University of California San Francisco
UCSF School of Medicine UCSF Medical Center

Physicianship Policy

Purpose

To specify the process for documenting unprofessional behavior by a student.

Overview

Professionalism is a core competency for UCSF medical students and is fundamental to the practice of medicine. Students are expected to demonstrate professional and personal behavior both within and outside the boundaries of a course or clerkship.

Isolated professionalism lapses of mild to moderate severity are managed with notification through the Physicianship Evaluation Form and remediation as designed by education leadership. Recurrent, persistent or severe professionalism lapses or failure of the student to engage in remediation may lead to adverse academic actions, up to and including dismissal from the School of Medicine.

Examples of unprofessional behaviors that would warrant a Physicianship Evaluation Form include repeated tardiness, unexcused absence from a required activity, disruptive behavior in the classroom, clinical arena, or administrative setting, academic dishonesty (cheating or plagiarism), abdication of responsibility for patients, harassment or violence.

Related LCME Standards

3.5 Learning Environment (Professionalism)

Principles

  1. Rapid turnaround of feedback to students whenever information becomes available is a goal of this evaluation process.
  2. A Physicianship Evaluation Form indicates that a student needs additional help developing physicianship skills.
  3. The Associate Dean for Students will provide support to the student in meeting competency expectations for professionalism.
  4. Professionalism lapses that lead to the submission of a Physicianship Evaluation Form may lead to adverse academic actions, including failure of the relevant course/clerkship and/or referral to the Committee on Academic Standards.
  5. The School of Medicine is required by the AAMC to report persistent, recurrent or seriously unprofessional behavior on the Medical Student Performance Evaluation, along with information about the student’s response to educational interventions.

Policy

  1. A course/clerkship director or associate dean who is concerned about a student's behavior should give feedback to the student and make suggestions for improvement.
  2. If attempts to give the student feedback about these issues are unsuccessful, the behavior is repeated, or is initially serious enough, then the course/clerkship director or associate dean will complete a Physicianship Evaluation Form and will meet with the student to review the form and discuss feedback with the student. The Physicianship Evaluation Form should be filed as close to the incident of concern as is practical.
  3. The completed form will be submitted to the Associate Dean for Students, who will meet with the student to review the issues and explore remediation strategies.
  4. Students may be given the provisional non-passing grade of E in a course or clerkship for failing to demonstrate appropriate professional behavior required for a physician.
  5. Students who receive three Physicianship Evaluation Forms during the curriculum, or two Physicianship Evaluation Forms in Foundations 2/Career Launch, or who have a single confirmed report of a serious professionalism lapse that the Committee on Academic Progress determines to have placed a patient at risk of immediate harm will have the following consequences:
    • These issues will be reported in the Medical Student Performance Evaluation (MSPE). The School will notify residency program directors about Physicianship Evaluation Forms that meet the above criteria but are received after submission of the MSPE.
    • The student will be placed on academic probation.
    • The student will be referred to the Committee on Academic Standards.
  6. Students who receive a Physicianship Evaluation Form but do not feel that its issuance was merited can ask for clarification or review from the faculty member.
    • If the issue is not resolved after this informal discussion, the student can submit an appeal to the Associate Dean for Students; this appeal will be reviewed by the Physicianship Appeal Committee, who will determine whether its issuance should stand or be retracted.
    • The student has up to two weeks after being notified of the issuance of the Physicianship Evaluation Form to review its issuance with the faculty member and/or the Associate Dean for Students and submit an appeal.
    • Grievances are not the same as disagreements. A student cannot grieve a Physicianship Evaluation Form merely because the student disagrees with its issuance.
    • The student cannot further appeal the Physicianship Evaluation Form unless: (1) the student feels that it was based on discrimination (for example, that bias or wrongdoing by a faculty member has occurred), -or- (2) the student feels there was an infringement of the student’s academic freedom. An example of possible infringement of academic freedom is when a student alleges that the Physicianship Evaluation Form was submitted by a faculty member based upon the student's expression of opinions or academic positions that differed from that of the faculty member's opinions or positions. An example might be where a student wrote an opinion piece in the student paper with which the faculty member expressed disagreement.
    • A student with a grievance of an alleged act of discrimination as expressed through a Physicianship Evaluation form may contact the Office for Diversity and Outreach for further information.

 

Procedure

  1. A course/clerkship director or dean who is concerned about a student's behavior should give feedback to the student and make suggestions for improvement.
    • The faculty member is encouraged to meet with a student who does not meet physicianship standards as soon as concerns are raised and prior to the end of the course/clerkship or program.
    • The purpose of this meeting is to discuss ways in which performance can be improved, thus allowing the student adequate opportunity to make appropriate changes.
    • Such feedback meetings, though strongly encouraged, are not required in order to submit a Physicianship Evaluation Form.
  2. If the behavior is repeated or is initially serious enough, then a Physicianship Evaluation Form will be completed by a course/clerkship director or associate dean.
  3. The faculty member who issues the Physicianship Evaluation Form will send the completed form to the student.
  4. The course/clerkship director or associate dean should meet with the student to review the form.
  5. To document this process, the student can sign and date the form and may respond to the evaluation by providing additional information.
  6. The faculty member who completed the form will submit it to the Associate Dean for Students.
  7. The Associate Dean for Students generally meets with the student to review the issues and explore remediation strategies.
  8. Students who receive a Physicianship Evaluation Form but do not feel that its issuance was merited can ask for clarification or review from the faculty member.
  9. If the issue is not resolved after this informal discussion, the student can submit an appeal to the Associate Dean for Students.
  10. The Associate Dean for Curriculum or the Associate Dean for Assessment will be assigned to manage the appeal.
  11. This appeal will be reviewed by the Physicianship Appeal Committee, who will determine whether its issuance should stand or be retracted.
  12. The committee will return the final decision to the Associate Dean for Students to communicate the committee decision to the student.

Accountable Dean or Director: Associate Dean for Competency Assessment and Professional Standards

Approval Date and Governing Body: May 21, 2019, CCEP