Academic Progress and Promotion Policy

Effective: 1/2/2024

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.

Definitions

Preclerkship curriculum: UNR Med blocks curriculum.

Clinical skills courses: Practice of Medicine (POM), Advanced Clinical Skills (ACS), and Clinical Reasoning in Medicine (CRIM).

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

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

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

Curricular year: The UNR Med curriculum is designed to take 4 years to complete and includes four curricular years. Each curricular year is based on the 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.

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

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

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

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

Policy

MD Degree Completion Timeline

UNR Med medical students must meet the requirements, criteria and standards of the medical education program within six calendar years from the date of their initial matriculation to UNR Med.

  1. The only allowable extensions are for either activated military service for the period of the active duty or enrollment in a dual degree program, and are subject to the approval of the SPCC.
    1. To request an extension, the student must submit the extension request to the Associate Dean of Student Affairs who submits request to the SPCC for decision.
  2. If the student fails to complete the requirements for the MD Degree within six academic years and has not received an extension, the student is subject to dismissal.

Academic Status Academic Monitoring is the status that designates concerns regarding student academic progress, including professionalism. Students on Academic Monitoring remain in good standing and are considered to be making satisfactory academic progress.

  1. Consequences:
    • At the discretion of the SPCC and in support of the student’s best interest, a student on Academic Monitoring may 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.
    • Academic Monitoring status is not noted on the MSPE.
  2. If a student is placed on Academic Monitoring three or more times during their enrollment at UNR Med, they are placed on Academic Probation.
  1. Academic Probation is the status that designates deficiencies in student academic progress, including professionalism. Students on Academic Probation are not in good academic standing and are considered to be not making satisfactory academic progress.
    1. Consequences:
      • The student must appear before the SPCC unless specifically granted an exception in writing from the chair of the SPCC.
      • 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.
      • All instances of Academic Probation status are noted on the MSPE.
      • A student on Academic Probation will remain on that academic status for a minimum of one semester or a time frame designated at the discretion of the SPCC in support of the student’s best interest.
      • A student who completes Academic Probation will be placed on Academic Monitoring for a time frame determined by the SPCC in support of the student’s best interest.
      • Upon completion of all requirements for graduation, a student on Academic Probation will automatically return to Academic Monitoring.

Failure in Preclerkship Curriculum In order to pass a Preclerkship course, a student must meet all of the course criteria, requirements, and standards as described in the syllabus.

  1. Failure of final exam
    1. A student is informed of a final exam failure through the learning management system.
    2. A student who fails a final exam will be allowed to retake the exam, as stated in the syllabus.
  2. Failure to meet the requirements of a Preclerkship curriculum course
    1. If a student fails to meet the requirements of a course, they will:
      • Be placed on Academic Monitoring for at least the remainder of the curricular year at the discretion of the SPCC and in the student’s best interest.
      • Receive a grade of incomplete. Upon successful remediation, the grade will be changed to a pass.
      • Must remediate the course according to the syllabus.
  3. Failure to remediate a Preclerkship curriculum course
    1. If a student fails to remediate the course, as specified in the syllabus:
      • They fail the course.
      • They must repeat the year.
      • They are placed on Academic Probation.
      • They must appear before SPCC.
  4. Failing to meet the requirements of a second Preclerkship curriculum course in a curricular year
    1. A student may only remediate one course per curricular year. If a student fails to meet the requirements of two courses in a curricular year:
      • They fail the second course.
      • They must appear before the SPCC.
      • They are subject to dismissal.
    2. The student may petition the SPCC in writing to remain enrolled and to repeat the curricular year.
    3. The SPCC may vote to proceed with dismissal proceedings.
    4. In the case that the SPCC votes not to proceed with dismissal proceedings, the student:
      • Is placed on Academic Probation.
      • Must repeat the curricular year.
      • Must work with Student Affairs to develop a plan to improve and monitor academic progress for the remainder of the MD program.
  5. Repeated Years in the Preclerkship curriculum
    1. During a repeated year in the Preclerkship curriculum:
      • Students remain on Academic Probation.
      • Students must pass each assessment on first attempt. Failure to pass an assessment on the first attempt will result in the student being subject to dismissal.
      • Students are not eligible to repeat any courses.
    2. Students may only repeat one curricular year during their enrollment at UNR Med.
    3. Progression to next curricular year
      1. Students must complete all requirements of their current year curriculum to be promoted to the next year.

Clinical Skills Courses (POM, ACS, CRIM) In order to pass a clinical skills course, a student must meet all of the course requirements as described in the syllabus.

  1. Failure to meet the requirements of a clinical skills course
    1. If a student fails to meet the requirements of a clinical skills course:
      • They will be placed on Academic Monitoring.
      • They must remediate according to the syllabus.
      • The remediation will be noted in the MSPE.
      • They will receive a grade of incomplete. Upon successful remediation, the grade will be changed to a pass.
  2. Failure to remediate a clinical skills course
    1. If a student fails to remediate the course as specified in the syllabus:
      • They are placed on Academic Probation.
      • They fail the course.
      • They must repeat the course.
    2. If a student fails to meet the requirements of a clinical skills course after repeating the course:
      • They must repeat the entire year.
      • If the failure occurs during a repeated year, failure will result in the student being subject to dismissal.
      • Students may only repeat one curricular year during their enrollment at UNR

Clerkships In order to pass each clerkship, a student must meet all the requirements, criteria and standards as stated in the syllabus. Clerkship grades are determined by the assessments and requirements listed in the syllabus including but not limited to NBME Clinical Science Subject Exam performance. A passing grade of no less than 70% in addition to passing the NBME Clinical Science Subject exam is required to pass the clerkship. NBME Clinical Science Subject exams are referred to in section 1b. Other criteria and standards are referred to in sections 2 through 5.

  1. Failure of assessments and requirements other than the NBME Clinical Science Subject exam:
    1. If a student earns less than 70% on the cumulative clerkship assessments other than NBME Clinical Science Subject exams, they must remediate according to the syllabus.
    2. There is no rounding up and there are no extra assignments.
    3. Failure of NBME Clinical Science Subject Exams:
      • First failure of NBME Clinical Science Subject Exam in a single clerkship:
        • Students must retake the exam on dates according to the assessment calendar.
        • Students will receive an incomplete and be placed on Academic Monitoring for at least the remainder of the curricular year at the discretion of the Student Promotion and Conduct Committee and the student’s best interest.
        • A student cannot pass the clerkship until they have successfully passed the NBME Clinical Science Subject exam.
        • This failure will be noted on the MSPE.
      • Second failure of NBME Clinical Science Subject Exam in a single clerkship:
        • Students fail the clerkship and must repeat the clerkship. This may affect their graduation date.
        • Students are placed on Academic Probation and must appear before the SPCC.
        • This failure will be noted on the MSPE.
      • Third failure of NBME Clinical Science Subject Exam in a single clerkship:
        • Students are subject to dismissal.
        • This failure will be noted on the MSPE.
      • Failure of NBME Clinical Science Subject Exam on a first attempt in a second clerkship:
        • Students will not progress in the clerkship year until they pass both exams. This will impact their graduation date.
        • Students will be placed on Academic Probation.
        • Students must retake the exam.
        • Students must appear before the SPCC with a plan of study co-developed with Student Affairs.
        • This failure will be noted on the student’s MSPE.
      • If a student fails on their second attempt of two NBME Clinical Science Subject Exams in two different clerkships, they will be subject to dismissal.
      • Students who fail three NBME Clinical Science Subject Exam attempts in two or more clerkships are subject to dismissal. For example:
        • A student who failed the Internal Medicine NBME Exam on the first and second attempts and then fails the Neurology Exam on the first attempt is subject to dismissal.
        • A student who failed the Family Medicine and the Surgery NBME exams and then fails the OB/GYN NBME exam on the first attempt is subject to dismissal.
  2. Failure to meet the requirements of a clerkship
    1. If a student fails to meet the requirements of a clerkship as stated in the syllabus:
      • They will be placed on Academic Monitoring.
      • Will receive a grade of incomplete. Upon successful remediation, the grade will be changed to a pass.
      • They must remediate the clerkship.
      • The remediation will be noted on their MSPE.
    2. Failure to remediate a clerkship
      1. Will result in failure of the clerkship.
      2. The student will be required to repeat the entire clerkship.
      3. The student will be placed on Academic Probation.
  3. Failure to meet the requirements of a repeated clerkship
    1. If a student fails to meet the requirements of a clerkship on the second attempt:
      • They fail the course.
      • They will not progress in the curricular year.
      • They remain on Academic Probation.
      • The student is subject to dismissal. If not dismissed, they will be required to repeat all core clerkships.
      • Students may only repeat one curricular year during their enrollment at UNR Med.
  4. Failure to meet the requirements of a second clerkship in the same curricular year
    1. If a student fails to meet the requirements of a second clerkship in a curricular year:
      • They fail the course.
      • They will not progress in the curricular year.
      • They will be placed on Academic Probation.
      • Student is subject to dismissal.
      • If not dismissed, they will be required to repeat all core clerkships.
  5. Failure of required electives
    1. In order to pass each elective, a student must meet all the requirements, criteria and standards as stated in the syllabus. Elective grades are determined by the assessments and requirements listed in the syllabus. If a student fails to pass a required elective:
      • The student must appear before the SPCC.
      • They will be placed on Academic Monitoring or Probation at the discretion of the SPCC and in the best interest of the student.
      • The student must meet the UNR Med elective requirements for graduation.
  6. Repeated Years
    1. During a repeated clerkship or elective year:
      • Students remain on Academic Probation
      • Students must pass each assessment on first attempt. Failure to pass an assessment on the first attempt will result in failure of the course and the student will be subject to dismissal.
      • Students are not eligible to repeat any other courses or content during the repeated year.
    2. Students may only repeat one curricular year during their enrollment at UNR Med.
  7. Progression to next curricular year
    1. Students must complete all requirements of their current year curriculum to be promoted to the next year.

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.  To be eligible for graduation, passing scores for Step 1 and Step 2 CK must be received by the UNR Med Registrar’s Office no later than May 1st of the year of graduation.

  1. Timing:
    1. USMLE Step 1
      • Deadlines and prerequisites for taking the USMLE Step 1 will be set in the academic calendar. Students may only delay taking the exam beyond the defined deadline if granted permission by the SPCC.
      • Students are required to take USMLE Step 1 prior to beginning the clinical clerkship year of the medical education curriculum.
      • Students enrolled 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-M.D. degree.
      • Students granted leave of absence following the second year of medical school are subject to the same deadlines as those progressing directly to the third year unless specifically granted an extension by the SPCC.
      • Students must receive a passing score on the USMLE Step 1 within 12 months of the date set in the academic calendar. If students do not have a passing score within 12 months, they are subject to dismissal.
    2. USMLE Step 2 CK
      • Students are required to take USMLE Step 2 CK no later than October 15th of their final year of medical school unless granted an extension by the SPCC.
  2. USMLE Step Exam Failures
    1. If a student fails a USMLE Step Exam on their first attempt:
      • The student will be placed on Academic Probation.
      • The failure will be noted on the student’s MSPE.
      • The student may be required to appear before the SPCC. The SPCC may determine and direct remediation and deadlines, including the possibility of a leave of absence.
      • Students must be enrolled in MED 601 to be eligible to retake a USMLE Step exam.
      • The SPCC will set a deadline for a retake exam. Students may petition the SPCC for an extension of the deadline.
      • Failure of the USMLE step 1 will result in a delayed start to the clinical clerkships and may result in a delay in graduation.
      • Failure of the USMLE Step 2 CK may result in a delay in graduation.
    2. If a student fails a USMLE Step exam on their second attempt:
      • The student will remain on Academic Probation.
      • The second failure will be noted on the student’s MSPE.
      • The student may be required to appear before the SPCC. The SPCC may determine and direct remediation and deadlines, including the possibility of a leave of absence.
      • Students must be enrolled in MED 601 to be eligible to retake a USMLE Step exam.
      • If a student has a second failure of the Step 2 CK, the student must withdraw from electives until a passing score is received.
    3. If a student fails a USMLE Step exam on their third attempt:
      • The Student is subject to dismissal.
    4. If a student fails a total of 4 USMLE Step exams, including any combination of Step 1 and Step 2 CK exams, the student is subject to dismissal.