Standards of Ethical and Professional Behavior for Medical Students

SOP #:
Version #:
1
Implementation Date:
July 23, 2025
Last Reviewed/Update Date
July 23, 2025
Approval by EAC
July 23, 2025
Expiration Date
July 23, 2028

I.  Preamble

The purpose of the East Carolina University (“ECU”) Brody School of Medicine’s Standards of Ethical and Professional Behavior for Medical Students (“BSOM Standards”) is to articulate guidelines for expected personal, academic, and professional behavior of medical students. The Chancellor of ECU has designated the Executive Dean of the Brody School of Medicine as the person responsible for the administration of the BSOM Standards. The BSOM Standards fully comply with the University of North Carolina (“UNC”) Code and Policies. The BSOM Standards are academic, and they teach and enforce ethical and professional standards required for the profession of medicine.  As an academic policy, the BSOM Standards are excluded from disciplinary and conduct rules as defined by UNC Policy Manual 700.4.1.1[R] II(C) but afford students similar due process protections prior to the implementation of any sanction. The BSOM Standards are separate from ECU’s Student Conduct Process and exempt from the requirements of UNC Policy Manual 700.4.1. Violations of the BSOM Standards may also constitute violations of the ECU Student Conduct Process (REG11.30.01). In those situations, a student may face University wide sanctions in accordance with the ECU Student Conduct Process as well as Brody School of Medicine sanctions in accordance with these BSOM Standards.

The BSOM Standards provide a framework for personal honor and integrity. The medical profession is responsible for monitoring its own ethical standards, and this practice must begin in medical school. Promoting an environment of professionalism in which ethical standards define day-to-day activities requires full cooperation and support of all members of the Brody School of Medicine community, including students, staff, and faculty. Each student is expected to show an appreciation of the trust placed in themselves and is expected to insist upon the same standards among fellow students.

II.  Interface with the ECU Office of Student Rights and Responsibilities

ECU’s Office of Student Rights and Responsibilities (OSRR) administers the ECU Student Code of Conduct, which governs students’ on- and off-campus conduct in accordance with ECU’s Student Conduct Process, and the requirements of UNC Policy Manual 700.4.1. While the Chancellor has approved the Brody School of Medicine’s administration of its own Standards of Ethical and Professional Behavior for medical students, the BSOM collaborates with OSRR when reported violations include potential violations of the ECU Student Conduct Process. In such instances, the matter will first be reviewed and adjudicated by OSRR unless the Director of OSRR and the BSOM Associate Deans for Student Affairs agree that the matter should first be handled in accordance with the BSOM Standards.

For matters adjudicated by the BSOM Standards, the Associate Deans for Student Affairs will report the outcome(s) of the BSOM Standards process to OSRR.

For matters initially adjudicated by OSRR, the reported violation(s) and outcomes will also be reviewed and adjudicated in accordance with the BSOM’s Standards. Behavioral expectations for members of the medical profession are higher than for most members of society based on the inherent trust in the patient-doctor relationship. If a student violates the BSOM Standards, the Associate Deans for Student Affairs or a Professional Conduct Committee may find the OSRR sanctions appropriate and decline to recommend additional sanctions. Alternatively, a Committee may recommend additional sanctions to the Dean of the BSOM.

III.  Ethical and Professional Behavior

All students are expected to maintain high standards of moral and ethical behavior and to conduct themselves in a professional manner at all times, both on and off campus. This includes, but is not limited to, such settings as: the classrooms, laboratories, simulation center, clinical care areas and other ECU facilities; at other community-based clinical activities; while participating in community service; while attending meetings or conferences of professional organizations; at social events or in personal encounters with other individuals; and while using social media.

Ethical and professional behavior is characterized by honesty, integrity, and fairness in all circumstances; respect for the rights, differences, and property of others; concern for the welfare of others, including patients, always striving to do one’s best in providing care, and preserving patient confidentiality.

Examples of unacceptable professional behavior include, but are not limited to:

    1. Acts of dishonesty, including but not limited to the following:
      1. Cheating, plagiarism, or other forms of academic dishonesty.
      2. Furnishing false information to any School of Medicine official, faculty member, or office with intent to deceive.
      3. Forging, altering, or misusing any School of Medicine document, record, or instrument of identification.
      4. Submitting falsified ballots in an election of any School of Medicine recognized student organization or class election.
    2. Disruption or obstruction of teaching, research, administration, disciplinary proceedings, or other School of Medicine activities.
    3. Verbal and/or physical abuse, threats, intimidation, harassment, coercion and/or other conduct which threatens or endangers the health or safety of any person.
    4. Attempted or actual theft or receipt of stolen property and/or damage to property of the School of Medicine or University community or other personal or public property.
    5. Failure to comply with directions of School of Medicine Security, ECU Security personnel, or law enforcement officers acting in performance of their duties.
    6. Unauthorized possession, duplication, or use of keys to any School of Medicine/University premises or unauthorized entry to or use of School of Medicine/University premises.
    7. Violation of published School of Medicine and/or East Carolina University policies, rules or regulations.
    8. Violation of federal, state, or local law.
    9. Illegal use, possession, manufacture, sale, or distribution of narcotic or other controlled substances.
    10. Independently writing and signing a prescription for any medication without a medical license or without authorization.
    11. Use, possession, or distribution of alcoholic beverages except as expressly permitted by the law and University regulations.
    12. Illegal or unauthorized possession of firearms, explosives, other weapons, or dangerous chemicals on School of Medicine or University premises.
    13. Conduct which is disorderly, lewd, or indecent; or conduct or disruptive language directed toward and offensive to a member of or a visitor to the School of Medicine community; breach of peace; or aiding, abetting, or procuring another person to breach the peace on School of Medicine premises or at functions sponsored by, or participated in by, the School of Medicine.
    14. Theft or other abuse of computer time, including but not limited to:
      1. Unauthorized entry into a file, to use, read or change the contents, or for any other purpose.
      2. Unauthorized transfer of a file.
      3. Unauthorized use of another individual’s identification and password.
      4. Use of computing facilities to interfere with the work of another student, faculty member, or School of Medicine official.
      5. Use of computing facilities to send obscene or abusive messages.
      6. Use of computing facilities to interfere with normal operation of the School of Medicine computing system.
      7. Use of University owned device to view or store pornography.
    15. Abuse of implementation of official BSOM conduct or academic procedures, including but not limited to:
      1. Failure to obey the summons to present information as a witness of a Professional Conduct Committee or School of Medicine official.
      2. Falsification, distortion, or misrepresentation of information before a Professional Conduct Committee, Review and Promotion Committee, or Academic Appeals Committee.
      3. Disruption or interference with the orderly conduct of a Professional Conduct Committee, Review and Promotion Committee, or Academic Appeals Committee proceeding.
      4. Filing of a charge against a student knowingly without cause.
      5. Attempting to discourage an individual’s proper participation in, or use of, the ECU Student Conduct Process, BSOM Standards or other applicable University policy.
      6. Attempting to influence the impartiality of a member of a Professional Conduct Committee, Review and Promotion Committee, or Academic Appeals Committee prior to, and/or during the course of, the proceeding.
      7. Harassment (verbal or physical) and/or intimidation of a member of a Professional Conduct Committee, Review and Promotion Committee, or Academic Appeals Committee prior to, during, and/or after a proceeding.
      8. Failure to comply with the sanction(s) imposed under the Code of Student Conduct.

    All students will endorse and pledge to abide by the principles included in these BSOM Standards at the beginning of their education at the Brody School of Medicine during yearly orientations and anytime the BSOM Standards are revised. The affirmation will be in writing or electronically and will express the individual’s commitment to ethical and professional behavior.

    The Brody School of Medicine reserves the right to investigate instances of unacceptable behavior, even after a student or resident has graduated, if such acts contributed to the fulfillment of graduation requirements and were not evident prior to graduation. In such instances, sanctions could potentially include rescinding the degree or certificate. The BSOM also reserves the right to report information regarding violations of former students to any state licensing board where the former student has applied for or received a license.IV. Reporting and Initial Review of Perceived Violations

    A student who has been arrested or charged with any offense other than a minor parking or minor traffic violation must self-report in writing to the Associate Deans for Student Affairs as soon as possible but in any event within five (5) business days of the arrest or charge. Such matters will be addressed as alleged violations of the BSOM Standards.
    A student, faculty, or staff member (the “Complainant”) who has reason to believe that a violation of the BSOM Standards has occurred are strongly encouraged to report the violation. The report must be in writing and submitted to the Associate Deans for Student Affairs within a reasonable time frame. The report of a perceived violation must be in the form of a dated, signed letter, and should include:

    • The name(s) of the student(s) accused of a violation (the “Respondent(s)”) involved; and,
    • Names of additional individuals who may have witnessed what occurred, if applicable; and,
    • Names of individuals who may be able to provide information that may be pertinent to the complaint.
    • A description of the perceived violation.

    If the reported violation involves a student, the Associate Dean for Student Affairs will conduct an investigation to determine whether the alleged infraction has merit and/or whether it can be addressed administratively by mutual consent of the parties involved, in a manner acceptable to the Associate Deans for Student Affairs. If the matter can be addressed by mutual consent of all parties, such disposition shall be final and there shall be no subsequent proceedings. Administrative resolution cannot be considered in instances where there is a criminal matter, or when the Respondent has a previous violation of the BSOM Standards.

    If the matter cannot be addressed by mutual consent, the Associate Deans for Student Affairs, will determine whether the matter should be referred to an ad hoc Conduct Committee (the “Committee”) for review and potential action (i.e., a hearing). Academic integrity violations must be addressed in accordance with University Regulation on Academic Integrity but additional sanctions may imposed by the BSOM in accordance with these BSOM Standards.

    V. Interim Suspension

    When the OSRR is conducting an investigation in accordance with the Student Conduct Process (https://www.ecu.edu/prr/11/30/01) the OSRR may impose an interim suspension from the BSOM, and/or clinics prior to the OSRR’s inquiry due to, but not limited to, the following:

    • To ensure the safety and well-being of members of the Brody School of Medicine or the ECU community, or the preservation of Brody School of Medicine or ECU property; or,
    • To ensure the student’s own physical or emotional safety and well-being; or,
    • If the student poses a threat of disruption or interference with the normal operations of the Brody School of Medicine.

    In addition to the above, in the sole discretion of the Senior Associate Dean for Academic Affairs, they may limit a Respondent’s access to any class or part of the BSOM curriculum, and/or clinical sites, prior to the OSRR’s or BSOM’s hearing. The Senior Associate Dean for Academic Affairs may limit access to the BSOM curriculum or clinical sites even when OSRR does not implement interim suspension in accordance with the Student Conduct Process. This may occur due to, but not limited to, the following:

    • Unsafe treatment of a patient, including, but not limited to, treating patients under the influence of any substance
    • Inappropriate treatment of a patient
    • HIPAA violations

    During the interim suspension the Respondent may be denied access to Brody School of Medicine classes or other activities and privileges for which the Respondent would otherwise be eligible. Respondents who are placed on an interim suspension may appeal OSRR implemented interim suspension to the ECU Dean of Students and BSOM implemented interim suspension to the Executive Dean of the Brody School of Medicine. In the event that OSRR and/or the Committee does not find the Respondent responsible for a violation of the ECU Code or BSOM Standards, all information related to the interim suspension will be removed from the student’s official record.

    VI. Professional Conduct Committee

    The charge to the Professional Conduct Committee is:

    • To uphold the professional standards of personal, academic, and professional behavior expected of Brody School of Medicine students.
    • To review reported violations of the BSOM Standards and determine whether a violation has occurred.
    • To recommend appropriate sanctions in instances where a violation has occurred.

    A Professional Conduct Committee or Appellate Board (“Board”) shall be composed of six members representative of the Brody School of Medicine community. Three student members and three faculty members shall be selected by the Executive Dean of the Brody School of Medicine to hear a particular case. There must be at least one MD/DO faculty representative and one PhD faculty representative on a Professional Conduct Committee or Appellate Board. All members of a Professional Conduct Committee or Appellate Board must be present in person for a scheduled hearing.

    A chairperson shall be selected by the members of the Professional Conduct Committee prior to the beginning of the review process and must be a faculty member. The chair shall rule on what information can be introduced and on all questions of procedure. All decisions of the chair are final.

    The Deans for Student Affairs shall be ex-officio, non-voting members of each Professional Conduct Committee and shall provide administrative assistance for the implementation of the procedural rules for the conduct of hearings.

    Respondent Notification: The Associate Deans for Student Affairs shall notify the Respondent in writing of the following: the alleged infraction; the date and the time set for the hearing; the right to a fair hearing; and the right to have a legal or non-legal advisor present during the process. The advisor may be present but may not actively participate in the hearing nor speak on behalf of the Respondent. If an attorney is present, they may advise the Respondent to remain silent and may remind the Respondent that all statements may be admissible in any related criminal proceedings. If a student chooses not to have an attorney present, they will sign a waiver stating they were made aware of their right to have an attorney present.

    The Respondent has the right to review all evidence; the right to provide a written response to the allegations(s); and the right to appeal any Committee recommendation to the Executive Dean. The Associate Deans will notify the Executive Dean that the Committee will convene for a hearing but will not provide any additional details about the alleged violation(s). The Committee shall convene the hearing as soon as practicable, but not less than 10 business from the date of the Respondent notification.

    The Associate Deans for Student Affairs will notify the Respondent of the members of the Committee. If no conflict of interest is identified by the Respondent, the name of the Respondent will be given to the Committee members who will notify the Associate Deans of Student Affairs if they need to recuse themselves from the hearing. If the Respondent challenges a potential Committee member based on a conflict of interest or bias, the Associate Dean for Student Affairs will make a decision regarding the challenge as soon as possible but in any event within 5 calendar days. Committee members will be impartial, and any member who lacks impartiality must recuse themselves from the proceedings at the time the Respondent’s name is provided.

    Hearing Procedures: The Chair of the Professional Conduct Committee will conduct the hearing, consulting with the Associate Deans for Student Affairs as needed. Confidentiality of the proceedings will be always maintained and in compliance with FERPA. The Complainant and the Respondent each have the right to be assisted by an advisor at their own expense. If the Respondent’s advisor is an attorney, the attorney may be present but may not actively participate. The attorney is not permitted to ask questions or present information. In all cases, the advisor may not speak on behalf of the individual represented or address the Committee.

    The Committee may accept pertinent records, exhibits and written statements, provided by the Complainant or the Respondent. These materials must be provided to the Associate Deans of Student Affairs at least five (5) business days in advance of the hearing.

    The Respondent has the right to appear at the hearing, to make formal statements on their own behalf, to present and/or cross examine witnesses, and to examine evidence. The Committee has the right to question witnesses. All procedural questions are subject to the final decision of the Chair of the Committee, in consultation with the Associate Deans for Student Affairs.

    There will be a single verbatim record (e.g., an audio recording) of the Committee hearing. Committee deliberations will not be audio-recorded. The recording and all official written materials presented at the hearing shall be maintained by the Brody School of Medicine in the Office of Students Affairs and are governed by the same confidentiality and file retention policies applicable to other educational records in accordance with FERPA and the University’s FERPA policy (POL02.40.01) https://www.ecu.edu/prr/02/40/01. The Respondent may, upon request, receive a copy of the written transcript of the hearing proceedings. Recording quality problems and/or malfunctions will not invalidate or nullify the decision of the Committee.

    Committee Deliberations and Report to the Executive Dean: After the hearing, the Committee will deliberate to determine whether a violation of the BSOM Standards has occurred. Neither the Respondent, nor the Complainant, nor any witnesses may be present during Committee deliberations. The Committee’s determination shall be on the basis that the preponderance of evidence (which is the same as the “greater weight of the evidence”) presented supports the conclusion that the Respondent violated the BSOM Standards. In order to determine that the Respondent has violated the BSOM Standards, a simple majority vote is required.

    If the Committee determines that a violation of the BSOM Standards has not occurred, the Committee will present its findings and conclusions in writing to the Executive Dean. The Associate Deans for Student Affairs will keep a copy of the findings, but they will not be retained in the Respondent’s official records.

    If the Committee determines that a violation of the BSOM Standards has occurred, the Committee will present its findings, conclusions, and recommendations for sanction(s) in writing to the Respondent within five (5) business days. If the Respondent does not appeal these findings and recommendations (see section IX below), the Committee will send them to the Executive Dean for consideration and final disposition of the case.

    The Committee may recommend one or more sanctions as follows:

    1. Warning – a notice in writing to the student that the student is violating or has violated institutional regulations.
    2. Probation – A written reprimand for violation of specified regulations. Probation is for a designated time period and includes the probability of more severe academic sanctions if the student is found to violate any institutional regulation(s) during the probationary period. If applicable, the Committee may specify conditions that would apply to the student during the probation period.
    3. Restitution – Compensation for loss, damage, or injury. This may take the form of appropriate service and/or monetary or material replacement. When determining restitution, the Committee shall consider any order for restitution arising from civil proceedings.
    4. BSOM Suspension – Separation of the student from the BSOM for a definite time period, after which the student is eligible to return. Conditions for re-enrollment may be specified.
    5. BSOM Dismissal – Permanent separation of the student from the BSOM and removal of all rights and privileges. If the circumstances warrant for the student’s own emotional well-being, the Committee may make a specific recommendation that a student be allowed to access counseling services through the BSOM during the period of suspension or for a defined time period following expulsion.

    A student found to have committed a second violation of the BSOM Standards, or failed to comply with previously imposed sanctions, may be subject to more serious sanctions, up to and including dismissal from the Brody School of Medicine.

    The Committee may also make recommendations to the Executive Dean or BSOM administrators regarding changes to policy or practices separate from its findings and/or recommendations regarding the Respondent.

    VII. The Executive Dean’s Review and Respondent Notification

    Finding of No Violation: The Executive Dean will review the letter from the Committee, and as referenced below, may not change the finding of no violation. The Executive Dean shall then issue a final letter to the Respondent noting a finding a no violation.

    Finding of Violation: The Executive Dean will review the letter from the Committee, and at the Executive Dean’s discretion, may meet with members of the Committee and/or the Respondent. The Executive Dean may not change the finding of the Professional Conduct Committee but may decide to implement sanction(s) other than those recommended by the Committee.

    Within five (5) business days of receipt of the Committee’s letter, the Executive Dean will notify the Respondent, the Committee, the Associate Deans for Student Affairs, and the OSRR (if previously involved) of the final disposition of the case.

    VIII. Due Process Protections for Students

    The Respondent may elect to participate, or not to participate, in the hearing. No Respondent may be found to have violated the BSOM Standards simply because the Respondent failed to appear or chose to remain silent before the Committee considering the Respondent’s case. In all cases, the evidence in support of the charges shall be presented and considered.

    All students shall have the right to: a fair hearing; the presumption of innocence until found responsible; know the information in support of a violation; face and cross examine witnesses testifying against them; and such advice and assistance in his or her own defense as may be allowable as noted above.

    Sanctions will remain part of the student’s confidential academic record during the time of enrollment at the Brody School of Medicine. At the time of the student’s graduation, upon written application by the student/resident to the Associate Deans for Student Affairs and subsequent approval by the Dean, the Brody School of Medicine may expunge the student’s confidential record of sanctions other than suspension or dismissal. Cases involving the imposition of sanctions other than suspension or dismissal shall be expunged from the student’s confidential record five years after final disposition of the case, unless the Professional Conduct Committee has specifically made this confidential file a part of the student’s permanent record.

    IX. Appeal Process

    The Respondent may appeal a Committee recommendation of an adverse decision and action, provided that they can demonstrate there was (1) a violation of due process, (2) that there is additional, compelling information sufficient to alter the outcome that was not readily available at the time of the hearing, or (3) that 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 appeal must be submitted to the Associate Deans of Student Affairs, in writing, within five (5) business days of receiving the Committee recommendation, and must clearly delineate the specific basis for the appeal. The Senior Associate Dean for Academic Affairs will have final decision-making authority to determine if the appeal is granted, based on the information presented by the respondent.

    Claims of Violation of Due Process
    After a student properly makes a timely appeal, an ad hoc Appellate Board (“Board”) will be convened. The Board shall exclude any members of the original Committee. The Executive Dean has the discretion to determine whether sanctions or other interim restrictions should be imposed while an appeal is in process. The Board shall convene the appeal as soon as practicable.

    The Board will follow the same hearing guidelines and following due deliberations, will make a determination regarding whether there was a violation of due process. The Board will submit a written recommendation to the Executive Dean within five (5) business days of the hearing. Any recommendation of the Board should be limited to addressing a violation of due process. The Executive Dean will consider this recommendation in addition to the recommendation from the original Committee in making their final determination.

    Claims of Additional, Compelling Information
    In the event of a request for an appeal due to additional, compelling information that was not readily available at the time of the hearing, the Associate Deans for Student Affairs will reconvene the original Committee to review the new information. The Executive Dean has the discretion to determine whether sanctions or other interim restrictions should be imposed while an appeal is in process. The Committee shall convene the appeal as soon as practicable.

    If any original Committee member is unable to participate in the appeal, the Associate Deans of Student Affairs shall appoint a similar substitute (e.g., a student would replace a student) to the Board.

    The reconvened Committee will follow the same hearing guidelines and following due deliberations, will make a determination regarding whether this new information is sufficient to alter findings. The Board will submit a written recommendation to the Executive Dean within five (5) business days of the hearing. The Executive Dean will consider this recommendation in addition to the recommendation from the original Committee in making their final determination.

    Claims that the Determination and/or Sanctions were Arbitrary or Capricious
    After a student properly makes a timely appeal, an ad hoc Appellate Board (“Board”) will be convened. The Board shall exclude any members of the original Committee. The Executive Dean has the discretion to determine whether sanctions or other interim restrictions should be imposed while an appeal is in process. The Board shall convene the appeal as soon as practicable.

    The Board will follow the same hearing guidelines and following due deliberations, will make a determination regarding whether the Committee’s determination and/or sanctions were arbitrary or capricious. The Board will submit a written recommendation to the Executive Dean within five (5) business days of the hearing. The Executive Dean will consider this recommendation in addition to the recommendation from the original Committee in making their final determination.