Academic Achievement Program

Rationale

To support the learning and success of all medical learners, the Brody School of Medicine (BSOM) Division of Academic Affairs has established procedures for intervention and remediation for learners having academic difficulty.

Scope

Learners in M1 and M2 years

The Academic Achievement Program aims to help learners who have academic difficulty as defined below by low grade average, exams or quiz scores below required thresholds, or failures of USMLE Step 1. The program has a plan in place to provide support and resources to those learners.

Learners in M3 and M4 years

The Academic Achievement Program outlines a plan for providing feedback for all learners in the M3 and M4 years. Additionally, the program aims to help those learners who have academic difficulty as defined by exam or quiz scores below required thresholds or failure of USMLE Step 2CK. The program has a plan in place to provide support and resources to those learners.

Definitions

OSCE: Objective Structured Clinical Exam

USMLE: United States Medical Licensing Exam

NBME: National Board of Medical Examiners

Academic Difficulty: Any one or more of the following items: low grade average, failure of exams or quizzes, OSCE remediation identification, USMLE Step 1 or 2CK failure, or NBME Clerkship Subject Exam score < 6th %

• Low Grade Average
  • M1 or M2 Years: Cumulative Course Average of < 70% after an exam
• Exam/Quiz Failures
  • M1 Year: Failure (score of <70%) of:
    • Two (2) quizzes before the first exam of the Block
    • The first exam of the Block
    • Two (2) or more exams in one course or thread
  • M2 Year: Failure (score <70%) of:
    • Two (2) quizzes before first exam of the Block or course
    • One (1) or more courses or two (2) or more threads (that are not part of a course failure)
  • M3 or M4 Years: Failing final grade in any Core Clinical Clerkship (as defined in each clerkship syllabus).
• OSCE Remediation Identification: Identification of ‘Needs Remediation’ on a midterm practice or final graded OSCE in the Medicine Course, Doctoring Course, or a Core Clinical Clerkship.
• Core Clinical Clerkships: Clerkships which are mandatory for all BSOM learners. These include Family Medicine, Internal Medicine, Obstetrics and Gynecology, Surgery, Psychiatry, Pediatrics, Emergency Medicine and Neurology/Physical Medicine and Rehabilitation
• Clinical Correlations Seminar (CCS): Remediation Course for USMLE Step 1 (8 weeks). The Course Director is the Associate Dean for Medical Education. The Course description can be found in the course catalog on the Office of Medical Education website.
• Clinical Medicine Enrichment (CME): Remediation Course for NBME Subject Examinations (8 weeks). The Course Director is the Associate Dean for Medical Education. The Course description can be found in the course catalog on the Office of Medical Education website.
• Clinical Applications and Practice Seminar (CAPS): Remediation Course for USMLE Step 2 CK (4 weeks). The Course Director is the Associate Dean for Medical Education. The Course description can be found in the course catalog on the Office of Medical Education website.

Responsibilities

All Medical Learners

All medical learners who are in academic difficulty must complete the ‘Learning Improvement Plan Pre-Meeting Reflection’ (LIPPMR) process. That process is defined as follows:

1. For learners who are in academic difficulty (they will be notified):
   • Learners must complete a LIPPMR form on the first occurrence of academic difficulty in any course in M1 courses; upon the first occurrence of academic difficulty in any course or thread in M2 courses; for any OSCE remediations; and
     any USMLE and NBME failures.
   • Once the LIPPMR form is completed, learners must meet with the applicable Course/Clerkship Director to seek assistance. Exceptions to this rule include:
     • Learners with a course, thread, or exam/quiz average >65 and <70. In
       these situations, the course director may contact the learner via email to discuss their performance in lieu of a meeting. A learner may always
       request a meeting with a Course/Clerkship Director.
     • Learners with subsequent occurrences of academic difficulty in the same course in M1 courses or the same course or thread in M2 courses. These learners are not required to complete a LIPPMR. Instead, these learners will receive a notification from the course director, offering an opportunity to meet and remind the learner to seek support resources. The course director may require a meeting with a learner in academic difficulty.
   • Meet with academic support staff in the Office of Student Success and Wellness (OSSaW) or the Associate Director of the Office of Clinical Skills Assessment and Education (OCSAE, if applicable) if referred by a Course/Clerkship Director.
2. Ensure that the LIPPMR form, when required, is signed by the Course/Clerkship Director and the learner.
3. Learners must follow through with the recommendations from all parties.
4. Learners are expected to complete the LIPPMR form process and required meetings immediately after receiving notification from a Course/Clerkship Director of being in academic difficulty.
5. Learners who fail to complete/document the requirements of the program will be reviewed by the year-appropriate Review and Promotion Committee. The Committee will meet with the student, discuss the student’s failure to complete the LIPPMR process, receive any information the student wishes to present, and address the matter as a professionalism issue. Potential consequences for failure to complete the LIPPMR process include counseling from the Committee concerning professionalism, referral to the Associate Deans for Student Affairs for additional counseling, a letter of concern to the learner from the Committee, and, in the case of repeated professionalism issues, referral to a Professional Conduct Committee for possible sanctions.

M1 and M2 Learners

• M1 and M2 learners will be identified as being in academic difficulty after the first two quizzes in a Block and after each exam set.
• Learners identified as ‘Needs Remediation’ on an OSCE must complete the LIPPMR form and required meetings prior to taking the subsequent final OSCE.
• Learners who fail an initial attempt at USMLE Step 1 are required to meet with the Associate Dean for Medical Education and OSSaW academic support staff to plan the Clinical Correlations Seminar for remediation and preparation for a subsequent attempt at the examination. Learners must submit a copy of the completed LIPPMR within 3 weeks of receiving the failing score.

M3 and M4 Learners

• Learners identified as ‘Needs Remediation’ on an OSCE must complete the LIPPMR form and required meetings prior to taking the subsequent final OSCE.
• LIPPMR forms for USMLE and NBME exam failures must be completed and submitted no later than 3 weeks after the test results are received.
• Learners who score below the 6th%ile on an NBME Clerkship Subject Exam must retake the exam. It is the learner’s responsibility to communicate with the Associate Dean for Medical Education and the Testing Administrator regarding the scheduling of this retake. Learners are allowed three attempts at each NBME Clerkship Subject Exam. If a learner does not achieve the 6%ile on an NBME Clerkship Subject Exam after three attempts, they will fail that Clerkship and must remediate the entire Clerkship.
• Learners who have two outstanding NBME Clerkship Subject Exam scores below the 6th%ile will have until the second (2nd) Friday after the end of the clerkship to remediate a failed NBME shelf exam (in the event of an observed holiday, learners will have until the last business day of the second week to remediate).
• Learners who fail an initial attempt at USMLE Step 2CK are required to meet with the Associate Dean for Medical Education and OSSaW academic support staff to plan the Clinical Applications and Practice Seminar for remediation and preparation for a subsequent attempt at the examination.

M1/M2 Course Directors

Course Directors must link to this policy on their course Elentra site. Course Directors are responsible for notifying learners (within one week of the failed exam/quiz) when they are in academic difficulty in their Course by completing the Student Notification Form – the Associate Dean for Student Affairs, Foundational Sciences must be copied on these notifications. Learners will be identified as being in academic difficulty after the first two quizzes and after each exam set.

Course Directors must notify learners each time that they are identified as being in academic difficulty. Course directors must meet with students on the first instance of academic difficulty in a course or thread, with the option for email in lieu of a meeting for students with a course average or exam/quiz average >65 and <70. For subsequent instances of academic difficulty in a course or thread, the Course Director will send a notification to the learner to offer an opportunity to meet and to remind the learner to seek support resources.

When a LIPPMR form is required, it is recommended that Course Directors require that the LIPPMR form be completed by the learner prior to meeting, thus maximizing discussion and meeting efficiency. Course Directors must make every effort to meet with learners within two (2) calendar weeks of the failed exam/quiz (one week is ideal).

M3/M4 Clerkship Directors

Clerkship Directors must link to this policy on their Clerkship Elentra site. Clerkship Directors are responsible for notifying and meeting with learners identified as ‘Needs Remediation’ on the OSCE (within two weeks of the OSCE date) for their respective Clerkship. It is recommended that Course Directors require that the LIPPMR form be completed by the learner prior to meeting, thus maximizing discussion and meeting efficiency. Clerkship Directors must make every effort to meet with learners within two (2) calendar weeks of the OSCE or NBME Clerkship Subject exam (one week is ideal).

OSSaW Academic Support Staff

When a LIPPMR form is required, it is recommended that the meeting with OSSaW academic support staff occur following meetings with the Course/Clerkship Directors. OSSaW academic support staff must work with the Associate Deans for Medical Education to facilitate learner remediation plans for USMLE Step 1, 2CK, and NBME Clerkship Subject Exams. OSSaW academic support staff must make every effort to meet with learners within a reasonable timeframe (ideally within one to two calendar weeks of learner notification of academic difficulty).

Associate Director of the OCSAE

The Associate Director of the OCSAE will partner with OSSaW academic support staff to provide meet with students who are identified as ‘Needs Remediation’ on an OSCE. The Associate Director of the OCSAE must make every effort to meet with students within a reasonable timeframe (ideally within two calendar weeks of receipt of the score report).

Associate Dean for Medical Education

The Associate Dean for Medical Education is responsible for identifying/overseeing the notification of learners who fail USMLE Step 1 and 2CK as well as those who score below the 6th%ile on NBME Clerkship Subject Exams. The Associate Dean for Medical Education serves as the Course Director for the CCS, CME and CAPS Courses. In this role, they are responsible overseeing remediation plans for these exams.

Associate Deans for Student Affairs

The Associate Deans for Student Affairs are responsible for tracking learner compliance with the Academic Achievement Program. They are expected to provide data, as requested, to the BSOM Promotion and Review Committees, OSSaW academic support staff, the Director of the OCSAE as well as the Associate Dean for Medical Education to guide their work.

BSOM Review and Promotion Committees

The BSOM Review and Promotion Committees will review and make recommendations as appropriate for all students who are identified as having academic difficulty. The Committees are responsible for creating timely reports (within one week of each exam in the M1 and M2 year, for each M1/M2 Committee meeting) of learners in academic difficulty. The M1 and M2 Committee reports must address the indicators outlined in this procedure (low grade average, exam/quiz failures and OSCE remediation). The Committees will meet with all learners who do not comply with the Academic Achievement Program guidelines. After a first offense (noncompliance with the guidelines), the Committee will issue a written warning. Repeated issues with compliance will warrant a consideration of referral to a Professional Conduct Committee for sanctions. The BSOM Review and Promotion Committees will follow BSOM procedures for learner advancement.

Procedures for Implementation and Review

This procedure is to be reviewed by the M1-M4 Curriculum Committees before approval by the Executive Curriculum Committee every three years.

This procedure will be disseminated by the Office of Student Affairs to students and teaching faculty/administration.

Related Policies

9.9.1

Applicable Laws, Regulations & Standards

LCME Standard 11, Element 1