A mark of a great medical school is the ability to create an environment that nurtures future physicians who possess knowledge of the most advanced scientific fundamentals and who demonstrate clinical competencies while behaving in ways that honor the profession of medicine. Helping students to achieve this level of professionalism is as important to MUSC as is its success in educating students.
College of Medicine Competencies and Institutional Learning Objectives (ILOs) for Professionalism and Personal and Professional Development
Professionalism: Students must demonstrate a commitment to professional and personal excellence in all settings, including adherence to ethical principles and sensitivity to a diverse patient population.
PR 1 Demonstrate honesty, integrity, respect, and compassion in all interactions with patients, peers, faculty, staff, and other health care professionals in all settings.
PR 2 Demonstrate ethical, patient‐centered decision‐making, informed consent, and respect for autonomy and confidentiality of patient information in all settings (i.e., clinical, academic, electronic or web‐based.)
PR 3 Demonstrate sensitivity and responsiveness to the personhood of the patient inclusive of culture, race, ethnicity, spirituality, gender, sexual orientation, age, physical characteristics, medical condition, disabilities, socioeconomic status, family‐context and other aspects of personal and health beliefs, practices and decisions.
PR 4 Demonstrate accountability for academic, patient care and professional responsibilities including concern for societal needs.
PR 5 Demonstrate responsiveness to patient needs that supersedes self‐interest.
Personal and Professional Development: Students must demonstrate the qualities required to sustain lifelong personal and professional growth.
PD 1 Acknowledge personal limitations and mistakes openly and honestly, seek and respond to feedback in a positive way, and demonstrate flexibility and maturity in adjusting one's behavior.
PD 2 Demonstrate strategies for analyzing, identifying and improving personal deficiencies in knowledge and skills by setting learning and improvement goals.
PD 3 Demonstrate a commitment to personal health and well‐being, and recognize and address personal attributes, attitudes, and behaviors that may adversely influence one’s effectiveness as a physician.
PD 4 Define professional impairment and describe the role and responsibility of health care professionals in addressing impairment and unprofessional behavior in colleagues and in the profession.
PD 5 Use self‐awareness and assessment data of one's knowledge, skills and attributes to identify appropriate career options.PD 6 Recognize that ambiguity is part of clinical health care and respond by utilizing appropriate resources in dealing with uncertainty.
As noted above, Professionalism is one of the domains of the Institutional Learning Objectives (ILOs) and is also a core competency for the College of Medicine. As professionalism is fundamental to the practice of medicine, medical students are expected to demonstrate appropriate professional and personal attributes at all times. In addition, each student is encouraged to hold their colleagues to the standards of professionalism.
Students’ Professional Behavior
Just as it is expected that faculty, staff, and residents will interact with students in a professional and respectful manner, it is expected that all College of Medicine students interact with others in a professional manner. We also wish to reiterate that students are expected to consistently demonstrate professional values such as
- Maintaining a commitment to scholarship
- Assuming responsibility and being dutiful
- Interacting with peers, faculty, residents, staff, and community-based preceptors with courtesy and respect
- Helping colleagues meet their responsibilities
- Exhibiting a high standard of moral and ethical behavior
Examples of Concerns
The following examples illustrate some of the types of unprofessional behavior that should be documented:
- a student who is absent without excuse, misses deadlines, or is late for mandatory activities, for clinical duties, or submitting assignments.
- a student who is disrespectful or inappropriate in oral or written communication.a student who exhibits disrespectful behavior toward students, faculty, staff, or others.
- a student who exhibits inappropriate use of cell phone and/or social media.
- a student who does not function adequately as a part of the health care team or as a part of their small group.
- a student who is insensitive to the needs, feelings, and wishes of others.a student who is defensive in the face of constructive criticism or who resists making changes in their professional behavior.
- a student who engages in inappropriate relationships with patients, teachers, residents ,or faculty, thereby disrupting the learning environment.
- a student who engages in disruptive behavior in the learning environment.
Procedure for the Documentation, Tracking, and Reporting of Unprofessional Conduct
To foster students’ professional growth and encourage high standards of professional behavior among students, the College of Medicine leaders have adopted a feedback system to inform a student when his or her behavior has been unprofessional. An incident that raises significant concerns about a medical student’s behavior should be documented using either the Physicianship Evaluation Form, E*Value Concern Card, or an E*Value Learning Environment Card. An email notification may be submitted to the Associate Deans for Student Affairs as well. Any of these methods are appropriate to document unprofessional conduct in the College of Medicine.
E*Value Concern Card and an E*Value Learning Environment Card may be submitted anonymously by College of Medicine faculty, residents, staff, or students. It is expected that forms will be submitted in good faith and will not be utilized to resolve personal disputes.
The Associate Deans for Student Affairs monitor the system, review all submissions, and take appropriate steps to address any concerns. Any submission that documents unprofessional conduct indicates that a student may need assistance in developing their skills as a medical professional and may result in a referral to the Professional Standards Subcommittee.
Physicianship Evaluation Form
The Physicianship Evaluation Form is intended to provide students and faculty a formal opportunity to discuss perceived transgressions of professional behavior on the part of the student. Physicianship forms may be generated by administrators, faculty, residents, or staff. The form is not intended to be punitive, but rather to encourage self-assessment and improvement where needed to ensure positive professional growth.
Professional Standards Subcommittee
When a pattern of concern about a student’s professional behavior is determined, either documented by the Physicianship Evaluation Form or through other communication to the Dean’s Office, the student will be referred to the Professional Standards Subcommittee. The Professional Standards Subcommittee is a component of the College of Medicine Student Progress Committee.
Tracking and Reporting
- In cases of professionalism infractions, a physicianship form, an E*Value Concern Card, an E*Value Learning Environment Card, or an email notification will be issued to the Office of Student Affairs with a summary of the incident(s). The preclinical and clinical education coordinators track and document reports of unprofessional conduct. The student will be notified when a report of unprofessional conduct is filed.
- If a student receives two physicianship forms, E*Value Concern cards, an E*Value Learning Environment Card, or note(s) of concern, the Office of Student Affairs will schedule a meeting with the student to give the student an opportunity to discuss their perspective on the issues identified. Failure to meet with the Office of Student Affairs in a timely manner constitutes an additional professionalism infraction.
- If a student receives three physicianship forms, and/or an E*Value Concern cards, and/or an E*Value Learning Environment Card, or note(s) of concern, the student will be referred to the Professional Standards Subcommittee.
- If an incident is determined to be egregious, the Office of Student Affairs should be informed immediately; at which point an Associate Dean for Student Affairs will meet with the student and/or conduct a review of the incident. The severity of the infraction will be determined by the Associate Dean and may result in a referral to the Professional Standards Subcommittee.
- The Professional Standards Subcommittee will discuss the issue and will determine the most appropriate course of action. Potential consequences include, but are not limited to, no action, supportive intervention, or adverse actions (i.e., professionalism probation, suspension, or dismissal).
- All students are expected to appear before the Professional Standards Subcommittee if referrals are made to the committee. Failure to respond to the referral constitutes an additional professionalism infraction. In addition, if a student fails to appear before the committee in a timely manner, the subcommittee is empowered to meet and impose sanctions with the student in absentia.
Adverse Actions and the Medical Student Performance Evaluation (MSPE)
The College of Medicine Progress Committee or the Professional Standards Subcommittee can render an adverse action (i.e. suspension, academic probation, and professionalism probation). The Medical Student Performance Evaluation (MSPE) must include adverse actions that have been taken as a result of a students’ referral to the Progress Committee or the Professional Standards Subcommittee. The MSPE must also include approved leaves of absence for personal, medical, academic, or administrative reasons. In cases where adverse actions are rendered following the release of the MSPE, the Dean’s Office will amend the MSPE and will notify the student’s program director and provide details regarding the incident that warranted the adverse action.
Every attempt will be made to foster students’ professional growth and development throughout their enrollment.