances in required preclinical courses account- ing for more than half of the scheduled required course hours in a single academic year can expect to repeat an academic year or to withdraw from school. Students who deliver marginal performances in more than two re- quired clerkships can expect to have their progress delayed in order to complete remedial work or to withdraw from school.

Students who fail in a course, whether required or elective, will be re- quired to remedy the failure before being permitted to enter the courses of the next academic year. Credit may be given on the basis of re-examina- tion or satisfactory repetition of the course work, but failures will remain on the record and may be counted as cause for dismissal if additional fail- ure occurs. Students who fail in two courses or fail a re-examination or course repetition may be required to withdraw from the school.

Promotion Committees will ordinarily recommend that students be placed on academic probation if their course work includes any failures or is generally of marginal character. Students placed on academic probation who do not perform in a satisfactory manner during the subsequent acad- emic year will be dismissed from school unless there are mitigating cir- cumstances approved by the Dean. Students on probation may be withdrawn from school if their academic performance continues at a mar- ginal level, even though there may be no recorded failures. Promotion Committees may recommend removal of probationary status when a stu- dent has demonstrated a continuing record of satisfactory performance in the succeeding units of study.

Students who are shown by work or conduct to be unfit for the practice of medicine may be required to withdraw from the school at any time.

Extracurricular Work

The School of Medicine does not regulate the outside work of its stu- dents, although it does take the firm position of discouraging outside work. No outside commitments may be assumed by medical students that may compromise their responsibilities at the medical school. If the outside obligation is considered prejudicial, the student may be required to discontinue it.

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