Academic Progress and Promotion Policy

Effective: 7/1/2026

To whom this policy applies

University of Nevada, Reno School of Medicine (UNR Med) Medical Students, including students in any phase of a dual degree program

Purpose/Background

Students at the University of Nevada, Reno School of Medicine undergo a rigorous undergraduate medical education program. The school places significant emphasis on student performance in both academics and professionalism. This policy provides the requirements for progression through the UNR Med curriculum and includes consequences for failure to meet the program requirements.

UNR Med shall comply at all times with the Americans with Disabilities Act. Requests for accommodation under the ADA must be submitted to the University’s Disability Resource Center.

Definitions

Academic year: The fall and spring semesters as described in the academic calendar.

Clerkships: Clinical rotations and courses in year 3 of the curriculum.

Clinical skills courses: Practice of Medicine (POM), Advanced Clinical Skills (ACS), Context of Patient Care (CPC), and Clinical Reasoning in Medicine (CRiM).

Curricular year: The UNR Med curriculum is designed to take four years to complete and includes four curricular years. Each curricular year is based on the current curricular structure and includes the components of the curriculum that a student is expected to complete in a given academic year. If the student is delayed, a curricular year may take more than one academic year to complete.

Electives: Clinical and non-clinical rotations and courses, typically in year 4, that are required to meet unit requirements for graduation. The courses may vary by student interest and specialty.

Fail (course/clerkship grade): A final course or clerkship grade indicating that the student did not meet the criteria, standards, and requirements according to the syllabus.

Failure to meet the requirements of a course: A situation when a student does not fulfill the criteria, standards, and requirements according to the course syllabus within the established timeframe.

Failure to remediate a course: A situation when a student does not fulfill the criteria, standards, and requirements according to the course syllabus and fails to successfully complete remediation within the established timeframe.

Good Academic Standing: The status that designates a student that is currently enrolled and making satisfactory academic progress as determined by the Student Promotion and Conduct Committee.

Incomplete (grade): A grade that reflects that a student has not yet completed the required work for the course.

Initial Matriculation Date: The first day of Year 1 as indicated on the Academic Calendar.

Medical Student Performance Evaluation (MSPE): A summary letter of evaluation intended to be provided to residency program directors and will include, but is not limited to clerkship grades, clerkship summative comments, and clinical skills course grades and comments. In addition, the MSPE will include all probation and suspension actions that have been taken by the Student Promotion and Conduct Committee. The MSPE will also include leaves of absence for personal, medical, academic, or administrative reasons.

National Board of Medical Examiners (NBME) Clinical Science Subject Examination (“shelf exam”) failure: Overall exam score below the threshold identified in the clerkship syllabus.

Pre-clerkship curriculum: UNR Med block (used interchangeably with course) curriculum offered in preparation for the clinical years.

Required Post-Clerkship Course: Required courses in year 4 of the curriculum that all students must satisfactorily complete.

Satisfactory academic progress: Having successfully passed or remediated all the criteria, standards, and requirements of the curriculum.

Student Promotion and Conduct Committee (SPCC): UNR Med Committee that oversees the promotion, and personal and professional development of medical students. The SPCC evaluates student progress and performance pursuant to UNR Med policies and makes decisions concerning student promotion, probation, suspension, dismissal, reinstatement and related academic matters.

Subject to dismissal: The SPCC may initiate proceedings which could result in a student’s dismissal from UNR Med.

Policy

MD Degree Graduation Requirements and Completion Timeline
UNR Med medical students must meet the criteria, standards, and requirements of the medical education program within six calendar years from the date of their initial matriculation to UNR Med.
1. To be eligible to graduate, students must be in Good Academic Standing and successfully pass all required courses in the pre-clerkship curriculum, all components of third year clinical clerkships and courses, and required post-clerkship courses and elective credits necessary to meet the 36-week requirement.
2. In addition, UNR Med requires passing scores for USMLE Step 1 and Step 2 CK within the timeframes listed in Section 9 of this policy. The deadline to receive a passing score on all attempts of Step 2 CK is May 1st of the year of graduation.
3. Extensions may be granted for activated military service for the period of the active duty, enrollment in a dual degree program, or approved ADA accommodation. Extensions because of a leave of absence are subject to the approval of the SPCC pursuant to the Leave of Absence policy.
4. Students must complete all requirements of their current year curriculum to be promoted by the Student Promotion and Conduct Committee (SPCC) to the next year (or to graduate).
5. If the student fails to complete the requirements for the MD Degree within six calendar years and has not received an extension, the student is subject to dismissal in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
Academic Status
The SPCC determines a student’s academic status after appearance at an SPCC meeting, unless as otherwise stated in this section. A student not in Good Academic Standing will be designated an academic status listed below as determined by the SPCC. Changes in academic status are not necessarily progressive, and it is within the discretion of the SPCC to determine the status that best reflects the circumstances under consideration.
1. Academic Monitoring is the status that designates concerns regarding a student’s progress towards meeting the criteria, standards, and requirements of the curriculum. Students on Academic Monitoring are making satisfactory academic progress but are not in Good Academic Standing. The consequences of Academic Monitoring are:
  1. At the discretion of the SPCC in its professional judgement, a student on Academic Monitoring may not serve in elected leadership positions, serve on medical school committees, participate in admissions applicant interviews, or participate in dual degree programs, research activities or other academic enrichment experiences.
  2. Academic Monitoring status is not noted on the Medical Student Performance Evaluation (MSPE); however, the circumstances leading up to this status will be noted. A student who completes the requirements determined by the SPCC while on Academic Monitoring will return to Good Academic Standing. The SPCC will inform the student that they have been returned to Good Academic Standing and may elect not to require the student’s appearance at a meeting.
2. Academic Probation is the status that designates deficiencies in a student’s progress towards meeting the criteria, standards, and requirements of the curriculum. Students placed on Academic Probation are not making satisfactory academic progress and are not in Good Academic Standing. The consequences of Academic Probation are:
  1. A student on Academic Probation shall not serve in elected leadership positions, serve on medical school committees, participate in admissions applicant interviews, or participate in dual degree programs, research activities or other academic enrichment experiences.
  2. All instances of Academic Probation status are noted on the MSPE.
  3. A student on Academic Probation will remain on this academic status for a time frame designated at the discretion of the SPCC in its professional judgement. Upon the completion of the requirements of Academic Probation, the student will be returned to Academic Monitoring or Good Academic Standing at the discretion of the SPCC in its professional judgment. The SPCC will inform the student that they have been returned to Academic Monitoring or Good Academic Standing and may elect not to require the student’s appearance at a meeting.
3. Professionalism issues may inform the SPCC’s determination of academic status.
Pre-clerkship Curriculum
To pass a pre-clerkship course, a student must meet all of the course criteria, requirements, and standards according to the syllabus.
1. When a student fails to meet any requirements of a pre-clerkship curriculum course, the student will:
  1. Receive a grade of Incomplete for the course.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Monitoring, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgement.
  4. Be required to remediate the course according to the syllabus.
  5. Have the grade changed to a Pass upon successful remediation.
  6. Have the remediation noted on the MSPE.
2. When a student fails to successfully remediate any requirement in a pre-clerkship curriculum course, the student will:
  1. Fail the course.
  2. Appear before SPCC.
  3. Be subject to being placed on Academic Probation, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgment.
  4. Be subject to repeating the year or dismissal at the discretion of the SPCC in its professional judgement per the Medical Student Discipline, Dismissal, Due Process policy.
    - The SPCC may vote to proceed with dismissal proceedings.
    - In the case that the SPCC votes not to proceed with dismissal proceedings, the student will:
      - Repeat the curricular year.
      - Be placed on Academic Probation during the repeated year.
      - Work with Student Affairs to develop a plan to improve and monitor academic progress for the remainder of the MD program.
      - Be subject to additional requirements and restrictions as determined by the SPCC.
3. A student may remediate two courses per curricular year. If a student fails to meet any requirements of a subsequent course in a curricular year, they will:
  1. Fail the course.
  2. Appear before SPCC.
  3. Be subject to repeating the year or dismissal at the discretion of the SPCC in its professional judgement per the Medical Student Discipline, Dismissal, Due Process policy.
    - The SPCC may vote to proceed with dismissal proceedings.
    - In the case that the SPCC votes not to proceed with dismissal proceedings, the student will:
      - Repeat the curricular year.
      - Be placed on Academic Probation during the repeated year.
      - Work with Student Affairs to develop a plan to improve and monitor academic progress for the remainder of the MD program.
      - Be subject to additional requirements and restrictions as determined by the SPCC.
4. Students must complete all requirements of their current year curriculum to be promoted to the next year by the SPCC.
Clinical Skills Courses: Practice of Medicine (POM), Advanced Clinical Skills (ACS), Context of Patient Care (CPC), and Clinical Reasoning in Medicine (CRiM)
To pass a clinical skills course, a student must meet all of the course requirements according to the syllabus.
1. When a student fails to meet the any requirements of a clinical skills course, the student will:
  1. Receive a grade of Incomplete for the course.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Monitoring, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgement.
  4. Be required to remediate the course according to the syllabus.
  5. Have the grade changed to a Pass upon successful remediation.
  6. Have the remediation noted on the MSPE.
2. When a student fails to successfully remediate a clinical skills course, the student will:
  1. Fail the course.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Probation, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgement.
  4. Be subject to repeating the year or dismissal at the discretion of the SPCC in its professional judgement per the Medical Student Discipline, Dismissal, Due Process policy.
    - The SPCC may vote to proceed with dismissal proceedings.
    - In the case that the SPCC votes not to proceed with dismissal proceedings, the student will:
      - Repeat the curricular year.
      - Be placed on Academic Probation during the repeated year.
      - Work with Student Affairs to develop a plan to improve and monitor academic progress for the remainder of the MD program.
      - Be subject to additional requirements and restrictions as determined by the SPCC.
Clerkships
To pass a clerkship, a student must meet all criteria, standards, and requirements according to the clerkship syllabus. Clerkship grades are determined by the assessments and requirements listed in the syllabus, including but not limited to performance on the NBME Clinical Science Subject Examination (“shelf exam”). Failure to complete any required component of a clerkship other than the NBME Exam will result in an ‘Incomplete’ in the clerkship regardless of overall clerkship grade calculation. Any delays in progression due to failure and/or remediation may affect a student’s graduation date.
1. When a student fails the NBME Clinical Science Subject Exam for the first time in a single clerkship, the student will:
  1. Receive a grade of Incomplete for the clerkship.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Monitoring, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgement.
  4. Be required to remediate the exam according to the syllabus.
  5. Have the grade changed to Pass upon successful remediation.
  6. Have the remediation noted on the MSPE.
2. When a student fails to successfully remediate a failed NBME Clinical Science Subject Exam in that same clerkship, the student will:
  1. Fail the clerkship.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Probation, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgement.
  4. Be subject to repeating the clerkship or repeating the year at the discretion of the SPCC and in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
3. When a student fails the NBME Clinical Science Subject Exam for the first time in a second clerkship, the student will:
  1. Receive a grade of Incomplete for the clerkship.
  2. Be removed from the current clerkship schedule and not progress in the curricular year.
  3. Appear before the SPCC.
  4. Be subject to Academic Probation, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgement.
  5. Be required to remediate the exam and any outstanding NBME Clinical Science Subject Exam remediations from other clerkships according to the syllabi.
  6. Have the remediation noted on the MSPE.
  7. Have the grade(s) changed to Pass and re-enter clerkships to continue the curricular year upon successful remediation of all outstanding NBME Clinical Science Subject Exams.
4. When a student fails to successfully remediate a failed NBME Clinical Science Subject Exam in the second clerkship, the student will:
  1. Fail the clerkship.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Probation, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgement.
  4. Be subject to repeating the curricular year, or dismissal, at the discretion of the SPCC and in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
5. Upon failure of any subsequent NBME Clinical Science Subject Exam, the student will:
  1. Fail the clerkship with no remediation option.
  2. Appear before the SPCC.
  3. Be subject to repeating the year or dismissal, at the discretion of the SPCC and in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
6. With the approval of the clerkship director, a student may have 14 calendar days after the conclusion of the clerkship to complete outstanding clerkship requirements (other than the NBME Clinical Science Subject Exam). After this window, if a student fails to meet the clerkship requirements according to the syllabus, the student will:
  1. Receive a grade of Incomplete for the clerkship.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Monitoring, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgement.
  4. Be required to remediate the deficiency according to the syllabus.
  5. Have the remediation noted on the MSPE.
  6. Have the grade changed to Pass upon successful remediation.
  7. Students will have one opportunity to remediate any clerkship requirement other than the NMBE Clinical Science Subject Exam within the curricular year.
7. When a student fails to successfully remediate a clerkship requirement according to the syllabus (other than the NBME Clinical Science Subject Exam), the student will:
  1. Fail the clerkship.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Probation, and be required to engage in a performance improvement plan, for a duration determined by the SPCC in its professional judgment.
  4. Be subject to repeating the clerkship, repeating the curricular year, or dismissal, at the discretion of the SPCC and in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
8. Any combination of two or more shelf or non-shelf failures across more than one clerkship will result in being removed from the current clerkship schedule and not progressing in the curricular year until all failures are successfully remediated.
Required Post-Clerkship Courses
To pass a required post-clerkship course, a student must meet all the requirements, criteria and standards according to the syllabus. Grades in required post-clerkship courses are determined by the assessments and requirements listed in the syllabus. Any failure to meet the requirements may result in failing the course. Any delays in progression due to failure and/or remediation may affect a student’s graduation date.
1. When a student fails to meet the requirements of a required post-clerkship course, the student will:
  1. Receive a grade of Incomplete in the course.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Monitoring or Academic Probation, and be required to engage in a performance improvement plan, for a duration determined at the discretion of the SPCC in its professional judgement.
  4. Remediate the post-clerkship course per the Course Director(s) requirements, which may include repeating the required post-clerkship course.
  5. Have the remediation noted on their MSPE. If the MSPE has been finalized, an addendum will be created and shared as required.
2. When a student fails to remediate a required post-clerkship course, the student will:
  1. Fail the required post-clerkship course.
  2. Appear before the SPCC.
  3. Be subject to being placed on Academic Probation (or remain on Academic Probation if they are already on Academic Probation) and be required to engage in a performance improvement plan for a duration determined by the SPCC in its professional judgment.
  4. Be subject to repeating the post-clerkship course, repeating the year, or dismissal, at the discretion of the SPCC and in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
3. When a student fails to meet the requirements of a required post-clerkship course on the second attempt, they will:
  1. Fail the course.
  2. Appear before the SPCC.
  3. Not progress in the curricular year at the discretion of the SPCC.
  4. Remain on Academic Probation, and be required to engage in a performance improvement plan, for a duration determined at the discretion of the SPCC in its professional judgment.
  5. Be subject to repeating the post-clerkship course, repeating the year, or dismissal, at the discretion of the SPCC and in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
Electives
1. When a student fails to meet the requirements of an elective according to the syllabus, they will:
  1. Remediate the elective in accordance with the requirements specified by the elective director, or
  2. Enroll in a different elective if needed to meet the unit requirements in the graduation requirements, and
  3. Appear before the SPCC, which may result in a change in academic status as determined by the SPCC in its professional judgement.
  4. Electives that are not remediated will be noted as a “Fail” on the student’s transcript.
Repeated Years
Students may only repeat one curricular year during their enrollment at UNR Med.
1. During a student’s repeated year in any phase of the curriculum, they remain on Academic Probation.
  1. For course(s)/clerkship(s) in which the student was previously enrolled:
    - Students must pass the course/clerkship by meeting all the criteria, requirements, and standards according to the syllabus with no course/clerkship remediation. If a student fails the course/clerkship the student will appear before the SPCC and be subject to dismissal in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
  2. For course(s)/clerkship(s) in which the student was not previously enrolled:
    - Students must pass the course/clerkship by meeting all the criteria, requirements, and standards according to the syllabus.
    - If a student fails, they will be required to remediate according to the syllabus. A student may only remediate one course/clerkship in which the student was not previously enrolled during a repeated year.
    - If a student fails more than one course/clerkship in which the student was not previously enrolled, the student will appear before the SPCC and be subject to dismissal in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
  3. Students returning from an approved Leave of Absence (LOA) are not considered to be repeating a curricular year and are therefore not subject to the conditions, requirements, or restrictions that apply to a repeated year, unless otherwise determined by the Student Promotion and Conduct Committee (SPCC).
United States Medical Licensing Exam (USMLE) Requirements
UNR Med requires students to pass the USMLE Step 1 and Step 2 Clinical Knowledge (CK) as part of the medical education curriculum. Students must be enrolled at UNR Med to be eligible to take any USMLE exam.
1. Deadlines and Timing
  1. USMLE Step 1
    - Deadlines for taking the USMLE Step 1 will be set in the academic calendar.
    - Students must meet all prerequisites for taking the USMLE Step 1 prior to the deadline set in the academic calendar.
    - Students may only delay taking the exam beyond the deadline if granted permission by the SPCC. This deadline also applies to students pursuing a dual degree.
    - Students are required to take and pass USMLE Step 1 prior to beginning the clinical clerkship year of the medical education curriculum. A student will not be placed in clerkships until a passing score on Step 1 is received.
    - Students who plan to enroll in a dual-degree program beginning after the second year of medical school must pass the USMLE Step 1 prior to starting coursework for the non-MD degree.
    - Students must sit for their first attempt at the USMLE Step 1 within 4 months of the deadline set in the academic calendar or they will subject to dismissal in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
    - Students must complete all attempts at the USMLE Step 1 by sitting for the exam(s) on or prior to the last day of fall semester of the academic year following the deadline set in the academic calendar, or they will subject to dismissal in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.§
      - § Example provided for illustration purposes only. These deadlines will change based on the current academic calendar:
        
        Year 2 Academic Calendar 2025-26 sets initial USMLE Step 1 deadline as May 15, 2026.
        
        Students must sit for their first attempt by September 15, 2026.
        
        Students must complete all attempts by sitting for the exam on or prior to December 11, 2026, which is the last day of the fall semester of the following (2026-27) Year 3 Academic Calendar.
  2. USMLE Step 2 CK
    - Students are required to take USMLE Step 2 CK no later than September 15th of their final year of medical school unless granted an extension by the SPCC.
2. USMLE Step 1 Exam Extensions
  1. Students may only delay taking the exam beyond the deadline if granted permission by the SPCC.
  2. Students who do not take Step 1 by the deadline set on the academic calendar may be placed on Academic Monitoring and be required to engage in a performance improvement plan for a length of time determined at the discretion of the SPCC.
  3. Any extensions will be noted on the MSPE and count towards the six-year MD Completion Time Frame.
  4. As a condition of an approval for extension, the SPCC may impose additional requirements and restrictions at its discretion and in its professional judgment.
  5. Students who do not take Step 1 by the deadline must be enrolled to be eligible to take a USMLE Step exam and will incur additional tuition.
  6. Students who do not take Step 1 by the deadline may not be eligible to graduate with their class.
3. USMLE Step 1 and 2 Exam Failures
  1. Students must be enrolled to be eligible to retake the USMLE Step exam.
  2. Failure of the USMLE Step 1 will result in a delayed start to the clinical clerkships and may result in a delay in graduation.
  3. Failure of the USMLE Step 2 CK may result in a delay in graduation.
  4. When a student fails a USMLE Step 1 or Step 2 CK Exam on their first attempt, the student will:
    - Appear before the SPCC and the SPCC will determine remediation conditions and deadlines.
    - Be subject to being placed on Academic Probation, and be required to engage in a performance improvement plan, for a duration determined at the discretion of the SPCC in its professional judgement.
    - Have the failure noted on the student’s MSPE.
  5. When a student fails a USMLE Step exam on their second attempt, the student will:
    - Appear before the SPCC and the SPCC will determine remediation conditions and deadlines.
    - Be subject to remaining on or being placed on Academic Probation for a duration determined at the discretion of the SPCC in its professional judgment.
    - Have the second failure noted on the student’s MSPE.
  6. If a student has a second failure of the Step 2 CK, the student must withdraw from electives or required post-clerkship courses until a passing score is received.
  7. When a student fails a USMLE Step exam on their third attempt, the student will:
    - Appear before the SPCC.
    - Be subject to dismissal in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.
  8. Students are only allowed three attempts to pass any single USMLE Step exam (Step 1 or Step 2 CK).
  9. When a student accumulates four total USMLE Step exam failures (a combination of Step 1 and Step 2 CK exams):
    - The student must appear before the SPCC.
    - The student is subject to dismissal in accordance with the Medical Student Discipline, Dismissal, and Due Process policy.

Review

Approved by Student Promotion and Conduct Committee 5/21/2026, and the Medical Education Steering Committee 5/28/2026