6.4. PROCEDURES FOR ADDRESSING PERFORMANCE, PROFESSIONAL AND TECHNICAL STANDARDS CONCERNS
Updated August 2017
A. In general:
- The Student Progress Committee will periodically review the record of all students; additionally, it can place any student on its agenda for discussion and action if there is a concern about his or her performance or progress in fulfilling academic, professionalism or technical standards.
- The Student Progress Committee can take any action it deems appropriate in its discretion under the facts and circumstances presented to address any concerns about academic, professional or technical standards issues, including (but not limited to):
- Requiring a student to correct a marginal pass or a failing grade in a specified manner and/or by a specified date;
- Placing a student on academic probation with a prescribed and restricted curriculum (including the discontinuation of activities such as extracurricular activities, community service) for a time period specified by the Student Progress Committee;
- Placing the student’s enrollment on administrative hold for one or more quarters;
- Requiring a remedial curriculum, or that the student be referred for an assessment;
- Dismissing the student from Stanford School of Medicine MSPA Studies program under circumstances deemed by the Student Progress Committee to warrant such action.
NOTE: See “6.5 Appendix: Chart of Student Progress Committee Responses to Student Actions” of this chapter for examples of some of the actions that may be taken by the Student Progress Committee to address certain academic deficiencies.
B. Procedures regarding academic deficiencies:
- As a general proposition, students will be notified in advance if they are to appear on the agenda of the Student Progress Committee.
- Students who appear on the Student Progress Committee agenda in regard to an academic deficiency will be accorded the following rights:
- To ask for and receive from a Faculty Advisor a written explanation as to why they are receiving attention by the Student Progress Committee.
- To have an opportunity to discuss their academic progress and/or deficiencies with their Faculty Advisor and to participate in formulating for presentation to the Student Progress Committee a proposal for a remedial program (where appropriate).
- To have an opportunity to submit a written statement to the Student Progress Committee.
- In any case involving dismissal from Stanford School of Medicine MSPA Studies program, to be invited to appear in person at the scheduled Student Progress Committee meeting during the presentation of their case prior to the closed deliberation of the committee. NOTE: Students appearing before the Student Progress Committee may have a qualified advocate of their choice accompany them to the meeting; advocates may be either the student’s Faculty Advisor, mentor, Stanford PA or another faculty member of Stanford School of Medicine. An attorney is not a qualified advocate.
- Under ordinary circumstances, to receive a written report within 10 working days after the Student Progress Committee meeting detailing the committee action taken. The time frame may be extended for good cause at the discretion of the Student Progress Committee chair.
- To have an opportunity to discuss the Student Progress Committee action and report with their Faculty Advisor and to submit a written request to the Student Progress Committee chair that the action be reconsidered. The request must be based on compelling new information not available at the time the action was taken, not on a complaint expressing dissatisfaction with the outcome or with an underlying University or Stanford School of Medicine policy of general application. Such a request should be submitted within 14 working days of receipt of the report, but the time frame may be extended for good cause at the discretion of the Student Progress Committee chair.
- To have the opportunity to file a formal grievance, as outlined in the Stanford University Bulletin (Student Academic Grievance Procedure). Grievances appealing a Student Progress Committee action are filed with the Dean of the School of Medicine.
C. Procedures regarding professionalism concerns:
- In general:
- The faculty of Stanford School of Medicine endorses students as suitable to practice medicine based on maintenance of continuous satisfactory performance in the areas of meeting academic, professional, and technical standards.
- The Student Progress Committee may address minor professionalism concerns at its discretion and as it sees fit, such as by referral to a student’s Faculty Advisor or completion of a program of remediation.
- As to serious professionalism concerns, such concerns will be addressed under a three-step process as presented below.
- NOTE: Alleged violations of Stanford’s student conduct codes (including the Honor Code and the Fundamental Standard) are adjudicated by a different University process. That conduct, however, may also raise concerns regarding professionalism requiring review under this process.
- The Three-Step Process
- a. Step 1: Personal Communication
- A faculty member or any other individual should communicate a possible substantive deficiency in professionalism of a PA student to the Associate Dean for PA Education. The Associate Dean will then inform the Student Progress Committee. This should be done as soon as practicable after the professionalism deficiency is identified.
- The Associate Dean (or his or her delegate) should give the student a copy of these guidelines and arrange a meeting with the student and, as appropriate, the individual identifying the deficiency and the Faculty Advisor. If the alleged deficiency can be explained or corrected in a mutually satisfactory manner, the matter need go no further. The Associate Dean should then communicate his or her conclusions or actions to the Student Progress Committee.
- To facilitate identification of students who may have professionalism deficiencies, the PA program will maintain impermanent files separately from students’ permanent files as a repository for such concerns. If a serious professionalism concern is communicated to a student, a memorandum regarding the conversation should be sent to the student and a copy placed in the student’s impermanent file. By having a central repository for such information, students whose performance repeatedly provokes professionalism concerns can be identified. The impermanent file should also contain records on formal or informal hearings, and/or Student Progress Committee considerations of students regarding professionalism. Except as disclosure is necessary under this process, access to impermanent files will in general be restricted to those Stanford personnel with a need to know (such as the program leadership, faculty, student service officers and Student Progress Committee and the student. As a general proposition, the contents of any such impermanent file are to be destroyed within one year after the student graduates.
- Step 2: Informal Hearing
- If the student, the identifier of the deficiency, the Student Progress Committee, or the Associate Dean is not satisfied with the result of the personal communication described above, the Student Progress Committee will hold an informal private hearing upon being notified of that dissatisfaction. The informal Student Progress Committee hearing will involve the student, a quorum of the Student Progress Committee, the student’s Faculty Advisor, a student-chosen advocate (who must be a faculty member of Stanford School of Medicine or a clinically practicing Stanford PA), and any other individual (e.g., the faculty member identifying the deficiency) who the chair of the Student Progress Committee thinks pertinent to discuss the matter. The purpose of the informal private hearing will be to permit the student and any other involved individuals to present their versions of the alleged deficiency and work out, if possible, a mutually satisfactory remedy.
- The chair of the Student Progress Committee will communicate, in writing, the results of the hearing to the student and the Associate Dean within ten working days of the meeting. At the discretion of the Associate Dean, the written communication or other summary of any mutually satisfactory remedy may also be placed in the student’s permanent file. If there is no mutually satisfactory remedy, the written communication and any other records of the informal hearing will be placed in the student’s impermanent file.
- Step 3: Formal Hearing
- If the matter cannot be satisfactorily resolved at the Student Progress Committee informal hearing, if the student or the Associate Dean for PA Education is not satisfied with the outcome of the hearing, or if there is a breakdown of (or failure to timely complete or adhere to) the mutually agreed-upon remedy, the Student Progress Committee chair will call a formal hearing.
- A formal hearing is intended to provide an opportunity for the parties to present their positions in a process with the authority to decide on a remedy and/or an outcome, including dismissal from the Stanford School of Medicine MSPA Studies program. The Associate Dean will compose an ad hoc Committee on PA Suitability to hear the matter. The committee will be composed of five SOM faculty and or clinically practicing PAs within the Stanford community. The Committee will hear the matter and make findings and recommendations to the Associate Dean for PA Education. Decisions will be made by majority vote.
- The chair of the Committee on PA Suitability will conduct the formal hearing using the general procedural guidelines outlined below:
- The student will be informed in writing of the alleged deficiency to be considered, of the situation upon which the concern is based, and of the scheduled date of formal hearing (which shall be at least 10 days after the date of this written statement). The written statement will also include a copy of this process and any special rules and procedures to be followed in the hearing. The student may request a reasonable extension of the hearing if necessary to prepare his or her position.
- The student will be allowed to inspect his or her School of Medicine education record to which he or she would be entitled under Stanford’s policy on the Privacy of Student Records, including material in such files concerning the alleged deficiency.
- No person who has first-hand information concerning this matter, who presents evidence at the hearing, or who otherwise is involved in this process may serve on the Committee on Suitability. A replacement, when necessary, will be appointed by the Associate Dean for PA Education
- The student will be permitted to have a qualified advocate accompany him or her at the hearing, but that advocate may not participate directly in the hearing. The advocate must be a member of the Stanford University School of Medicine faculty or a Stanford clinical PA; an attorney is not a qualified advocate. The student shall notify the chair of the Committee on Suitability at least five days prior to the hearing of the identity of any advocate.
- The student has a right to be present during the presentation of evidence supporting the alleged deficiency, to question any witness who presents evidence at the hearing, and to offer evidence or argument at the hearing to rebut that evidence. The student will be given a reasonable opportunity to present his or her version of the situation, and may present relevant evidence and witnesses on his or her behalf.
- The presentation of evidence and arguments will be recorded.
- Unless the student asks for an open hearing, the data and discussions of the hearing will be kept confidential, and no record will be placed in the student’s permanent file unless the charge of deficiency is substantiated.
- The findings and recommendations resulting from the formal hearing should be based upon the evidence presented at the hearing and on the contents of any pertinent Stanford School of Medicine student records and files.
- After the hearing, the Committee on PA Suitability will convey its findings and recommendations in writing to the Associate Dean for PA Education in a timely manner. The Associate Dean for PA Education will consider the findings and recommendations and issue a final decision in writing to the student in a timely manner. The Associate Dean for PA Education will also inform the Student Progress Committee chair of the final decision.
- The student may appeal the decision to the Dean of Stanford School of Medicine as a formal written grievance under (and within the time limits of) the Stanford University Student Academic Grievance Procedure.
- a. Step 1: Personal Communication
D. Procedures regarding technical standards concerns: If concerns arise as to a PA student’s continuing ability to fulfill the technical standards of Stanford School of Medicine, the Student Progress Committee will appoint an ad hoc committee to review the matter and advise the Student Progress Committee.