Promotion Guidelines

Rationale

The Brody School of Medicine (BSOM) is committed to clearly communicating its learner promotion and advancement guidelines, as well as the responsibilities of all parties in the process. The purpose of this policy is to provide notice to learners of the requirements for advancement in the academic curriculum and to clearly outline BSOM’s policies regarding leaners in poor academic standing.

Scope

This SOP applies to all currently admitted/enrolled learners at the BSOM, in addition to learners on a leave of absence with a plan to return to the curriculum.

Definitions

Review and Promotion Committee(s)

Learner academic progression is reviewed by the Review and Promotions (R&P) Committees. There are two separate R&P Committees (M1/M2 and M3/M4). These committees are responsible for reviewing the academic and professional assessments of each learner and making decisions regarding learner promotion to a subsequent year.

Academic Standing

A learner with an un-remediated ‘F’ course grade, an un-remediated failing score on a USMLE examination, or has not taken USMLE Step 1 prior to the start of M3 year is in ‘poor academic standing.’ A learner currently on suspension for a violation of the Code of Student Conduct may also be considered in ‘poor academic standing’ at the discretion of an ad hoc Professional Conduct Committee.  Once a learner remediates the failed course or USMLE exam (when such remediation is possible), they are back in ‘good academic standing’. When a learner returns from a suspension, they are back in ‘good academic standing’ but may still be subject to sanctions at the discretion of an ad hoc Professional Conduct Committee. A learner’s academic standing is often requested by scholarship programs, away rotations, or dual degree programs.

Withdrawal

Learners may only withdraw from all courses in a term. They may withdraw to take a leave of absence with the intent to return to the Brody School of Medicine (term withdrawal), or they may withdraw with the intent to leave the Brody School of Medicine entirely.

In-Progress Grade (IP)

An in-progress grade (IP) can be assigned by a Course Director — at their discretion, as outlined in the syllabus — if the learner has not completed the required work for the course. An in-progress grade should be assigned only if there is a plan to complete the coursework in a reasonable timeframe as outlined in the syllabus. Any ‘IP’ grades that remain after that timeframe will be converted to ‘F’ grades by the BSOM Registrar. The Course Director must submit a ‘Change of Grade’ form to the BSOM Registrar to change the ‘IP’ grade to the final earned grade in the course. It is the responsibility of the Course Director to inform the learner and the BSOM Registrar when a learner fails to complete the coursework within the time required by the Course Director.

Responsibilities

Review and Promotion Committee(s)

M1/ M2 R&P Committee meets and votes on review and promotion issues involving M1 and M2 learners. The Chairs of the M1/M2 R&P Committee will set the meeting schedule at the beginning of the academic year, with attention to scheduling meetings after exam grades are available. The M3/ M4 R&P Committee meets and votes on review and promotion issues involving M3 and M4 learners after each M3 cohort, with a required meeting in March or April to review the class being considered for graduation.

The following procedures apply to all R&P committee meetings, without regard to program year. A quorum is achieved when more than 50% of the voting members are present.  Course Directors who have a learner who has earned a current ‘F’ grade in their course must abstain from any votes on motions regarding that learner. Committee members will be impartial, and any member who lacks impartiality must recuse themselves from the proceedings at the time of the discussion about the learner. A simple majority of those present and eligible to vote determines a decision.

Office of Student Affairs

The Office of Student Affairs serves as a liaison for the learner and the R&P Committees. The Office of Student Affairs has a role in both helping learners understand and navigate the review and promotion process and ensuring that this SOP as well as other BSOM standard operating procedures are applied in all circumstances.

All Medical Learners

Learners are expected to utilize available resources to ensure academic success. When a change in registration is needed or desired, learners are required to communicate effectively with the Office of Student Affairs. Learners must educate themselves regarding all pertinent dates, deadlines and financial/academic consequences related to withdrawal from courses and navigate the extenuating circumstances process with the East Carolina University (ECU) Dean of Students Office.

Procedures for Implementation and Review

Student Review and Promotion Committee Membership

Committees are comprised of a representative from each course taught within the corresponding curriculum year. Representatives are selected by the Chair of the Department or Office from which each course originates. Administrators from the Office of Student Affairs, the Office of Medical Education, the Office of Admissions, and the Office of Student Success and Wellness serve as resource (non-voting) members of these Committees.

Dual Degree Students (MD/MBA or MD/MPH)

Learners must be in good academic standing to be considered for approval to participate in a dual-degree program. Due to the complexity of the medical school curriculum, learners pursuing a dual degree are expected to complete these degrees between the M3 and M4 years. All leaves of absence to pursue a dual degree must be approved by the year-appropriate R&P Committee. Learners approved for a dual degree program will be placed on a leave of absence (for ‘personal reasons’) from the Brody School of Medicine during the time that they are completing the other degree program. A learner cannot be enrolled in two separate degree programs simultaneously.

Learner Advancement

No learner will be advanced from one curriculum year to the next unless they are in good academic standing. A learner may not progress to the M3 year without passing USMLE Step 1, and a learner may not graduate without passing USMLE Step 2.

Foundational Years’ Progression

• M1 Year Performance: Please refer to the BSOM M1 Assessment SOP  for full details.
  • A learner who fails one (1) course in the M1 year will be placed on an academic leave of absence and repeat the entire M1 year.
    • If a learner has previously taken an academic leave of absence from the M1 year and after returning to the M1 curriculum fails one (1) course, they will be dismissed from the BSOM.
  • A learner who fails two (2) courses during the M1 year will be dismissed from the BSOM.

• M2 Year Performance: There are two remediation period s for learners to remediate a limited number of failed threads and/or courses: (1) after Winter Break prior to the start of SYST 9600, and (2) immediately after SYST 9600.
  • A learner may remediate up to one (1) course plus (1) thread OR two (2) threads during either remediation period.
  • Course failure remediations requires retesting all content (ie, all three [3] threads).
  • If a learner fails to remediate one (1) course failure OR has any unresolved threads at the end of the remediation period following SYST 9600, they will be placed on an academic leave of absence and recommended to repeat the M2 year.
    • If a learner has previously taken an academic leave of absence from the M2 year and after returning to the M2 curriculum fails to remediate one (1) course failure OR has any unresolved threads at the end of the remediation period following SYST 9600, they will be recommended for dismissal from the BSOM.
    • If a learner has two (2) or more unremediated course failures at the end of the remediation period following SYST 9600, they will be recommended for dismissal from the BSOM.

Clinical Years’ Progression

• Learners’ final grades in clerkships reflect the knowledge, skills, and attitudes demonstrated by the learners during the clerkships. Learners must pass multiple components of the clerkship (OSCE, NBME Subject Exam, and others as determined by the clerkship) to record a grade for that clerkship.
• Learners who do not attain a passing grade on their first attempt at the NBME subject examination will receive an ‘IP’ grade for the clerkship until the NBME subject examination is successfully passed. Learners who do not attain a passing grade after 3 attempts at the NBME subject examination will receive a failing grade for that clerkship.
• Learners cannot progress to the next clerkship with two ‘IP’ grades. Learners with two ‘IP’ grades will be enrolled in an eight (8) week remediation course and must remediate both ‘IP’ grades before continuing in the M3 curriculum.
• Learners cannot be more than one (1) clerkship behind their class. Learners who fall two (2) clerkships behind will be placed on an academic leave of absence and restart the entire clinical curriculum with the next class. A “W” grade will be assigned to any clerkships begun but not successfully completed, including any clerkships with “IP” grades. Learners restarting the clerkship year are expected to participate in the entire curriculum, including clerkships already successfully completed.
• The impact of performance on USMLE Examinations on learner academic progression is covered by a separate SOP.

Total Curriculum

• Learners must meet all requirements for graduation within 6 years of matriculation. Once a learner cannot meet all requirements for graduation within 6 years of matriculation, they will be dismissed from the BSOM.
  • The learner being considered for a dismissal based on an inability to meet all requirements within 6 years of matriculation shall have the opportunity to address the year appropriate R&P Committee at the time their case is discussed.
• The year appropriate R&P Committee may make an exception to this rule upon petition due to extenuating circumstances.
• Remediation courses are listed on the transcript with the grade earned. No ‘F’ grades are removed from the transcript after remediation.
• A learner will have no more than two (2) attempts through any year of the medical school curriculum to successfully pass the year.

Academic Dismissal Process

Any academic dismissal of a learner from the BSOM is made by the year appropriate Review and Promotion Committee. A learner being considered for an academic dismissal shall have the opportunity to address the year appropriate Review and Promotion Committee and present any extenuating circumstances at the time their case is discussed.

A learner shall be dismissed by the appropriate Review and Promotions Committee if that learner:

• Fails two (2) courses within the M1 curriculum year.
• Has previously taken an academic leave of absence from the M1 year and fails one (1) course in the M1 year upon returning to the curriculum.
• Has two (2) or more outstanding course failures at the end of the remediation period following SYST 9600 in the M2 curriculum year.
• Has previously taken an academic leave of absence from the M2 year and fails to remediate one (1) course failure OR has any unresolved threads at the end of the remediation period following SYST 9600 upon returning to the curriculum.
• Cannot meet all requirements for graduation within 6 years of matriculation.
• Has not passed a given year of the medical school curriculum after two (2) attempts.
• Fails to progress through the curriculum as would be expected from a similarly situated learner, at the discretion of the year appropriate R&P Committee.

Academic Dismissal Appeal Process

A learner may appeal a recommendation of dismissal from the R&P Committee by submitting a written statement to the Associate Dean for Student Affairs within three (3) business days of the recommendation.

1. During the appeal process, the learner will continue in the curriculum and participate in all required activities and assessments. Grades for assessments will be recorded pending the result of the appeal. Should the appeal be unsuccessful, any grades or assessments completed during the appeal process will be struck from the learner’s record.
2. The written statement by the learner must clearly articulate the facts related to one of the grounds for appeal: (a) there was a violation of due process, and/or (b) the Committee’s decision was arbitrary or capricious. Appeals that do not clearly articulate the facts related to one or more of the above grounds will not be granted. The Office of Student Affairs will assist in the preparation of such an appeal, and the Executive Dean will have final decision-making authority to determine if the appeal is granted, based on the information presented by the respondent.
3. An ad hoc Review and Promotion Appeals Committee, composed of five (5) faculty members appointed by the Executive Dean, will hear the appeal at the earliest possible time consistent with thorough review and preparation. At least two (2) members should represent the foundational science faculty and at least two (2) members should represent the clinical science faculty; all ad hoc Committee members must be present at the appeal.
4. The timing of the hearing should occur no later than ten (10) business days after the receipt of the learner’s written statement to the Associate Dean for Student Affairs, though may be reasonably delayed subject to committee member availability. The learner who is appealing has the opportunity to meet with the ad hoc Review and Promotion Appeals Committee to present a statement and/or answer questions the Committee members might have.
5. The ad hoc Review and Promotion Appeals Committee will consider the decision of the R&P Committee along with the learner’s statement in making their final determination.
6. The Grade Appeals Process SOP describes the process for appeals related to grades and/or prescribed remediation.

Withdrawals

Due to the nature of the curriculum, a learner cannot withdraw from individual courses and remain in others. Any withdrawal from the Brody School of Medicine will be a withdrawal from all courses registered in that Block. Additional information about withdrawals is at https://registrar.ecu.edu/course-drops-withdrawal-policy/. Prior to any withdrawal, learners must consult with the BSOM registrar and the Office of Financial Aid to determine the impact on tuition and financial aid.

Withdrawal Requests Made Within 60% of an Academic Block

During the first 60% of regularly scheduled class meetings in an academic block, a learner may withdraw from the Brody School of Medicine (or withdraw from the term and take a leave of absence) without receiving grades for courses in which they are enrolled. A ‘W’ will be recorded on the transcript as the final grade for each course.

Withdrawal Requests Made Beyond 60% of an Academic Block

After 60% of regularly scheduled class meetings in an academic block, a learner withdrawing (or taking a term withdrawal with a leave of absence) from the Brody School of Medicine shall receive no credit for the courses which they are passing at the time of withdrawal (the learner will receive their current grade in the course, with the missing coursework factored in as ‘0’ – it would be rare for a learner to receive a passing grade in this circumstance). A learner will receive a grade of ‘F’ for all courses in which they are failing at the time of withdrawal.

Extenuating Circumstances

Extenuating circumstances may warrant consideration for withdrawal by exception.  Learners must petition the East Carolina University Dean of Students (not the BSOM Office of Student Affairs) for course withdrawals by exception. Petitions for course withdrawal after the 60% withdrawal period deadline will typically be granted only for unforeseen and uncontrollable medical, psychological, or personal reasons directly affecting the course(s). The following are not considered a basis for exception: poor performance in course work, missed deadlines, a course grade’s adverse effect on the learner’s grade point average, probationary standing, or other eligibility. The Dean of Students cannot accept requests after the last regularly scheduled class meeting prior to the final examination for the course(s) in question. Learners whose request is received after the last class meeting or whose request is denied by the Dean of Students may appeal to the East Carolina University Student Academic Appellate Committee (SAAC). The decision of the Student Academic Appellate Committee is final.

Leaves of Absence

Leaves of absence from the BSOM fall into four categories: academic, financial, health, and personal/other.

A learner may request a leave of absence (for up to twelve months in length) for academic, financial, health, or personal/other reasons. This request must be requested in writing and must include the reason, proposed duration, and emergency contact for the time away. All requests must be approved by the year-specific R&P Committee, and all leaves of absence are noted on both the learner’s transcript and Medical Student Performance Evaluation (MSPE). The year-specific R&P Committee will determine any conditions or terms of the leave of absence, if applicable. Learners planning leaves of absence must meet with the Office of Financial Aid to ascertain how the leave will affect their financial aid status.

If a student requests a leave of absence within first 60% of regularly scheduled class meetings in an academic block because they are in academic difficulty (failing one or more courses or threads), that leave of absence will be academic in nature. This does not apply to students with established medical conditions that may impact their academic performance. Health leave of absence is addressed below.

At the time of a request for a health leave of absence, the learner must also submit a letter from their medical provider supporting the need for a health leave. Before returning to the curriculum, the learner must submit another letter from the same medical provider specifically stating that they are “healthy enough to participate in the rigors of the medical curriculum.” If extenuating circumstances exist precluding the same medical provider from clearing the learner to return to the curriculum, the learner must notify the Associate Dean for Student Affairs and the year-specific R&P Committee and obtain clearance from another medical provider.

Learners on a health leave of absence may not enroll in other degree programs at East Carolina University or other institutions as the intent of this type of leave is to allow learners to use the time to focus on their personal health. Learners on an academic leave of absence may not enroll in other degree programs at East Carolina University or other institutions as they are not in good academic standing.

Related Policies

Academic Achievement Program
M1 Assessment
Grade Appeals Process
USMLE Examinations
Transcript and Academic File

Applicable Laws, Regulations & Standards

LCME Standards for Accreditation of Medical Education Programs Leading to the MD Degree: Published March 2023; Standard 10, Element 3