Policies and Procedures for Evaluation, Grading, and Promotion of Boston University School of Medicine MD Students

Boston University School of Medicine (BUSM) is committed to high academic and professional standards for its curriculum, faculty, and students. These policies and procedures are designed to guide students in achieving their educational goals.

Three Curricular Pathways are available to students. In addition to the standard four-year curriculum, two alternatives are available for students who seek additional time to pursue other interests in addition to their medical studies or to reinforce particular aspects of their medical education.

Students must complete the MD program (or MD component, if enrolled in a dual degree program) in no more than six (6) years. Exceptions must be approved by the Student Evaluation and Promotions Committee (SEPC).

1.1 Standard Curriculum:

The Standard Curriculum leads to the completion of the MD degree in four (4) consecutive years following matriculation into BUSM.

1.2 Modified Curriculum:

A BUSM 3 or 4 student in good academic standing may apply for a Modified Curriculum for research, internships, clinical experiences, additional educational opportunities, or personal reasons. In the Modified Curriculum, the curricular year is extended beyond 12 months.

1.3 Decelerated Curriculum:

A student who experiences academic difficulties in the third or fourth curricular years may request, or may be required by the SEPC, to enter the Decelerated Curriculum. The remaining courses of that curricular year will be spread out over an extended period as determined by the SEPC. BUSM 3 and 4 students may enter a Decelerated Curriculum for up to a maximum of 12 additional months. Performance of a student admitted to the Decelerated Curriculum may be reviewed by the SEPC at any of its meetings. All subsequent failures for a student in the Decelerated Curriculum will result in review by the SEPC and may result in dismissal from BUSM.

The Academic Record includes the unabridged documents and electronic images maintained by the Office of the Registrar that reflect the academic history of the student at Boston University.

The student’s Official Transcript documents the student’s participation in the Modified/Decelerated curriculum, transfer into BUSM, interruptions in the student’s progress through the curriculum, and any administrative actions, including Suspension or Dismissal.

2.1 Student Evaluation:

Each department, faculty, or other organized teaching program evaluates students by standards that they determine to be appropriate to their respective courses, and forwards evaluations to the Registrar with a copy to the Associate Dean for Student Affairs.

2.2 Grades and Definition of Grades:

The BUSM grading system is used to report grades for all courses. Evaluation of student performance must be expressed as one of the following grades:

H (Honors) Awarded only for third- and fourth-year clerkships and rotations and indicates that the student’s performance and achievement are outstanding. Consistent performance at this level throughout the curriculum is required for graduation with Academic Honors.

HP (High Pass) Awarded only for third- and fourth-year clerkships and rotations and indicates performance exceeding satisfactory or acceptable performance, but not at the level necessary for Honors.

P (Pass) Indicates an acceptable performance and achievement. Consistent performance at this level throughout the curriculum is expected of a student qualified for promotion and graduation. BUSM students must earn all Pass grades to be eligible for promotion and for graduation.

I (Incomplete): Indicates that work in the course, clerkship, or rotation has not been completed. If a student is unable to complete a course, clerkship, or rotation due to circumstances beyond the student’s control, the student may receive an Incomplete if the student is otherwise in good standing in that course, clerkship, or rotation. The Course Director/Clerkship Director/Rotation Director will provide a plan for the student to complete the course.

When possible, a student must contact the appropriate Course Director or Clerkship/Rotation Director and the Associate Dean for Student Affairs in advance whenever possible to explain any inability to take a scheduled examination or to meet other course obligations. If the Course Director or Clerkship/Rotation Director finds the reason acceptable, e.g., serious illness or a death in the immediate family, arrangements should be made for the student to complete the course requirements as soon as practicable. If the explanation is not acceptable, then the “Incomplete” grade is inappropriate, and a grade of “Fail” (see below) will be awarded.

An Incomplete grade is an internal grade marker and will not appear on the Official Transcript. All Incomplete grades must be remediated within one year of the original start date of the course or clerkship. If not remediated within one year, the Incomplete will be converted to a Fail grade.

W (Withdraw): Assigned as the final grade in any course in which the student withdraws. The grade can be assigned at any time prior to the completion of a course. A student who is assigned a grade of “Withdraw” will be required to retake the course.

F (Fail): Awarded when a student’s work in a course fails to meet the minimum requirements determined by the department or faculty.

Grades for all completed courses will appear on the Official Transcript. All Incomplete and Fail grades must be remediated in order to be eligible for promotion and graduation. Any repeated course will be listed on the transcript and the word “Repeat” will appear next to the course name. Courses in the first two years of the curriculum in which a student receives a grade of Fail, but is able to remediate by re-examination, will appear on the transcript as “Fail/Pass.” A transcript note will be made to designate that the remediation was completed by re-examination.

If a student receives a grade of Fail in a third- or fourth-year clerkship, based on failure of the end of clerkship examination, the student will have the opportunity to remediate the failing grade by re-examination. Upon earning a passing score, the final grade will be recalculated as specified in the course syllabus and will appear on the transcript as a Fail/(Remediated Grade). A transcript note will be made to designate that the remediation was completed by re-examination.

If a student fails a third- or fourth-year clerkship for reasons other than, or in addition to, failure of the end of clerkship examination, the student will receive a Fail grade and will be required to repeat the clerkship. The grade for the repeated clerkship will be calculated based on the grading criteria outlined in the course syllabus for Pass, High Pass, or Honors. The original Fail grade will remain on the transcript.

Grade Reconsideration: The Module, Course, Clerkship, and Rotation Directors determine grades in consultation with the course or clerkship faculty based on the criteria described in the module or clerkship syllabus.

A student who chooses to appeal a grade must follow these procedures:

  • Contact the Registrar to review the grade appeal process. The Registrar will serve as a liaison between the student and department to ensure that all requirements are met.
  • Submit a written grade appeal to the Module, Course, Clerkship, or Rotation Director no more than 15 business days after the date on which the grade is officially recorded in the Registrar’s office.

The Module, Course, Clerkship, or Rotation Director must provide a written decision to the appealing student within 30 calendar days of receipt of the appeal.

BUSM 3 and 4: A student should first contact the Clerkship or Rotation Director with any specific concerns about the clinical evaluation. A student should not contact preceptors directly about grade complaints or reviews before discussing their concerns with the Clerkship or Rotation Director. Preceptors provide recommendations based on observations of the student’s clinical skills but do not provide a final grade for students. A student may request sequential reviews of the appeal in the following order within 10 calendar days of receipt of the appeal.

  1. The relevant course leadership committees (e.g., PrISM [BUSM 1] or DRx Leadership Committee [BUSM 2], Director of Medical Education office [IP or ICM], Chair of the department [EPH, HBM, clerkships]): The leadership committee must provide a written decision to the student within 15 business days of receipt of the appeal.
  2. The Associate Dean for Academic Affairs: The Associate Dean must provide a written decision to the student within 10 business days of receipt of the appeal. The decision of the Associate Dean is final.

A student should file an appeal with the Appropriate Treatment in Medicine (ATM) Committee only if the student contends that a grade was based on discrimination based on the student’s protected class status (i.e., gender, race, sexual orientation, ethnicity).

2.3 Professional Behavior:

Many important facets of a student’s medical training and subsequent professional practice cannot be measured by quantitative examination. Examples include, but are not limited to, personal responsibility, sensitivity and adaptability to the needs of others, and the ability to form effective and respectful working relationships with peers, to cope with stressful situations, and to accept and respond appropriately to constructive criticism, and other attributes.

Professionalism is a component of the student’s overall performance in medical school and may be reported by the faculty, as appropriate. Additional details describing the mechanism for reporting, as well as potential consequences of unprofessional behavior, are available here. If a breach of professional conduct occurs, the Course Director, Clerkship Director, or Rotation Director must meet with the student to provide direct feedback regarding the conduct breach and must work with the student and the Student Affairs office to develop a remediation plan. All reports of deficiencies in professional behavior must be discussed directly with the student. The faculty member may also contact the Associate Dean for Student Affairs if there is an egregious or persistent breach in a student’s professional conduct. The Associate Dean for Student Affairs may refer the matter to the Disciplinary Committee or the SEPC for further action.

The SEPC meets monthly, or as necessary, to assess student readiness for evaluation and promotion for all four years of the MD curriculum. In accordance with BUSM policies and standards, the SEPC:

  • Monitors a student’s entire academic and professional record and performance, and takes appropriate action;
  • Act upon written petitions from students who request a waiver from promotion policies;
  • Reviews any student’s deficient performance and takes appropriate action;
  • Reviews students who may not meet the maximum time for BUSM degree completion;
  • Act on requests for more than one re-examination, including end-of-clerkship exams; and
  • Reviews all medical students with two or more Fail grades in any curricular year.

3.1 Composition:

The Composition of the SEPC is outlined in Article 5, Section G5 of the Boston University School of Medicine Bylaws on Faculty Central. A member of the SEPC who may have a conflict of interest in a particular case, such as having served as the student’s advisor or personal physician, or who is the Director of a Course/Clerkship being discussed, shall be recused from that student’s case.

3.2 Expedited Procedures:

The SEPC Chair, after discussion with the Associate Dean for Student Affairs, may, in place of a formal meeting, email SEPC members to request approval of a student’s petition. SEPC members may approve the petition or request a meeting for resolution. In addition, the Associate Dean for Student Affairs may act on petitions from students who are in good academic standing without previous lapses in professional conduct or previous appearances before the SEPC. Such actions may include approving or denying petitions:

  • for a Leave of Absence (LOA) for personal reasons;
  • for a medical LOA;
  • to enter a Modified curriculum; and
  • to return to the curriculum from a LOA.

3.3 Student-Generated Petitions:

All student petitions must be prepared in consultation with the Associate Dean for Student Affairs (or designee) and must comply with the rules established by the Faculty of Medicine governing evaluation, grading, and promotion. All petitions must be typed, dated, signed, addressed to the SEPC, and received by the Student Affairs office at least three (3) business days before the scheduled meeting, unless an emergency prevents the student from complying with the deadline.

3.4 Procedures:

All students on the SEPC’s agenda will be notified by email of the date, time, and location of the meeting, and will be informed of the right to appear at the meeting and/or to submit a written statement to the SEPC. A student is not required, but is strongly encouraged, to attend the meeting. Within 24 hours of notification, a student must contact the appropriate Student Affairs officer to indicate whether or not the student will attend.

A student who elects to appear before the SEPC may bring a faculty advisor. The advisor may present information to the SEPC, but will not participate in the general discussion about the student. Neither the student nor the advisor may be present during discussion, deliberation, or voting on the petition or performance issues. Attorneys are not permitted to attend SEPC meetings.

Records and other documents relating to a student on the SEPC’s meeting agenda are available to Committee members prior to or at the meeting. Upon request, the student will have the opportunity to review in advance all documents to be submitted to the Committee. The student should have the opportunity to discuss adverse reports or evaluations with the appropriate Course Director or Clerkship/Rotation Director before the SEPC acts on any reports or evaluations.

SEPC decisions are based upon the student’s entire academic record and disciplinary record, if any, at the time of the meeting. SEPC actions may include, but are not limited to, requiring a Repeat Year, mandating that the student enter a Decelerated Curriculum or take a LOA, placing the student on probation, suspending the student, or dismissing the student from BUSM.

The Chair will communicate the SEPC’s decision to the student in writing, ordinarily within 10 business days.

3.5 Disciplinary Proceedings Reports to the SEPC:

When a student in the MD or any of the combined MD programs has been found responsible for violating any disciplinary code of academic or professional conduct of the University, the SEPC shall be notified of the final decision. The SEPC may review the final decision and the student’s complete academic record and may determine if other action is appropriate.

3.6 Committee Records Retention:

Records of all SEPC meetings, as well as meetings of the Committee on Appeals, will be kept for six (6) years after the graduation or separation of the students on the agenda.

4.1 Composition:

The composition of the Committee on Appeals is outlined in Article 5, Section G7 of the Boston University School of Medicine Bylaws on Faculty Central. A committee member who may have a conflict of interest in a particular case, such as having served as the student’s advisor or personal physician, or who is the director of a course/clerkship being discussed, shall be recused from that student’s case.

4.2 Procedures:

Appeals must be submitted in writing within ten (10) business days after a student receives written notice of a SEPC decision. The Associate Dean for Student Affairs may grant an extension of the filing deadline if requested within the 10-day period. The Committee on Appeals will hear any appeal of a SEPC decision and take such action as it finds appropriate with respect to the original decision.

Students may elect to appear before the Committee on Appeals alone or accompanied by a faculty advisor. The advisor may present information to the committee but will not participate in the general discussion about the student. Neither the student nor the advisor may be present during discussion, deliberation, or voting on the appeal. Attorneys are not permitted to attend meetings of the Committee on Appeals.

The Committee on Appeals may grant or deny a student’s appeal, or may modify the SEPC’s decision.

The recommendations of the Committee on Appeals should comply with the Policies and Procedures for Evaluation, Grading, and Promotion of Boston University School of Medicine MD Students.

A student whose academic progress is interrupted by a decision of the SEPC, or who appeals the SEPC’s decision, is not permitted to register for or participate in courses, clerkships, or rotations while an appeal is pending.

The Chair of the Committee on Appeals will communicate the Committee’s decision to the student in writing, ordinarily within ten (10) business days.

The Committee on Appeals will report all decisions to the Dean of the School of Medicine.

4.3 Additional Appeals:

A student may submit a written appeal to the Dean of the School of Medicine within ten (10) business days after receipt of the written decision of the Committee on Appeals. The Dean may affirm, modify, or reverse the decision, or remand matters to the Committee on Appeals or the SEPC for reconsideration, and will communicate the decision and rationale to the student in writing. The student may, within ten (10) business days of receipt of the Dean’s decision, submit a written appeal to the Provost of Boston University Medical Campus. In addition, the student may, within ten (10) business days of receipt of the Provost’s decision, submit a written appeal to the Boston University Provost.

The appeal to the Boston University Provost is the final appeal.

5.1 Qualifications for Promotion:

To be promoted to the next curricular year, medical students must meet all requirements of the current curricular year and satisfactorily adhere to all University standards. A student’s academic and professional performances are both subject to evaluation.

Students in “good academic standing” perform at a passing level in all courses and their overall progress renders them eligible for promotion. Students who are not in good academic standing include those who:

  • Fail any courses/clerkships;
  • Are on probation; or
  • Are suspended.

Students are expected to be honest, conscientious, respectful, and reliable in carrying out their assignments. Their behavior toward colleagues, faculty, staff, patients, and others with whom they interact in their roles as medical students is expected to be appropriate, reasonable, and considerate—consistent with medical professional standards.

5.2 Failure to Qualify for Promotion:

The SEPC may, at any of its meetings, review the record of any student who fails to qualify for continuation within the curriculum, or for promotion from year to year, and take appropriate action. A student who fails any remediation exam must repeat that course and may be placed on Probation.

5.3 Repeat Year:

A student with two or more Fail grades in a single academic year may be required to repeat all or a portion of the academic year and may be placed on Probation. A student will be allowed to repeat only one of the four curricular years. Any Fail grade during or following a repeated curricular year will put the student at risk for Dismissal.

5.4 Probation:

A student with two or more Fail grades in a single academic year may be placed on Probation. Upon remediation of all Fail grades, the student may petition the SEPC to be removed from Probation. Any future Fail grade, puts the student at risk for dismissal. The SEPC may also place a student on Probation if the student’s academic performance or professional conduct fails to meet BUSM standards.

A student on Probation continues in the curriculum, but is monitored by the Student Affairs office and is required to meet the standards and remediation requirements, as determined by the SEPC. Failure to meet these standards may lead to additional action by the SEPC, up to and including dismissal from BUSM.

Probation is not noted on the student’s transcript, but at the discretion of the Associate Dean for Student Affairs, may be included in the student’s Medical Student Performance Evaluation. Any periods of Probation will be noted on the student’s Academic Record and will be available to appropriate external professional organizations that request such information, including, but not limited to, state medical registration boards.

5.5 Suspension:

The SEPC or Committee on Appeals may suspend a student whose performance is especially deficient or egregious. Any student who is suspended will be notified in writing within ten (10) business days of the date of the Suspension. The notification will include the length of the Suspension and outline any requirements for the student’s return to the curriculum. A Suspension will be noted on the student’s transcript and on the student’s academic record.

Suspended students are required to comply with the requirements of the SEPC or Committee on Appeals. Suspended students are prohibited from participating in the curriculum are not permitted to avail themselves of any Boston University services on any Boston University campus, and are required to turn in all BUSM and Boston University property, including, but not limited to, identification cards.

5.6 Dismissal:

BUSM reserves the right to dismiss any student, including a student on a LOA, for failure to maintain a satisfactory academic record, including acceptable professional behavior. A student who is dismissed from BUSM is not permitted to continue with courses, clerkships, or rotations, or to register for future courses, clerkships, or rotations while an appeal of the Dismissal decision is pending. Grounds for Dismissal from BUSM include, but are not limited to:

  • Failure to comply with decisions of the SEPC or the Committee on Appeals.
  • Three or more Fail final grades within a curricular year.
  • After reexamination, any Fail grade within the same curricular year.
  • Failure to pass USMLE Step 1 after three attempts.

Dismissed students are required to turn in all BUSM and Boston University property, including, but not limited to, identification cards.

A Leave of Absence (LOA) is defined as one semester or more away from the curriculum. Absences of less than a semester are defined and addressed in 6.3, below.

Students are required to complete the medical school curriculum within a maximum of six (6) years. The SEPC must approve any exception to this requirement.

A student may petition the SEPC for a LOA for academic, personal, financial, administrative, or non-urgent medical reasons. A petition for a LOA should be prepared in consultation with the Associate Dean for Student Affairs or designee and must articulate the reasons for the requested LOA.

If a student initiates a LOA before the completion of a course or clerkship, the student will receive a grade of Withdraw. A student on an approved LOA is a matriculated student; however, that student is not registered for any courses in the School of Medicine curriculum. The SEPC may impose academic conditions relating to any LOA. All LOAs count toward the required six-year period to complete the BUSM curriculum.

6.1 Medical LOAs:

6.1.1 Student-Initiated Medical LOA:

A student’s petition for a medical LOA should include:

  • A letter from the student’s treating health care professional documenting that a medical leave is necessary and its likely duration.
  • Any plans the student has to address any current academic difficulties or those that might result from an extended period away from the curriculum.

6.1.2 School-Initiated Medical LOA:

If the Associate Dean for Student Affairs has evidence that a BUSM student may be a danger to themselves or to others, or is not fit to perform functions required of a medical student in non-clinical, clinical, or laboratory settings, the Associate Dean may act, either in accordance with the following guidelines or, immediately, under the Student Disciplinary Code of Academic and Professional Conduct, as appropriate under the circumstances.

The Associate Dean will meet with the student, inform the student of the nature of the fitness concerns, and provide the student with an opportunity to respond.

The Associate Dean will require the student to come before the SEPC, which may take the following action:

  • Temporarily suspend the student from participating in all or part of the BUSM program, if deemed warranted to protect the safety and well being of the student and others in the University community, including BUSM’s affiliates.
  • Require the student to provide satisfactory evidence of fitness, which may include the results of a medical evaluation of fitness by the student’s treating medical provider or by the Physician Health Services of the Massachusetts Medical Society to determine whether the student can perform safely and reliably. The student must consent to allow their medical provider to provide relevant medical information to a physician or psychotherapist designated by BUSM to advise the Associate Dean and the SEPC.

If the circumstances suggest that the student is unfit, the SEPC may, as appropriate based on the facts, ask the student to:

  • Take a LOA for a specified duration.
  • Receive treatment as appropriate during the LOA.
  • Enter a treatment program and monitoring program, (e.g., Physician Health Services).
  • Withdraw from the School of Medicine if remediation of unfitness is unavailable as an option, or has been reasonably tried without success.

If, at any time, the student refuses or materially fails to comply with a request made by the Associate Dean for Student Affairs in conformity with this Section of the policy, the Associate Dean may proceed under the Student Disciplinary Code of Academic and Professional Conduct. The student will have the rights of hearing and appeal provided under that Code.

If the student agrees to take a LOA at the request of the Associate Dean and/or to enter a treatment or monitoring program, then the Associate Dean for Student Affairs, in conjunction with the SEPC and/or with Physician Health Services, may require continued medical monitoring and reporting to the Associate Dean as a condition of re-entering the curriculum. In addition, if the student has been or will be out of the curriculum for a significant period of time, the SEPC will establish any necessary academic requirements for return to the curriculum.

Continued or repeated noncompliance with monitoring required in accordance with this policy or continued or repeated lack of medical fitness may lead to a determination by the Associate Dean, in conjunction with the SEPC and/or the Physician Health Services, that underlying causes of unfitness cannot be remediated. The Associate Dean may then recommend to the SEPC that the student be suspended or dismissed from the curriculum for repeated lack of fitness. If a student requests an accommodation for a disability, the student’s request will be evaluated in consultation with the Boston University Disability Services office and the Dean of the School of Medicine.

When requesting to return from a medical LOA, the student must be evaluated by BU’s Student Health Services (SHS). All students returning from a medical LOA (including those related to mental health) must begin the return process by submitting the paperwork entitled “Return from LOA”, accessible at the Student Health Services website.

SHS may either determine that a student has been satisfactorily reviewed, and thus able to return to the curriculum, or may deem “further review requiredand refer a student to Physician Health Services prior to allowing the student to re-enter the medical curriculum. Students reviewed by SHS will receive a letter from SHS outlining its assessment. Medical details are not shared with the SEPC members, except by the student or at the student’s request. Confidentiality of the student’s medical information will be protected to the extent possible, consistent with the needs of the University.

6.2 Other LOAs:

A student’s petition must include the reason for requesting a non-medical LOA and the expected duration of the LOA, and should describe the student’s plan to address any current academic difficulties or those that might result from an extended period away from the curriculum.

The Associate Dean for Student Affairs may approve a LOA for a student in good academic standing and will notify the SEPC Chair of any LOA approval. A petition for a non-medical LOA from a student who is not in good academic standing must be submitted to the SEPC for review, unless the SEPC Chair authorizes the Associate Dean for Student Affairs to act on the student’s petition.

6.3 Excused Absences:

A request for an excused absence of less than one semester is not considered a request for a LOA. The Associate Dean for Student Affairs may grant emergency absences from the curriculum and will notify the SEPC Chair and the appropriate Course/Clerkship directors. The SEPC may bring a student who is not in good academic standing, or with more than one emergency absence, before the Committee for further discussion at any time.

Delays in the curriculum for USMLE Step 1: The Associate Dean for Student Affairs, after consultation with the Office of Academic Enhancement, may permit a student to delay taking the Step 1 exam. A student in this position may be permitted to delay the first block of third year to continue USMLE Step 1 preparation. This action will be reported to the SEPC. A student who needs or requests more than one block for board exam preparation must file a petition with the SEPC. A student who fails the USMLE Step 1 must meet with a Dean in the Student Affairs office to develop a plan to retake Step 1, and may not begin the next third-year block until Step 1 has been retaken.

6.4 Petition for Return from a LOA:

For reinstatement to the curriculum after a LOA, a student must file a written petition with the SEPC. The Associate Dean for Student Affairs may approve routine petitions to return to the curriculum for students in good academic standing. The SEPC must review petitions from a student whose absence was related to academic or professionalism issues.

6.5 Two-Year Limit on Absences from Curriculum: 

The maximum time allowable for completion of the medical degree is six (6) years. Time taken for LOAs (whether a single leave or multiple leaves) counts toward the six-year period. The SEPC may allow exceptions under rare and unusual circumstances.

6.6 Withdrawal:

A student who seeks to leave BUSM permanently should prepare a request to withdraw in consultation with the Associate Dean for Student Affairs. The withdrawal is effective on the date the completed Withdrawal Form is received by the Office of the Registrar.

To facilitate communication concerning student performance, BUSM employs the following means of communication:

7.1 Administration-Student Communication:

This communication is by Boston University email. All students are expected to maintain and regularly access their BU email accounts. Checking email, at least daily, is strongly recommended.

In addition, Boston University requires students to provide a local street address, telephone number, email address, emergency contact, and cell phone, using the Student Link. Failure to maintain current contact information may result in disciplinary action.

7.2 Family Educational Rights and Privacy Act:

All access to information within student records is governed by the policies of the University Registrar in compliance with the Family Educational Rights and Privacy Act (FERPA).

8.1 First- and Second-Year Students

8.11 Qualitative Evaluations:

Qualitative evaluations of First- and Second-Year students that raise concerns to the Associate Dean for Student Affairs or Associate Dean for Academic Affairs may result in review of a student’s record by the SEPC for possible action, up to and including Suspension and Dismissal.

8.12 Final Course and Clerkship Grades:

A student will not be promoted with any Fail, Withdraw, or Incomplete grades in required courses. A student will be subject to Dismissal from BUSM for:

  • Two or more Fail grades within one academic year.
  • After re-examination, any Fail grade within one academic year.

8.13 Remediation of Course Grades by Re-Examination:

A single round of re-examinations will be administered before the start of the second or third curricular years at a time selected and coordinated by the Academic Affairs office and the Course Directors. A student with two or more Fail grades must petition the SEPC for permission to remediate the courses.

8.14 Repeating the First or Second Curricular Year:

The SEPC will require any student repeating the first or second curricular years to retake all courses in which the student received a Fail grade. To be eligible for promotion, a student must earn a grade of Pass in each repeated course after remediation. Students shall not be permitted to take a remediation examination for repeated courses. A student may not repeat the first or second curricular year more than once. A student who repeats the first curricular year may not repeat any subsequent curricular years, although the student may be allowed to petition the SEPC to enter a modified or decelerated curriculum in the third or fourth year.

8.15 USMLE Step 1:

Each student must pass the USMLE Step 1 examination to be promoted to the fourth curricular year. A student who fails USMLE Step 1 for the first time may finish the current rotation. The student’s course of study will stop until Step 1 has been re-taken, after which, the student may re-enter the curriculum. If the student fails Step 1 a second time, the student must leave the curriculum and may not re-enter until the student passes Step 1. If a student fails USMLE Step 1 three times, the SEPC may dismiss the student.

8.2 Evaluation and Grading of Student Performance in the Third and Fourth Year

8.21 Third-Year Requirements:

All BUSM 2 students must take USMLE Step 1 prior to the first day of the third-year Orientation in order to begin the third year.

The third-year Orientation provides an introduction to basic ward procedures, clinical skills training. Prior to entering the third-year curriculum and starting clerkships, a student must attend Orientation and complete all compliance obligations, including ensuring that the student’s health records comply with BUSM rules.

The required third-year curriculum includes (1) four-week selective and 7 clerkships (Family Medicine, Internal Medicine, Obstetrics/Gynecology, Pediatrics, Psychiatry, Surgery, and Neurology), which must be taken within the BUSM system.

Any student with one Fail grade in the third year will be reviewed by the SEPC. A student with more than two Fail grades in the clerkships may be placed on probation until the student has remediated the Fail grades, or for any period required by the SEPC.

A student will not be permitted to take any fourth-year rotations until the student has passed all third-year requirements.

USMLE Step 2: Each student must take USMLE Step II, CK & CS by November 1 of the academic year in which the student is graduating. Any student who plans to apply for residency must take the Step II Clinical Skills (CS) and Clinical Knowledge (CK).

A student must have registered and scheduled dates for USMLE Step II:

  • Clinical Skills exam by January 31 of the year prior to the student’s projected graduation
  • Clinical Knowledge exam by May 1 of the year prior to the student’s projected graduation.

8.22 Fourth-Year Requirements:

To graduate, 36 weeks of fourth-year rotations are required, including 12 weeks of required rotations (which includes a 4-week selective) and 24 weeks of electives.

Of the 36 weeks, 20 weeks must be taken within the BUSM system (including the 12 weeks of required rotations); up to 16 weeks may be taken at an outside medical school or hospital.

A student must submit the final fourth-year schedule, signed by the student’s Field-Specific Advisor, to the Office of the Registrar no later than the beginning of Block 11 in BUSM 4.

A student is not permitted to change the fourth-year schedule after Block 18 has commenced.

Three (3) four-week rotations are required in the Fourth Year: Geriatrics, a Sub-internship, and one selective (Ambulatory Medicine or a Surgical Subspecialty), which must be taken within the BUSM system.

Elective Rotations including Research: All electives taken for credit in excess of degree requirements will be recorded with grades on the transcript.

Limit of time in specialties: Credit will be granted for no more than 16 weeks of fourth-year rotations and/or electives in any one specialty. Research electives are included as part of this limit.

A student who plans to take a fourth-year extramural elective under the auspices of another medical school, institution, or organization must follow guidelines required by the Registrar. The student will evaluate the elective upon their return.

The International Health Program Director must approve all International Health rotations, whether arranged through the BUSM International Health Program, or arranged independently by the student. The Director may consult with the appropriate BUSM department as to the suitability of an independently arranged rotation.

Fourth-Year Research Elective for Credit: A student in good academic standing is encouraged to consider a research project within or outside BUSM. A student planning a research project for elective credit must submit all required paperwork at least six weeks before beginning the research project.

Up to eight weeks of fourth-year elective credit may be granted for a research project. (After successful completion of the PhD, an MD/PhD student may be given up to 8 weeks of credit in the fourth year.)

Any additional time spent doing a research project will not be eligible for credit. Research projects conducted outside BUSM will count as an outside elective for credit.

8.23 Method of Evaluation and Recording of Grades:

Grades for all courses, clerkships, rotations, and electives taken for credit by BUSM 3 and 4 students, including those taken in excess of degree requirements, will be recorded on the transcript and will be subject to BUSM promotions guidelines.

8.24 Standards and Requirements for Promotion:

Notwithstanding the final grade assigned for a clinical clerkship or rotation, adverse comments in the performance narrative, or unsatisfactory ratings in any portion of a student’s final evaluation, may result in review of a student’s entire record of academic and professional performance by the SEPC, which will then take appropriate action.

BUSM 4 students are ineligible to graduate with any Failing, Withdraw, or Incomplete grades in any clerkship, rotation, or elective taken during the third and fourth curricular years.

8.25 Remediation of a Fail Grade:

A student must remediate any Fail grade in a clinical clerkship, rotation, or elective, according to the requirements established by the clerkship, rotation, or elective at a clerkship or rotation site within the BUSM system approved by the Clerkship or Rotation Director.

  • Remediation of a Fail grade in any clinical clerkship, rotation, or elective should not be allowed to compromise a student’s efforts in any other course or rotation being taken for academic credit.
  • No student will be allowed to repeat any clerkship, rotation, or elective more than once without SEPC approval.

Timing of Third-Year Grade Remediation: All third-year Fail and Incomplete grades must be remediated before a student is eligible for promotion to the fourth year. A student must remediate all third-year grades at the beginning of the fourth curricular year at the earliest possible date, depending on availability.

8.26 Serious Issues Identified During a Clinical Clerkship or Rotation:

Clerkship or Rotation Directors must deal directly with any students who experience academic difficulty or lapses in professionalism, and must consult with the Associate Dean of Student Affairs or designee to resolve the issue or develop a remedial plan.

If necessary, the Clerkship or Rotation Director may temporarily remove the student from the clerkship or rotation and notify the Associate Dean for Student Affairs. The Clerkship or Rotation Director will submit a written report assessing the performance of the student during the clerkship or rotation and the reasons for removal to the Associate Dean for Student Affairs, who will determine what additional actions, if any, are required. The Disciplinary Committee or the SEPC will then meet to examine the issue and recommend appropriate intervention or action, based upon the student’s entire academic record of academic and behavioral performance. The student may not continue any clerkship or rotation until the final decision of the SEPC or the Disciplinary Code Committee is rendered.

Approved by the BUSM Executive Committee on May 25, 2017