Progress and Promotions

Promotional Guidelines

A student is considered to be achieving satisfactory academic progress as long as he or she passes the sequence of courses and clerkships established by the Curriculum Committee and meets the performance standards for the 28 SPAs as set by the Executive Curriculum Committee. The assessment of academic progress includes the domains of knowledge, skills, behaviors, and attitudes – as expressed in the form of SPAs. Hence, professionalism is an integral component when considering academic progress.

Independent of the final grade, unprofessional behavior may be the sole criterion for which a student may be recommended for a letter of concern, academic warning, academic probation, suspension, dismissal, or other sanctions as described throughout this document.

Students must be aware that the designation of academic probation or suspension may result in the loss of federal financial aid.

Progress and Promotions Committee

The Progress and Promotions Committee (P & P) monitors the progress of students during the EUSOM curriculum to ensure that students are performing at an acceptable level to successfully complete their present phase and advance to the next phase of the medical curriculum. In the process of these reviews, the P & P Chair will make recommendations to the EAD regarding academic advancement and academic sanctions according to the criteria below. The EAD or his/her designee will make the final decision as to whether a student can advance with or without sanctions or if a student will receive an academic sanction.

Academic Advancement

At the completion of each phase of the EUSOM curriculum, the Registrar will provide the Chair of the P & P with a list of students who are scheduled to advance to the next phase of the academic curriculum. The P & P can make recommendations to the EAD as to whether a student meets criteria to advance to the next phase by considering all aspects of a student’s performance, including course grades and adherence to the Emory School of Medicine (SOM) Conduct Code, Honor Code and medical school student policies. 

During the academic year, the P & P will regularly review the progress of all students to assess whether they are making adequate progress toward attaining the achievement levels required for promotion to the next phase of the academic curriculum. The P & P members will also determine if students are performing below standards, and may determine that a student should receive an academic sanction according to the criteria outlined below. 

The Chair of the P & P will inform the EAD of recommendations regarding individual student’s pending promotion using the following criteria:

1. Adequate Progress: Students with passing grades in all courses/clerkships.
2. Inadequate Progress (these students would not be promoted):
   1. Students with performance below expectations who did not complete the course requirements;
   2. Students placed on academic probation who did not satisfactorily complete the necessary remediation outlined in their probation, or;
   3. Students who are on suspension.

For those students who have two or more incompletes in any phase, this should prompt a review at the level of the EAD (or his/her designee) to create an academic plan for the student that will be shared with the P&P committee at their next meeting.

Academic Sanctions

A letter of concern will be considered when the P & P has concerns about a student’s performance but feel that the concern is not indicative of a pattern of underperformance, or lapses in professional behavior. The following is a nonexhaustive list of reasons why a student would automatically be recommended by the P and P to receive a letter of concern: 

• In the Foundations Phase students will be recommended to receive a letter of concern when they require remediation of two courses.
• In the Foundations, Application, Discovery or Translation phases, students will be recommended to receive a letter of concern when they have a professionalism or performance issue that is significant and the P & P members are concerned, but do not feel this behavior represents a pattern of poor performance or professionalism problems.

An academic warning will be considered when a student’s deficiencies are of a more serious nature. The following is a nonexhaustive list of academic difficulties for which a student would automatically be recommended to receive an academic warning:

• In the Foundations Phase, students will be recommended to receive an academic warning when they have been required to remediate three courses and the summed credit hours for the three courses is 6 credit hours or more.
• During the Application/Translation phases, an academic warning will be recommended when a student is noted to have a deficiency in their clinical skills over more than one clerkship or course (e.g., difficulty synthesizing clinical information); or, when a student receives a grade of C in two clerkships/courses.
• In the Discovery Phase, students will be recommended to receive an academic warning if they are late in turning in their materials to start their Discovery project.
• In the Foundations, Application, Discovery and Translation phases, a student will be recommended to receive an academic warning if professionalism problems are recurrent over multiple courses or clerkships or a single professionalism transgression that rises above the level of letter of concern.

The entirety of the student’s academic performance is factored into decisions by the P & P, and an academic warning may also be recommended if a student had difficulties in the Foundations Phase and continues to struggle academically in the Application Phase. An academic warning is intended to alert the student that, without improvement, they are in danger of more serious academic sanctions such as probation.

Academic probation will be considered when the P & P is concerned about a student’s performance and, without improvement, the student is in danger of being suspended or dismissed.  The following is a non-exhaustive list of academic difficulties for which a student would automatically be recommended to receive an academic probation:

• In the Foundations Phase, students will be recommended to be placed on academic probation if they are required to remediate four courses and the total credit hours for the four courses is 10 credit hours or more.
• In the Application, Discovery Phase or Translation phases, students will be recommended to be placed on academic probation if they receive a D or F in a clerkship or course. The student will not progress in the phase until they have completed remediation of the clerkship or course. The period of probation will continue until they have successfully completed the phase.
• Any student who is required to repeat a phase will be recommended to be placed on academic probation while they are repeating the phase.
• In any phase, a student will be recommended to be placed on academic probation if the student has a professionalism issues that the P & P members judge to be significant and concerning.

Academic probation serves three functions:

1. It is official documentation that the student is deficient in areas related to academic performance;
2. It provides a pathway and defines a timeline that the student must follow in order to regain good standing. This may include, but is not limited to, remediation, maintaining appropriate performance standards and/or adhering to professional expectations;
3. It describes the consequences that will result if a student does not meet stated expectations during the period of academic probation.

Repetition allows the student to repeat a phase of the curriculum. There are two primary reasons for repetition.  1) Students may voluntarily repeat a phase because of specific events (e.g., health, personal or family issues). This voluntary repetition can only be approved by the EAD or the EAD’s designee. In these cases, the student can repeat the phase without any academic penalties. 2) Repetition of a phase is recommended by the P & P, due to a concern that the student has not mastered the academic skills of that phase.

The following is a non-exhaustive list of actions for which the P & P would require a student to repeat a phase or course in the curriculum:

• Required remediation of five or more courses
• Grade of D or F in the Discovery Phase.

Suspension is considered for serious academic issues when the P & P has information regarding the student’s academic performance or professional behavior that would support the student benefitting from a period to manage external distractions or other concerns. The period of suspension is recommended by the P & P and will include the conditions for restarting the medical school curriculum. Students who are on academic suspension cannot proceed to the next phase and can only restart their program after the concerns that placed them on suspension have been resolved.

Dismissal is considered for either serious breaches in professional conduct or academic concerns including failure of a course and/or clerkship.

The following is a non-exhaustive list of actions that would automatically lead to dismissal:

• During required repetition of a phase:
  • Any student in the Foundations Phase who is required to remediate four courses and the total credit hours for the four courses is 10 credit hours or more.
  • In the Application, Transition or Discovery phases, students who receive a D or an F in any course or course.
• Two F’s, two D’s or a D and an F in the initial grades for clerkships in the Application Phase or the same criteria for courses or clerkships in the Translation Phase.
• The P & P would recommend dismissal for a professionalism violation that the P & P members consider gross negligence which could include negligence that, in the mind of the committee, could have led to the death or serious injury of a patient, or behavior in the clinic setting that is grossly inappropriate by the standards of the profession.

Student Right to Appeal P & P Decisions

Students may appeal any academic sanction. If a student wishes to appeal an academic sanction, this request should be presented in writing to the EAD within 14 calendar days of receiving the academic sanction from the P & P. The appeal may be based on the following grounds:

1. To consider new information, sufficient to alter the decision, or other relevant facts that the person appealing the decision feels the P & P may not have known, but should have taken into account, in considering their academic sanction.
2. To allege a procedural error within the process that led to the P & P decision that may have substantially impacted the fairness of the decision.

For appeals of academic sanctions not involving dismissal, the EAD will make the final decision on the appeal and will notify the student of that decision. For appeals from P & P findings that include dismissal, the EAD will convene an ad-hoc review panel of faculty members to consider the appeal. The review panel, at its discretion, can meet with the student, EAD, faculty or chair of the P & P to get clarification of any issues. The review panel reviews the documentation from the P & P and sends its recommendation to the EAD whether or not to uphold the decision of the P & P. The EAD will ultimately make the final decision on the appeal and will notify the student of that decision. All appeal decisions are final.

It should be noted that all appeals should be conducted in a professional manner by the student involved; that is, demonstrating respectful disagreement with the perspective and judgment used by faculty members. Failure to exhibit appropriate professional attitudes may immediately terminate the appeal process and lead to an unprofessional conduct report.  

Length of Time to Complete Degree

The standard MD program at EUSOM takes four years to complete; however, students may apply to postpone graduation for a year if they:

1. Want to obtain another degree (e.g., MPH)
2. Want to spend a year doing a scholarly project (or extended Discovery)
3. Want to take an additional year of formal coursework

Students who need time off for extenuating medical/personal issues are advised to take a Leave of Absence (LOA) from medical school (Section 9). Students may be eligible to be enrolled at EUSOM for additional periods for purposes of remediation or completion of degree requirements.

Students who plan to obtain the MD degree with no additional degrees or certificates must complete all academic requirements of the MD degree within no more than six academic years from the date of matriculation. Approval for a well-planned fifth year is required. The academic records of students who are approaching the deadline of “Time to Degree” for the MD degree will be reviewed by the Registrar and the Progress and Promotions Committee, with enough notice to enable the student to complete the requirement by the end of “Time to Degree”.