VCOM Student Policies and Procedures Handbook

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Academic Policies and Procedures

Grading Policies, Academic Progress, and Graduation Requirements.

VCOM students are evaluated for promotion and graduation based on core competencies consistent with osteopathic core competencies required at the medical student level. The competencies include communication skills, problem solving skills, clinical skills in patient care, osteopathic philosophy and manipulation, medical knowledge, and professionalism and ethics.   In the first two years of the medical curriculum, examinations are used to test student’s medical knowledge, standardized patient exams are used to test communication, clinical reasoning, differential diagnosis skills, and physical diagnosis skills.  Knowledge of osteopathic philosophy and manipulation is tested through written examinations and OMM practicals. Knowledge regarding professionalism and ethics is tested by examinations.

In the clinical years these same competencies are measured in the application to patient care.  The clinical rotation evaluation form is completed by the observation of the clinical faculty and the student is evaluated on knowledge, clinical decision making and problem solving skills, communication skills, professionalism and ethics, physical diagnosis and problem solving skills, and osteopathic philosophy and manipulative medicine skills.  Additional VCOM values of altruism and skill and empathy in caring for those from underserved  populations are also evaluated.  Medical knowledge is also assessed through post-rotation exams.
Students have end of year testing following the OMS II and OMS III years to assess comprehensive medical knowledge and clinical performance.  Grades are issued and become a part of the permanent record.
In all four years students are assessed as to whether or not they are making academic progress on the basis of their performance of assignments, written and practical examinations, their evaluations in the clinical setting, and their performance on COMSAE.  Students are also evaluated for making academic progress by performance on national osteopathic board examinations.

Students who are not making satisfactory progress are evaluated by the Promotion Board.  The Promotion Board, in the process of determining eligibility for promotion or graduation, may consider the results of the student assessments, attendance, conduct and potential professional attributes in making final determinations.

Grades are recorded on the transcript at the end of each block and the end of each year. Students may request a copy of the transcript free twice per year and it is recommended this be after Blocks 2, 4, 6, and 8.  Students in the OMS III and OMS IV years should request their transcript at the completion of OMS III and OMS IV.

Grading and GPAs

Grading Scale and GPAs OMS 1 & OMS 2
OMS 1, OMS 2			Other Grades
A	90-100	4.0
B+	85-89	3.5	IP	In Progress
B	80-84	3.0		Withdrew
C+	75-79	2.5
C	70-74	2.0	R	Repeat
D	65-69	1.0	Au	Audit
F	<65	0.0
*both traditional grades and clinical modules/exam grades are assigned in OMS 3 and OMS 4 (see below).

Clinical Grading Scale and GPAs
ECE		OMS-III End-of-Rotation Exam Grade			OMS-III AND OMS-IV* Traditional Rotation Grades
P	Pass	A	90-100	4.0	H	Honors
F	Fail	B+	85-89	3.5	HP	High Pass
IP	Incomplete	B	80-84	3.0	P	Pass
		C+	75-79	2.5	U	Fail
		C	70-74	2.0	IP	Incomplete
		F	<70	1.0
		IP	Incomplete	0.0
*both traditional grades and exam grades are assigned in OMS-III

The grade point average (GPA) is the sum of earned grade points divided by the sum of credit hours passed and failed. Students are required to remediate all courses within a block where the student's grade falls below 70 and above 65 (or a D). Students may be required to remediate or complete a curriculum where the student's grade falls in the I (Incomplete) or IP (In Progress) status. Students who do not successfully complete or remediate these courses are awarded an F or failing grade. A student will only be given a C for a remediated course they pass with a grade above 70. 

If a student repeats and entire academic year, depending upon the circumstances repeat courses may be recorded with the grade earned.   In cases where the grade falls within the F range, or there is a failed remediation of a D grade and the student is given an F for failure to successfully remediate, or the student fails to remediate an IP grade within the appropriate time period, the student will be referred to the Promotion Board to determine the appropriate action to be taken. All students with F grades are referred to the Promotion Board.

Campus courses are eligible for the receipt of all traditional grading assignments. For the first two years, most courses have a traditional letter grade (A, B+, B, C+, C, and D, and F) and are calculated into the GPA. Early Clinical Experiences are awarded a pass / unsatisfactory grade.  For the third and fourth years, all rotations have a clinical rotation grade and all core rotations have clinical modules/exam grade. The clinical rotation grade a use the Honors, High Pass, Pass, Fail system; these grades are not calculated in the GPA and the Modules are assigned an exam grade. An example of these grades is:

Clinical Rotation I
Clinical Pediatrics	4 credit hours	High Pass
Pediatrics Modules	1 credit hour	B+

Students must pass both the "module" and "rotation" portions of the course. All rotations on which a student receives a failing rotation grade must be repeated. The grade earned on the repeated clinical rotation will be recorded on the transcript.  The prior U (Unsatisfactory - Fail) grade will also remain on the transcript.  Failures of a module or post-rotation exam have a second opportunity to pass the exam within 30 days of notification.  If the student fails the second attempt at the post-rotation exam, an F is recorded on the module/exam grade, and the rotation must be repeated.  Students who fail one or more rotations or more than one post-rotation exam will be reviewed and acted upon by the Promotion Board.

No grade will be changed unless the Office of Medical Education or the Office of Clinical Affairs certifies to the Registrar, in writing, that an error occurred or that the remediation results in a grade change. A student may appeal to the Vice Dean for consideration only after the promotion board has met.

Academic Probation

In addition to the policies above, students are automatically placed on academic probation for the following reasons:

1. when the cumulative grade point average falls below 70 (C) at the end of the academic year, or
   
2. when the student receives an "F" in a clinical experience, or
   
3. when the student fails to score a 70 or above on the post rotation exam on the second attempt
   
4. when the student fails to complete a portion of the COMLEX exam in the expected time frame

The record of each student on academic probation will be reviewed each block to evaluate the student's academic progress by the Associate Dean for Medical Education. At the end of any block where the student on academic probation earns grades below 70, the Promotion Board may recommend promotion to the following year, repetition of the year just completed, repetition of a specific course or system, make-up examinations, summer courses, or dismissal. In general, students are not allowed to repeat an entire course more than once. The Promotion Board may on rare occasion allow a student to repeat a course or block. Students may appeal the decision of the Promotion Board to the Vice Dean based upon new and compelling information not available to the Promotion Board at the time of the decision.

 "IP" and "D" and "F" grades: A student who earned a "D" initially and is eligible to remediate the course will have the grade reported as In Progress ("IP") on his/her transcript until the prescribed remediation is attempted and a new grade is issued. The Registrar will report current "IP" grades to the appropriate Associate Dean at the time the "IP" is assigned. Once an "IP" grade has been officially changed to a letter grade on the transcript, the Registrar will not retain a record of "IP" courses as part of the academic record. The appropriate Associate Dean, however, maintains a listing of previously satisfied D grades in courses and will report such grades to the Promotion Board as needed for assessment of the student's overall academic performance and progress. Students who fail to remediate a "D" will have failed the course and receive an F on the transcript. If a student is allowed by the Promotion Board to repeat a failed course, the F will remain on the transcript. The new grade, if remediated successfully, will have the letter R in front of the course number to reflect a repeated course or rotation on the transcript. i.e.: Cardiopulmonary Physiology: F; R-Cardiopulmonary Physiology: C.
The highest grade that can be given for a remediated course is 70% or a C. A student may receive any of the following for a repeated rotation: Honors, High Pass, Pass, or Unsatisfactory. An R will be reflected with the rotation description. Example: R-course number Pediatrics High Pass.

Clinical Grading for Years Three and Four

Osteopathic medical students are assessed during the third year as described below:

1. Educational modules using lectures, cases, and other forms of delivery are used for third and fourth year curriculum. Each student must complete a post-rotation exam to assure that the expected basic content or medical knowledge has been acquired during the rotation. In addition to the experiences received in the clinical training sites, students are expected to read the content of the assigned textbooks and on line materials in order to complete all of the curriculum assigned for the clinical module.
   

2. Comprehensive exams: Comprehensive exams are given at year end of OMSII and OMSIII to evaluate long term retention. The comprehensive exam may be a faculty written exam or a standardized exam such as the Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE). The student is provided feedback to identify areas of weakness in their knowledge base.

3. Osteopathic Structured Clinical Performance Examination (OSCE) and standardized patient (SP) exams: These exams are given at end of OMS II and OMS III years. OSCEs and the simulated patient exams demonstrate the student's ability to perform clinical skills and to evaluate patient presentations for the most common disorders found in adult and pediatric patients.
   Performance exams include taking a medical history, evaluating signs and symptoms to form the most common differential, performing or assessing the results of the most common diagnostics to evaluate and narrow a differential diagnosis, the ability to perform a clinical exam, and the most common early management scenarios. The individual objectives, as described for each clinical rotation, outline the possibilities within each discipline.

4. Formative Evaluation: Student competency based rating forms are used by the preceptor to evaluate each student clinical skills and the application of medical knowledge in the clinical setting. These forms are only completed by the clinical faculty member or preceptor. Performance on rotations will be evaluated by the primary precepting faculty member. VCOM uses a competency based evaluation form which includes the osteopathic core competencies. These competencies evaluated include:
   1. Medical knowledge;
      
   2. Communication;
      
   3. Physical exam skills;
      
   4. Problem solving and clinical decision making;
      
   5. Professionalism and ethics;
      
   6. Osteopathic specific competencies; and
      
   7. Additional VCOM values.
      

Student competency is judged on clinical skill performance. Each skill is rated as to how often the student performs the skill appropriately (i.e.: never or infrequently, some of the time but less than half the time, greater than half the time, or the majority of the time, etc.).

Students who fail a rotation will be required to repeat a rotation. Students who have a repeat failure or fail more than one rotation will come before the Promotion Board. In addition, repeated performance of a specific competency area where many items performed in a specific category or across categories are rated as never, or seldom, will be a reason for remediation at the discretion of the Associate Dean for Clinical Affairs in consultation with the clinical chair, the preceptor, and/or the Promotion Board.

Students who receive a mere "pass" on a rotation may be counseled about overall performance. Students who receive several rotations at the overall performance level of "pass" may be required to perform additional curriculum to improve performance.

Any additional curriculum or required remediation will be based on the performance measure. In general, rotations should show a progression of improvement in performance. Those students who continually score in the "unsatisfactory" category or repeated "performs some of the time, but needs improvement" consistently and do not improve over time may be deemed as not making academic progress and, as a result, may be required to complete additional curriculum or may be referred to the Promotion Board.

Clinical rotations with failures will result in academic probation. Students who fail one or more clinical rotations are referred to the Promotion Board and may result in an additional required curriculum, a repeat of an academic year, or dismissal from VCOM. A Promotion Board will be called for this decision process.

During the curriculum delivery and assessment in all four years the staff, patients, and/or standardized patients with whom the student comes in contact may be asked to evaluate the student's communication and interpersonal skills. These evaluations are primarily completed in the ambulatory and testing setting and are a part of the grading process.

Poor ratings on the clinical evaluation in the professional and ethical areas of the assessment of a student are addressed by the Associate Dean for Clinical Affairs and may result in a remediation appropriate to correct the behavioral area. In the case of repeated concerns in a professional and/or ethical area, or in the case the Associate Dean for Clinical Affairs deems this to be Class II concern in professional and ethical behaviors, the Associate Dean may refer the student to the Vice Dean for a Behavioral Board or Promotion Board hearing. The Vice Dean will act upon this referral depending on the severity and the area of the performance measure. Poor ratings in this area must be accompanied by comments as to the exact nature of the rating.

6. Documentation: Students are required to maintain a log to identify the procedures performed, and the number of essential patient encounters. The faculty member will verify the information at the end of the rotation either online using a password signature, or by signing the log.
   

Rotation Evaluations

Rotation evaluation begins the first week of the rotation. Students are to request to be informally evaluated by the preceptor on a weekly basis.  Students should ask ("How am I doing?", "Are there things I should improve?") about their progress at the end of the first week and each week thereafter while on the clinical rotation in order to continually improve. This also prevents the student being surprised by a poor evaluation at the end of the rotation. Students bear the total responsibility to seek this ongoing feedback.
It is the student's responsibility to ensure that all clinical evaluation forms are either completed online or turned into the Clinical Affairs Office at the completion of each rotation. It is the student's responsibility to expediently inform the Clinical Affairs Office of any difficulty in obtaining an evaluation by the preceptor at the end of that rotation, (not several months later).

The clinical affairs staff may assist the student in the process of obtaining an evaluation if a preceptor is negligent in his/her responsibility by refusing to complete the evaluation form or to turn the form into the regional coordinator. The overall responsibility to assure evaluations have occurred and to assure the form has been returned to VCOM (or site coordinator) remains with the student. For this reason, students are responsible for setting up a time for final evaluation during the final week of the rotation, requesting such a meeting at the beginning of the final week of the rotation. At this meeting, students should supply the preceptor with the evaluation form and an envelope addressed to the site coordinator or to assure the preceptor is completing the form on line at the time of the evaluation.

It is VCOM policy for the student not to leave the rotation without the evaluation being discussed and signed by the preceptor. If a rotation form is not completed and turned into the site coordinator or Director of Clinical Rotations within 90 days of the rotation, the rotation may be considered as not performed or failed. Students should check with the site coordinators monthly to assure they have received the evaluation.

Satisfactory Academic Progress

In order for a student to be deemed as making satisfactory academic progress in years OMSI and OMSII, they must pass all courses in all blocks, successfully complete curricular requirements in the blocks, pass all components of the end-of-year testing, and/or meet the requirements as set forth by the Promotion Board. Students must also demonstrate adequate professional potential in progress as determined by the faculty and administration.

In addition a student must successfully pass the National Board of Osteopathic Medical Examiners€™ (NBOME) Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 1 at the conclusion of the OMSII year  and COMLEX CE and COMLEX Level 2 Physical Examination (PE) exams prior to graduation. See National Boards section in this Handbook for additional academic progress requirements including promotion to third and fourth years and for graduation.

In order for a student to be deemed as making satisfactory academic progress in years OMSIII and OMSIV, they must successfully complete rotations and post-rotation exams, and/or meet the requirements as set forth by the Promotion Board. See National Boards section in this Handbook (page 14) for additional academic progress requirements including promotion to third and fourth years.

Students who are experiencing difficulty successfully completing the VCOM curriculum or COMLEX exams may be placed into a combination curriculum/remediation program (altered degree program). Students placed in an altered degree program must sign and agree to comply with the altered degree program that has been approved by the Vice Dean. As long as student is making satisfactory progress they will remain in a full-time status. Students who do not follow the altered degree program or who do not make academic progress on the altered degree program may be referred to the Promotion Board for additional required remediation of repeated curriculum, rotations, or an academic year or for dismissal from the academic program.

Fourth year students should refer to the Graduation Requirements section in this Handbook for information about further graduation requirements.

Students who are not making academic progress may be dismissed from VCOM by the Promotion Board.

Academic Probation

Any student who has a failing grade in a course or rotation, who has been unable to complete the required COMLEX exam in the expected time frame, and/or who has been reviewed by the Promotion Board for any academic deficiency may be placed on academic probation. The student will be so informed in writing by the appropriate Associate Dean or the Vice Dean after the Promotion Board meeting. The purpose of academic probation is to alert the student, faculty, and administration to the fact that the student has experienced difficulty and that special consideration might need to be given such as counseling, tutorial assistance, special scheduling, or other activities to help resolve academic deficiencies. The length of academic probation and any requirements will be set through the operations of the Promotion Board. Academic probation is a required section of the Medical Student Performance Evaluation.

National Boards

Students are required to successfully pass the National Board of Osteopathic Medical Examiners’ (NBOME) Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Levels 1 and 2-CE, including the Level 2 Physical Examination (PE) component. Specific testing requirements are detailed below.

COMSAE and COMLEX Level 1:
Students complete the Comprehensive Review Course in Block 8. NBOME’s Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) serves as the cumulative exam for the Comprehensive Review Course. Students must attempt the COMSAE by June 30th following Block 8. A passing score on COMSAE is above 490 and at least nine bars in the acceptable performance or above range.

Students who do not pass COMSAE by June 30th will receive an F on the Comprehensive Review Course in Block 8 and this will be a permanent score on the student’s transcript. When COMSAE is passed, then the grade will be recorded as a repeat grade. (Students may attempt COMSAE greater than one time; however, VCOM only pays for one attempt.)

Students who pass the COMSAE MUST sit for COMLEX Level 1 prior to July 18th in the summer between the second and third year.

Failure of COMSAE:
Each student who has been unable to pass COMSAE by June 30th and receives an F on the COMSAE will be required to complete a remediation program for the Comprehensive Review Course. The remediation will be individually arranged for each student by the Vice Dean.

The Comprehensive Review Remediation is individually designed, based upon the student’s performance and needs. Students are required to complete the Comprehensive Review Remediation designed by the Vice Dean (in consultation with the Associate Deans).
All students, including those on appeal, MUST take COMLEX 1 prior to being promoted to third year and beginning third year rotations. If a student has not passed COMSAE and taken COMLEX Level 1 by the first date of the beginning of clinical rotations, they will be suspended as they will not qualify for promotion to third year. As the student will be on suspension, they will also not qualify for financial aid.

Failure of COMLEX Level 1:
Any student who fails COMLEX Level 1 must come to campus and meet with the Vice Dean. The Vice Dean will assist the student in analyzing their deficiencies and developing a remediation plan. If a student fails COMLEX Level 1 boards, they will be allowed to continue on rotations through the second week of December. If they have not passed boards by that time they will be suspended. The Vice Dean may allow a student to complete a one-time immersion course to prepare for boards; however, this course may not exceed eight weeks.

A student who has been suspended must demonstrate a passing score on COMLEX Level 1 prior to being removed from suspension (This means the exam must be taken by the fifth month on suspension.) If suspension lasts greater than six months, the student will be dismissed. If the student receives a passing score on COMLEX Level 1 during the six months period, they will return to the academic program and enter an Altered Degree Plan. The Altered Degree Plan upon return will be designed by the Office of Clinical Affairs.

COMSAE Phase 2, COMLEX Level 2 CE, and COMLEX Level 2 PE:
Third year students must take and complete an end of rotation exam after each OMS III Clinical Rotation. In addition to demonstrating the student has learned the appropriate materials on the rotation, the exams assist to prepare students for COMLEX Level 2 CE. The final weeks of the third year include end of third year comprehensive testing. Students must complete the COMSAE Phase 2 as a component of the comprehensive exam. In addition, students must take and pass standardized patient and objective structure clinical exams. These exams are done to assure the student has competently achieved the clinical skills expected in the third year and they will prepare the student for COMLEX Level 2 PE testing. Students who fail the Standardized Patient or OSCE exams will be required to remediate the exam a minimum of 14 days prior to taking COMLEX Level 2 PE. (Students who do not successfully remediate will have their COMLEX Level 2 PE release withdrawn.)

Students must attempt COMSAE Phase 2 prior to being promoted to fourth year. Students must pass COMSAE Phase 2 and take COMLEX Level 2 CE prior to the end of the second week of December.  Students who do not pass the COMSAE Phase 2 or who do not take COMLEX Level 2 CE by the end of the second week of December will be suspended. Students on suspension do not qualify for financial aid.

Students on altered degree plans of study will be given an individual date for passing COMSAE Phase 2 and taking COMLEX Level 2 CE that corresponds with the mid-point of their fourth year.  The altered degree plan will include additional VCOM-directed preparation time for COMLEX if there has been prior board performance issues.  The altered degree plan and COMLEX preparation plan for students is determined by the Associate Dean for Clinical Affairs to provide the student to be successful in making academic progress.

Students who fail COMLEX Level 2 CE twice must meet with the Vice Dean, the Associate Dean for Clinical Affairs, and the Academic Assistance Specialist to determine an altered degree plan.  The altered degree plan will provide for a VCOM-directed remediation time in order to prepare for COMLEX Level 2 CE.

Students are strongly recommended to take COMLEX Level 2 PE by the end of December of fourth year. This is recommended as it takes a minimum of 90 days to receive scores for COMLEX Level 2 PE. If students fail COMLEX Level 2 PE, they must have ample time to schedule and retake this exam prior to graduation.

Passing of both COMLEX Level 2 CE and COMLEX Level 2 PE is required to graduate. In addition most residency programs require passage of COMLEX Level 2 CE to match with their program. Some residencies require proof of passing COMLEX Level 2 PE prior to interviewing for residency.

Failure of COMLEX Level 2 CE or COMLEX Level 2 PE:
Students who fail COMLEX Level 2 CE or PE MUST meet with the Associate Dean for Clinical Affairs to develop an individualized remediation plan and must follow that plan, which may include Comprehensive Review Remediation for Phase 2. Students who fail COMLEX Level 2 CE or COMLEX Level 2 PE may be allowed to continue in fourth year rotations. Passing of both COMLEX Level 2 CE and COMLEX PE is required to graduate. Students who do not pass both CE and PE by graduation will be suspended. Students on suspension do not qualify for financial aid. Students will not be removed from suspension until they demonstrate a passing score.

Students on suspension for a period six months will be dismissed.*

(*To be able to demonstrate a passing score on a COMLEX Level 2 CE by six months, you must have taken the exam by the fifth month on suspension as the scores take a minimum of 30 days to return. To be able to demonstrate a passing score on COMLEX PE by six months, you must have taken the exam by the third month on suspension as the score take 90 days to return.)

The Comprehensive Review Remediation for Phase 2 is individually planned based upon the student’s performance and needs. Students are required to complete the Comprehensive Review Remediation designed by the Vice Dean (in consultation with the Associate Deans). Students not following an individualized plan for remediation may be suspended at any time. If a student decides upon an immersion course and is removed from fourth year clinical rotations, an Altered Degree Plan will be designed by the Associate Dean for Clinical Affairs.

Failure to Follow an Altered Degree Plan:
Students who fail a rotation or who fall behind in the first two years of curriculum may be placed on an Altered Degree Plan by the Vice Dean or the Associate Dean for Clinical Affairs and are required to sign the Altered Degree Plan of Study to continue. Students who do not comply with the Altered Degree Plan may be suspended at any time by the Vice Dean for failure to follow the plan. If a student has difficulty in following the Altered Degree Plan of Study, they must meet with the Vice Dean.

Students on Altered Degree Plans should be aware that they must be on track to complete all requirements to graduate by July 31st to enter ERAS and the Match. Students who fail COMLEX Level 2 PE or CE after the match and complete graduation requirements after July 31st may lose their matched position; this decision is made by the residency program director and/or director of medical education at that hospital.

Accommodations on COMSAE and COMLEX Exams:
Students who request accommodations for COMLEX must submit their applications to NBOME at least 90 days prior to their COMLEX date in order to allow time for NBOME’s decision. Therefore, students must request COMLEX accommodations from NBOME in writing by April 15th to meet the end of July deadline for taking the exam. Please contact NBOME for more information.

Students who are approved for accommodations by NBOME for COMLEX may also receive accommodations for COMSAE. These students should make their requests early (3 or 4 mos. Prior to the exam. Students should notify Laura Robinson at VCOM prior to taking COMSAE.

Promotion Board

The Promotion Board monitors the academic progress achieved by students throughout the academic program. The Promotion Board meets at the end of any block in which a student has achieved a failing grade, failed to successfully remediate a D grade resulting in an F, D or less on any course while on Academic Probation, failed to successfully complete a required laboratory or testing event, failed standardized patient remediation and/or simulation event, or when other delays in a student's academic progress are identified. The Vice Dean or the appropriate Associate Dean for the academic year involved may also call a meeting of the Promotion Board in cases where the academic progress of a student is affected by leaves of absence or other similar factors. (Promotion Board meetings are not generally held for remediation in the case of a first time D grade or an "in progress grade" and unless a repeat less than 70 or unsatisfactory grade is achieved.)

The Promotion Board is composed of following voting members: the Associate Dean for Medical Education, the Associate Dean for Clinical Affairs, the Associate Vice President for Student Services, and four faculty members to include at least one primary care clinical faculty member, one specialty clinical faculty member, and one biomedical faculty member. Faculty members are appointed by the Vice Dean. Non-voting members who attend are the Registrar, the Director of Clinical Rotations (when about a clinically related failure), the Assistant to the Associate Dean for Biomedical Education (who serves as secretary/recorder) and the Director of Financial Aid (on an "on-call" basis). Students are provided up to ten minutes to represent their performance and must submit their comments in writing. As this is not considered a legal hearing and is instead an academic proceeding, attorneys or other representatives are not allowed. Additional non-voting attendees who may attend the meeting include the Class President, the Course Director for a failed course, and/ or the Chair for a failed rotation. All non-voting members with the exception of the secretary are dismissed prior to deliberation and voting. It is the responsibility of the Promotion Board is to assess academic progress of students toward an osteopathic medicine degree.

Procedures for Calling and Conducting a Promotion Board

Promotion Board is held at the end of each block, after all grades have been determined by the Associate Dean for Medical Education and/or the Associate Dean for Clinical Affairs. The Associate Dean for Biomedical Education and/or the Associate Dean of Clinical Affairs will call for a Promotion Board hearing and serve as the Chair of the Promotion Board if a student has:

1. failed a course
2. attempted and failed to remediate a course resulting in an F
3. two D grades (or more) in any one block or across three blocks within an academic year.
   
4. received an additional D or F grade while the student has an outstanding D or F grade
   
5. failed two rotations or failed the same rotation twice
   
6. failed a post-rotation exam twice
   
7. experienced repeated failures in the end of year testing exams
   
8. been referred to promotion board for failure of or inability to pass an appropriate COMSAE or COMLEX exam in the time frame required
9. failed greater than three COMLEX exams in any one section
   
10. failed standardized patient remediation
    
11. demonstrated inability to make academic progress by any other academic measures the faculty and/or administration have approved or for remediation programs including an altered degree plan, remediation courses assigned on or off campus, and/or other directed VCOM curricula.

Promotion Board Procedures:

1. The appropriate Associate Dean will then convene the Promotion Board.
   
2. Members of the Promotion Board have the following roles:
   1. The appropriate Associate Dean for the academic year involved will report on the academic progress of the student(s).
      
   2. The Associate Dean will report on assistance that the student has received or been offered, including but not limited to tutoring or advising.
      
   3. The Associate Vice President for Student Services will report on documentation that the Office of Student Services may have which may be relevant to the student's academic progress.
      
   4. The Registrar may have the student's entire academic record available (course evaluations, performance assessments and the student's transcript) for the members to reference if needed.
      
   5. The Assistant to the Associate Dean shall serve as the secretary recording minutes and assuring all communication occurs by the Associate Dean in a timely manner.
      
   6. Each student coming before the Board will be allowed a ten minute presentation of any issues or considerations that they wish to make known to the Promotion Board. Members of the Board may then direct questions to the student. This is the only portion of the meeting at which the student may be physically present.
   7. The Course Director or Chair may represent the student's interactions in trying to achieve a passing grade within the course or on the rotation.
3. The Course Director for the course(s) failed may be present at a Promotion Board meeting to explain course procedures, grading, and to clarify any remediation processes that are available for that course only. He/she and the student representative will not vote and will be excused prior to deliberations.
4. For Students deemed to be at risk of not making academic progress or not making academic progress due to multiple grades in the D, or IP range in one block or across more than one block or an F grade; following deliberations the Promotion Board may make any of the following determinations:
   1. Award of a satisfactory grade (70%) and promotion to the next block
      
   2. Require remediation, further coursework, or repeat of a course
      
   3. Require one or more additional clinical rotations with satisfactory performance
      
   4. Place, not place, or extend the student on academic probation
      
   5. Specify a timeline or manner in which any remediation must occur.
      
   6. Make a determination for dismissal, or repeat of academic year.
      
   7. Determine the need for and/or require further assessment prior to making sure the student has the ability to make satisfactory progress to become an osteopathic physician including but not limited to: psychological evaluations, drug or alcohol screening / testing, or other evaluations required by the Promotion Board to make an appropriate decision. Such testing will be at the student's expense. The Promotion Board will require a written evaluation from the party of the referral to determine if the student is at risk or presents a risk to the institution, students, or patient care.
      
   8. Suspension with reinstatement pending satisfactory performance
      
   9. Suspension of a student with reinstatement decisions pending further evaluation and treatment
      
   10. Repeat of multiple courses in which the student initially earned a D grade when there are multiple D grades or D grades followed by an F grade,
       
   11. Repeat of an entire academic year, or
       
   12. An altered degree program that will delay promotion until satisfactory progress through a directed remediation program has occurred, or
       
   13. Dismissal.
5. Dismissal of a student is generally recommended by the Promotion Board when the student demonstrates that he/she is unable to make academic progress through:
   1. Multiple D grades or an F grade in Block 1
      
   2. D grades that become an F grade from inability to remediate
      
   3. An F grade on an altered degree program
      
   4. A history of multiple conditional grades and an F
      
   5. Failure of two or more clinical rotations in one academic year
   6. Failure and cumulative evidence that demonstrate the student is not gaining the appropriate knowledge and/or qualifications to become an osteopathic physician.
6. All students who fail a course or receive more than three D grades in one academic year will be placed on academic probation. However, students who have a D, or who have an incomplete or in progress grade will not be placed on academic probation except when more than one course is involved or three D grades were received in one academic year. The Promotion Board may place a student on academic probation for these reasons at any meeting.
7. The appropriate Associate Dean will notify the student of the outcome of the Promotion Board meeting and any sanctions if applicable. Upon notification, the student may appeal the decision in writing to the Vice Dean within seven calendar days of notification. The appeal should be based upon new and significant information. The Vice Dean will normally reply in 14 working days of receiving the written appeal. The Vice Dean will not meet with the student prior to receiving the written appeal material. In the case of an appeal, the student may appeal to the Dean based only upon new and meaningful information not available to the Vice Dean at the time of his or her decision. The Dean's decision will be final.

 Special Meetings of the Promotion Board

1. The Vice Dean may call a meeting of the Promotion Board to determine placement of a student who has taken an approved extended leave, or has been on suspension to determine where the student will pick up in the curriculum and to determine if any additional curriculum is needed.
   
2. The Vice Dean or the appropriate Associate Dean may convene the Promotion Board to meet about a student who has taken an unplanned leave, been brought before the Honor Council or the Professional and Ethics Standards Board, or about a student who has been temporarily suspended prior to a hearing to determine if there are issues related to academic progress as well. If the student's academic progress will be affected, the Promotion Board will make appropriate recommendations to the Vice Dean.
   
   Recommendations for special meetings of the Promotion Board may include but are not limited to those specified in IV.b. or IV.c. The Promotion Board will not make recommendations about behavioral infractions but may refer the issue to the Honor Council or Professional and Ethics Standards Board, if appropriate.
   
   Special meetings of the Promotion Board will be chaired by the appropriate Associate Dean and the role of voting and non-voting members will be the same as specified above. A course director will not be present at the meeting but a representative of the Honor Council, Professional and Ethics Standards Board or a similar representative may be invited to be in attendance to clarify issues related to the specific case being discussed.

Withdrawal/Leave Procedures¹

Withdrawal

All requests for withdrawal must be made in writing to the office of the Assistant Vice President for Student Services and must follow the following steps:

1. A voluntary withdrawal is requested in writing through the Office of the Assistant Vice President for Student Services. The student must complete an Change of Status Form and return the form and any designated VCOM issued items to the Office of the Registrar before the student will be considered "withdrawn in good standing" .
   
2. The date for a voluntary withdrawal will be the date of the student's written request.
   
3. Upon receipt of the completed Change of Status Form and VCOM issued items, the student will be voluntarily withdrawn (in good standing) from VCOM and entitled to certain benefits, i.e., application for readmission or an official transcript if requested.
4. Any pre-approved leave of absence (to extend no longer than six months) will require completion of an Change of Status Form and may or may not require the return of VCOM issued items (depending upon the specific circumstances of the leave of absence).

The Vice Dean, however, makes the final decision regarding withdrawals. Students who discontinue their education at VCOM, for any reason, are required to complete a withdrawal or Change of Status Form.

¹ To see the complete policy on withdrawal and disciplinary sanctions, please refer to the Policy/Procedure section on VCOM's website: http://intranet.vcom.vt.edu/clinical.

Medical Leave of Absence

A medical leave of absence is granted to students who provide documentation and are deemed to have a medical reason requiring the leave. The initial determination may be made by the Associate Dean for Medical Education and or the Associate Dean for Clinical Affairs. The medical leave is determined by the Vice Dean. A medical leave may last no longer than six months or the student is eligible for medical withdrawal. For students who are in good academic standing and returning from a medical leave, the Vice Dean, Associate Dean for Medical Education, and the Associate Dean for Clinical Affairs will determine the student's placement within the curriculum upon the student's return from the approved medical leave of absence with a physician release to return.

Medical Withdrawal

A medical withdrawal is granted to students who have an approved medical reason that exceeds six months. Students may apply for re-admission if granted a medical withdrawal. The Admissions Committee will determine acceptance; the Associate Deans will determine placement for all students who have withdrawn for medical purposes and are in good academic standing. The Promotion Board must meet about all students who are not in good academic standing to determine eligibility for reinstatement and for placement if reinstated.

Military Withdrawal

Military withdrawal is granted to students whose military reserve obligations may require a period of absence from the academic program when they are called to extended active duty. Readmission is guaranteed pending proof of compliance with the minimal technical standards and the Honor Code of Conduct. If the student returns within five years, they will be placed in the curriculum as close to their current position as possible in order to provide them the appropriate continuum in the curriculum and the training required to be successful, competent, and able to perform well on their board exams. In any case, the student will not be charged any additional tuition from their original obligation. The Vice Dean and Associate Deans will meet with the individual student to determine the appropriate curriculum to be completed in the remainder of the degree program that will bring the student to a competency level equal to his or her peer.

Personal Withdrawal

Personal withdrawal is granted to students who wish to voluntarily leave VCOM for personal reasons. Students withdrawing from VCOM are not guaranteed re-admission. To be deemed withdrawing in good standing, the student must complete all paperwork and follow all VCOM procedures during the withdrawal process.

Administrative Leave of Absence

An administrative leave of absence is granted by the Vice Dean. An administrative leave may last no longer than six months as deemed appropriate and necessary. An administrative leave of absence is rare and is present to address such situations as a death of a spouse, child, or such other severe circumstance that would interrupt a student's education.

Educational Leave of Absence

When accepted to a dual degree academic program (such as DO/MBA, DO/PhD), that has prior approval through VCOM administration, the student may be placed on an approved Educational Leave of Absence to complete the program. An Educational Leave of Absence is generally not granted for beyond one year, but may be extended to two years on occasion for the DO/PhD.

Suspension

Suspension is defined as a temporary separation from the institution. The duration of the suspension will be determined by the Dean and may include recommendations from the Promotion Board or the Professional Ethics Standards Board, or VCOM's Honor Code Committee. Students may be assigned independent studies during suspension to remain current; however, these independent studies do not replace course attendance or rotation requirements. If the terms set out under the suspension are not fulfilled and the period of suspension is six months or greater, the student may be dismissed from VCOM

Dismissal

Dismissal from VCOM, imposed solely by the Vice Dean or Dean, may be determined from results from recommendations made by the Promotion Board or the Professional and Ethics Standards Board.

Unofficial Involuntary Withdrawal (Pending)

Any student who ceases to maintain academic attendance in VCOM will be considered for an involuntary withdrawal. For students who are maintaining academic attendance, VCOM may use the grade of IP until such time attendance may be recorded.

Overall Withdrawal Policies

Failure to complete a Change of Status Form and to obtain the proper signatures will result in a hold placed on all academic records. Tuition refunds will be based upon the schedule shown under the section on Refund Policy, either on the VCOM website at www.vcom.vt.edu or its College Catalog. Failure to provide documentation in a timely manner could result in a guaranteed readmission becoming void.

For any withdrawal, voluntary or involuntary, VCOM recognizes and follows the date of determination as defined by the U.S. Department of Education in its Code of Federal Regulations.

Graduation Requirements

The degree of Doctor of Osteopathic Medicine is granted to and conferred upon candidates who:

1. Are of good moral, professional, and ethical character;
   

2. Have satisfied all academic requirements;
   

3. Have passed the COMLEX Level 1, COMLEX CE, and COMLEX PE; and
   

4. Completed all required exit paperwork and settled all financial obligations with VCOM and affiliate and collaborative partners incurred during as a result of the academic program.

To become eligible for graduation, each fourth-year student must have successfully completed all the above, satisfied all fourth year academic requirements and must have passed the written COMLEX CE and COMLEX PE. In addition, to be eligible for graduation students must satisfy all the above requirements within six years of matriculation. The six years allow for the student to have been in a delayed program due to medical, academic, and/or behavioral leaves of absence.

Professional and ethical competence is required for graduation. Students must demonstrate the ethical and professional qualities deemed necessary for success and continued study and practice of osteopathic medicine; the suitability for the practice of medicine by dutiful and responsible acceptance for patient care; and must demonstrate integrity in the conduct of clinical duties. Students may be dismissed from VCOM if any of these competencies are not met. Please refer to the Behavioral Policies and Procedures in this Handbook for more information.

A student must have completed all curricular requirements at VCOM, or a minimum of two years at VCOM and another eligible institution which is accredited by the Commission on Osteopathic College Accreditation (COCA) or Liaison Committee on Medical Education (LCME), between the date of matriculation and graduation. In addition to this requirement, the student must have been enrolled full time at VCOM during their OMS III and OMS IV academic years.

A VCOM student must complete to the satisfaction of faculty, as determined by the individual course directors and clinical rotations supervisors and through the Promotion Board, all prescribed courses and clinical experiences to graduate. The Vice Dean makes the determination on any appeals from promotion board recommendations, based solely upon new and meaningful information not available to the Promotion Board at the time of the deliberation. The Dean makes the determination on any appeal from the Vice Dean's recommendation, based solely upon new and meaningful information not available to the Vice Dean at the time of his or her decision.

Students must meet with the Director of Financial Aid and Registrar to complete all required exit forms and/or to receive a diploma. VCOM students must attend the exit process and the commencement program to receive a diploma.