Program-Wide Grading and Progression Policy
APPROVED September 16, 2009
Revised April 28, 2010, May 19, 2010, April 20, 2011, Feb. 15, 2012
Educational Policy Committee
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A. Determination of grades
1. The grade for a course (including blocks and longitudinal courses) is based on a student’s performance in the six ACGME competencies, described in the “Core Educational Competencies for the Program Leading to the MD Degree.” All competencies contribute to the final grade in a course, unless otherwise approved for a campus by the campus-specific subcommittee, TEPC or PEPC.
2. Policies and procedures concerning the number, frequency, weighting, format, and grading of exams will be established by the campus-specific subcommittees of the EPC.
3. In Years I & II, the student will receive a grade of Pass (P) or Fail (F) in each course.
a. Pass grade. In order to receive a grade of Pass, the student must demonstrate Satisfactory performance in each competency by meeting the established performance standard for that competency.
b. Fail grade. The student will receive a grade of Fail if s/he fails to meet the performance standard in any competency, after a retake examination for the Medical Knowledge competency or after reassessment for a behavioral competency.
B. Unsatisfactory performance in a Behavioral Competency - Reassessment
1. If a student does not meet the performance standard for a behavioral competency in a block, s/he will receive an Unsatisfactory for that competency and an Incomplete grade for the block. The student's performance in that competency will be reassessed in the subsequent block.
2. If the student achieves a Satisfactory performance in the same competency in the next block, then s/he will be deemed to have met the performance criteria for that competency in the first block.
a. If the student had achieved Satisfactory performance in the other competencies in the first block, the grade for the first block will be changed from Incomplete to Pass on the student's transcript.
b. For purposes of evaluating the student's academic progress, a record of the initial Unsatisfactory in the first block will be kept.
3. If a student does not achieve a Satisfactory performance in that behavioral competency in the second block, then grades of Fail will be entered in the student's transcript for both blocks.
a. This will constitute failure of two courses/blocks, which will result the halting of the student's academic progress.
b. The Associate Dean for Student Affairs will report the failures to the Student Progress Committee. The Student Progress Committee will meet with the student to design a plan of action.
C. Unsatisfactory performance in Medical Knowledge - Retake Exam
1. If at the end of a course a student has not met the criteria for passing medical knowledge, s/he will be offered one opportunity to take another examination, called a Retake Exam.
2. Specific policies concerning the format, content, timing, and performance criteria of Retake Exams will be established by the track-specific subcommittees of the EPC, and approved by the whole EPC.
3. Passage of the retake exam will result in Satisfactory performance in the Medical Knowledge competency.
4. Failure of the retake exam will result in Unsatisfactory performance in the Medical Knowledge competency and therefore failure of the block.
a. A grade of Fail for that block will then be recorded in the student's transcript.
b. The student's failure of the block will also be reported to the Student Progress Committee.
D. Unsatisfactory performance in Medical Knowledge - Remediation
1. A student who fails a course due to Unsatisfactory performance in Medical Knowledge will be given the opportunity to remediate that course in the summer, unless the Student Progress Committee determines otherwise.
2. Only one course per academic year can be remediated, unless otherwise approved by a campus-specific subcommittee.
3. A student is allowed only one attempted remediation per course.
4. Other policies concerning the format and timing of remediation within each track are established by the track-specific subcommittees of the EPC.
5. If the student passes the summer remediation, the original Fail grade for the block will remain on the student's transcript. The block will be entered on the transcript a second time at the next offering of the course with a grade of Pass.
6. If the student fails the summer remediation, the student will be required to repeat the course during the academic year.
a. Failure of the summer remediation is not recorded on the student's transcript.
b. Failure of a summer remediation does not constitute a separate course failure for purposes of the policy on automatic dismissal.
c. Failure of the summer remediation will be reported to the Student Progress Committee.
E. Repeating an Academic Year
A student who meets any of the following conditions will be deemed not to be making acceptable academic progress and will be required to terminate the academic year and repeat the year at a time decided by the Student Progress Committee, in consultation with the student.
1. The student fails two blocks in one year.
2. The student achieves unsatisfactory performance in the same competency twice in one year.
a. This policy includes Unsatisfactory performances in consecutive blocks, non-consecutive blocks, and concurrent courses.
b. For the Medical Knowledge competency, unsatisfactory performance for the sake of this policy is determined after any retake exam.
c. For the behavioral competencies, unsatisfactory performance is determined before reassessment.
d. For purposes of this policy, an initial unsatisfactory performance in a block is counted toward the total, even if the student successfully completed a reassessment of that competency in that block.
3. Unsatisfactory performance in three different competencies within one year.
a. This policy includes unsatisfactory performances in either a single course or multiple courses, including consecutive, non-consecutive, and concurrent courses.
b. For the Medical Knowledge competency, unsatisfactory performance for the sake of this policy is determined after any retake exam.
c. For the behavioral competencies, unsatisfactory performance is determined before reassessment.
II. Grading and Progression Policies for Academic Years III and IV
Grading Policies for Clerkships
The grade in a clerkship is based on a student’s performance in the competencies
The grade will be a composite grade, using the common assessment form, test scores, and other evaluation tools that are approved by the EPC.
The composite grade will be divided into four categories: Honors, High Pass, Pass, or Fail (H, HP, P, F).
The test will account for 25-30% of the composite score.
The test can be a shelf exam or self-designed.
Each clerkship will determine its own formulas for determining the composite score and will use the same formula at all sites (Tucson & Phoenix) of the clerkship. The formula must be documented and communicated to faculty and students.
The clerkship director is responsible for final determination of each student’s grade
Honors will be awarded to students with composite grades in the top 20-30% of all student scores, and High Pass will be awarded to students with the next highest 20-30% of scores. Clerkships will annually review procedures for determining Honors and High Pass and revise as needed.
A student must achieve Satisfactory assessment in every competency to receive either a P, HP, or H for the clerkship. Unsatisfactory in any competency will result in a failing grade in the clerkship.
High pass indicates a student who has excelled in either the exam or the clinical grade but not in the other, or who is outstanding in all areas and is close to an Honors score, but does not achieve it.
Each clerkship will set the minimum passing score on its exam.
If a student fails the exam, the student will be given one opportunity to complete a Retake Exam.
If a student needs to schedule a retake exam during Year III, it must be scheduled at the next academic break.
These are the Winter and Spring breaks. The ‘next’ break will be determined by the timing of the results of the 1st exam and the time it takes to order a new exam.
The retake exam cannot be scheduled during a clerkship or Intersessions or the third year elective block.
If a student needs to schedule a retake exam during Year IV, the student will arrange his/her schedule to accommodate a week without curricular requirements and will schedule the Retake Exam at the end of that week.
A student who fails a second clerkship exam before completing the Retake Exam for a previous failure must stop his/her academic progress and meet with the Student Progress Committee to agree on a plan for the student to complete the Retake Exams. If a student must schedule multiple Retake Exams, s/he must pass all of them before resuming his/her clinical training.
If a student fails the clerkship, the student will be required to repeat the course. This means that the student must complete all components and requirements for the clerkship course (for example, completion of exam and of clinical requirements).
A mid-clerkship assessment for each student is required, and the Mid-Clerkship Formative Feedback form approved by the EPC will be used for this. The student’s performance must be reviewed in a face-to-face meeting with a clinical teacher, and the student and clinical teacher must sign the Mid-Clerkship Formative Feedback form. The signed forms must be stored and available for review.
1. Intersessions is a single course consisting of one or more weeks that are distributed through the year(s). Student performance in the weeks of the course is combined into a single grade that is recorded on the transcript at the end of the course.
a. The grade can be either Pass or Fail.
b. Assessment is based on performance in each competency.
c. The final grade in each competency is awarded at the end of the course.
d. If a student receives an Unsatisfactory in any competency, the student has failed the course.
e. Each student's current performance in the competencies will be posted in ArizonaMed or E*Value, so that at the end of a week, the student can be informed of his/her status in the course.
i. If a student's performance in an Intersessions week is unsatisfactory, the student must meet with the course director to plan for improved performance in the next Intersessions week.
2. Attendance is required at all activities.
a. The campus Associate Dean for Student Affairs, in consultation with the course director, must approve any absence.
b. If a student has an excused absence for a session, the student must arrange with the course director to make up the session.
c. An unexcused absence can result in a failure of the course at the discretion of the course director.
3. The MK competency is based on exams, administered at the end of Intersessions week(s).
a. If there is more than one exam, each exam will contribute equally towards the final MK grade.
b. If at the end of the course, the student has not met the criteria for satisfactory performance in MK, s/he will be offered one opportunity to take another examination, called a retake exam.
c. The retake exam will be comprehensive, covering Intersessions material addressed across the week(s).
The retake exam will be scheduled by the course director in consultation with the Associate Dean of student Affairs. The retake exam will be scheduled within 4 weeks after the end of Intersessions.
d. Passage of the retake exam will result in satisfactory performance in the MK competency.
e. Failure of the retake exam will result in unsatisfactory performance in MK and therefore failure of the Intersessions course.
4. If a student fails the Intersessions course, the student must repeat the Intersessions course in Year IV.
a. The student will designate week(s) in his/her 4th year that is/are equivalent to the duration of the Intersessions course. During that time, the student can not be enrolled in other medical curriculum courses.
b. The student will be required to submit one to three papers on topics decided by course director. The topics will cover broad integrative content areas from the Intersessions course.
1. The student will be expected to review relevant podcasts, ArizonaMed posted materials from the Intersession course, as well as the student will be required to research additional information from literature sources (articles, textbooks, etc).
2. The paper will be evaluated by relevant faculty and given a grade of Pass/Fail. The paper(s) should be scholarly and include references.
3. The student will also be required to discuss and defend the ideas in each of his/her papers to the faculty who graded the paper in an oral examination. The grade for the oral examination will also be Pass or Fail.
4. The student can receive either a Pass or Fail grade for the repeat of the Intersessions course and must pass both the written and oral presentations.
5. If a student fails the repeat of the Intersessions, it will be a second failure of the same course and the student would be automatically dismissed, following the policies established by EPC 7/1/10.
C. Grading Policies for Transitions Course
1. The two grades available for this course are Pass and Fail.
2. The student's grade is based on a his/her attendance and participation.
3. The Attendance Policy must be followed, which means a student must receive approval from the campus Associate Dean of Student Affairs for any absence in the course.
4. If a student has an excused absence for a session, the student must arrange with the course director to make up the session.
5. An unexcused absence can result in a failure of the course at the discretion of the course director.
6. A student may not progress in Year III until s/he passes the Transition course.
III. Timing of USMLE Examinations
1. In the case of a student who is continuing in the M.D. program without interruption, s/he must take the Step 1 exam before starting his/her first clerkship.
2. In the case of a student in a dual-degree program, s/he must take the Step 1 exam before starting any additional work toward the non-M.D. degree.
3. In the case of a student taking a leave of absence that has been approved by the Student Progress Committee, s/he must take the Step 1 exam by the June 30th following the end of Year II or at another time determined by the Student Progress Committee.
NOTE: The following policy applies to any student who has not yet attempted the USMLE Step 1 exam by May 1, 2012.
A. FIRST ATTEMPT AT USMLE STEP 1 EXAM
1. A student must complete the USMLE Step 1 exam before starting any clerkship or elective for third- or fourth-year credit.
2. A student in a dual-degree program must complete the Step 1 exam no later than 6 weeks after the end of Year 2 courses.
3. A student may delay taking USMLE Step 1 exam only if the Associate Dean of Student Affairs has approved the delay. Conditions for which the Associate Dean of Student Affairs may approve a delay in scheduling the Step 1 exam are:
The student is taking a leave of absence or has an extraordinary life event.
The student is required to remediate a failed block from Year 2. The student must complete any block remediation before taking USMLE Step 1. The student may delay the date of his/her Step 1 exam no later than 8 weeks after the block remediation is completed.
Other special circumstances, at the discretion of the Associate Dean of Student Affairs.
The Associate Dean of Student Affairs will notify the Student Progress Committee about any student who is approved to delay taking the USMLE Step 1 exam.
4. Enrollment in courses after first attempt
a. A student may not begin any clerkship rotation or any medical school course for continuation of a dual degree program until s/he has taken the USMLE Step 1 exam.
b. A student who has completed the Step 1 exam may begin his/her first clerkship rotation while his/her result is pending.
1. In the case of a student taking a leave of absence that has been approved by the Student Progress Committee, s/he must take the Step II exam by another time determined by the Student Progress Committee.
2. The student must pass the USMLE Step 1 exam before entering his/her last academic year (Year IV).
3. If a student wishes to take the USMLE Step II CK exam after November 30, the student must obtain approval from the Student Progress Committee.
E. Every student must have passed the USMLE Step 2 CK exam within one calendar year (12 months) after the date of his/her first attempt. A student who has not passed one year after his/her first attempt will be automatically dismissed.
The exact deadline for a calendar year will be postponed only until a pending score is posted for an exam that was taken before the one-year deadline. No further attempts after the one-year deadline will be allowed.
The one-year clock will be stopped for a student who has an approved leave of absence. The clock will resume once the leave of absence is concluded.
B. NON-PROGRESSION FOLLOWING FAILURE OF FIRST ATTEMPT AT USMLE STEP 1 EXAM
A student who does not achieve a passing score on his/her first attempt at the USMLE Step 1 exam may not enroll in any medical school curricular course, including any course for any dual-degree program, until after s/he has taken the Step 1 exam a second time. The sole exception is that the student may enroll in courses that are approved by the Office of Student Development (Tucson) or Office of Learning Resources (Phoenix) and that serve to prepare for another attempt at Step 1.
1. If a student learns of a failure on his/her first attempt while in clinical training, the student must stop clinical training at the end of the block (up to 2 rotation periods) s/he is then enrolled in. If a student is enrolled in a course, the student may complete the course, but then must stop.
2. The student may not enroll in a subsequent clerkship rotation until a passing score has been posted. Similarly, the student may not enroll in any course contributing to a dual-degree program until a passing score has been posted.
3. The student is expected actively to engage in remedial efforts to improve his/her performance on the USMLE Step 1. For example, the student may enroll in a Step 1-preparation course offered by the University or outside the University. If needed, the student will be enrolled in an independent study and will be supervised by the Office of Student Development (Tucson) or Office of Learning Resources (Phoenix). As part of the independent study, the student will be required to meet weekly and have his/her study supervised by the Office of Student Development or Office of Learning Resources.
C. LIMITATIONS ON MULTIPLE ATTEMPTS AT USMLE STEP 1 EXAM (EPC 04-20-2011)
1. A student must obtain approval from the Student Progress Committee before scheduling a third or any additional attempts at the USMLE Step 1 exam.
a. The Student Progress Committee will consider the following criteria in deciding whether to approve a request:
i. scores on the student's previous attempts
ii. progress of scores on previous attempts
iii. recommendations of the staff of the Office of Student Development (Tucson) or the Office of Learning Resources (Phoenix) who have supervised the student
iv. the history of the student’s efforts to remediate, including what courses s/he has taken
v. for the Tucson track, the student's participation in the PASS Step 1 course offered during years 1 & 2
b. If an additional attempt is approved, the Student Progress Committee will review and approve the student’s study plan.
2. Every student must have passed the USMLE Step 1 exam within one calendar year (12 months) after the date of his/her first attempt. A student who has not passed one year after his/her first attempt will be automatically dismissed.
a. The exact deadline for a calendar year will be postponed only until a pending score is posted for an exam that was taken before the one-year deadline. No further attempts after the one-year deadline will be allowed.
b. The one-year clock will be stopped for a student who has an approved leave of absence. The clock will resume once the leave of absence is concluded.
IV. Dismissal from the
A. The following new policy was approved February 15, 2012 – effective immediately
A student who meets any of the following conditions will be automatically dismissed from the Doctor of Medicine degree program. The Associate Dean for Student Affairs will notify both the student and the Student Progress Committee of the criteria that triggered the automatic dismissal.
1. The student fails the same course twice. This includes any course in the curriculum, including for example blocks, longitudinal, clerkships, electives, and intersession courses.
2. The student fails three different courses. This includes any combination of failures of courses in the curriculum, including for example blocks, longitudinal, clerkships, electives, and intersession courses.
3. The student has not passed the USMLE Step 1 exam within one calendar year (12 months) after the date of his/her first attempt.
4. The student has not passed the USMLE Step 2 CK exam within one calendar year (12 months) after the date of his/her first attempt.
5. The student must complete all the requirements for the M.D. degree within six years from the date of matriculation. Leaves of absence for any reason are included and count towards the maximum time of six years.
6. The student in a dual degree program (e.g, MD-PhD, MD-MPH, etc) may exceed the six year limitation in satisfying the requirements of both degrees, but must take no more than three years from the date of matriculation to complete satisfactorily Years I & II courses and no more than three years after beginning the required Year 3 clinical experiences to complete satisfactorily required clinical experiences and electives.
B. B. Policies concerning requests for reinstatement following automatic dismissal are established by the Student Progress Committee.