Medical Student Fitness for Duty

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

All UNR Med students, including students in any phase of a dual degree program, must meet the technical standard requirements outlined as essential functions of fitness for duty with or without a reasonable accommodation. Fitness for Duty evaluations are used to determine if a student's academic or behavioral performance is meeting essential functions and/or affected by impairment that includes but is not limited to: medical, behavioral or substance abuse issues. Failure to meet the essential functions requirement compromises the student’s ability to perform their academic and clinical duties responsibly and safely, which could result in danger to patients, colleagues, self, or anyone in the learning environment or university/clinical properties. The Fitness for Duty policy will follow the procedures stated in the Medical Student Dismissal and Due Process Policy. (link when available)

UNR Med shall comply at all times with the Americans with Disabilities Act.

Definitions

Fit for duty: Means able to perform the essential functions for Admission, Promotion, Continuation and Graduation in a safe, secure, productive, and effective manner, with or without reasonable accommodation.

Fitness for Duty evaluation: An evaluation to determine the student's ability to perform the essential functions in a safe, secure, productive, and effective manner. The evaluation is completed by an evaluator selected by UNR Med and who is not affiliated with the University.

Evaluator: A licensed professional (e.g. physician or psychologist) who is qualified to conduct fitness for duty evaluations and authorized to practice in the state of Nevada.

Essential Functions Requirement for Admission, Promotion, Continuation, and Graduation: All accepted candidates who choose to matriculate into UNR Med are required to sign the Essential Functions Requirement for Admissions, Promotion, Continuation, and Graduation as a condition of their admission and continued enrollment at UNR Med. Essential functions include the required duties and responsibilities of a medical student in the MD program or all phases of applicable dual degree programs.

SPCC: Student Promotion and Conduct Committee

Fitness for Duty Evaluation Report: A written report by the evaluator who completed the Fitness for Duty evaluation. The report is addressed to the Associate Dean for Student Affairs and includes findings and opinions of the student’s ability to perform their academic and clinical duties responsibly and safely and whether the student is able to perform the essential functions with or without reasonable accommodation, and recommendations for relevant treatment.

Notification: Any and all notifications must be made in writing, which may include email communication.

Policy

Reporting
1. UNR Med may require a Fitness for Duty evaluation when one or both of the following applies:
  1. There is a notification from any source to the Associate Dean for Student Affairs regarding a concern about a student that may compromise the health or safety of the student, patients, colleagues, anyone in the learning environment or university/clinical property.
  2. There is a notification from any source to the Associate Dean for Student Affairs regarding a concern that the student is/may not be meeting the Essential Functions Requirements for Admissions, Promotion, Continuation, and Graduation.
2. A student may be placed on a leave of absence during the course of the Fitness for Duty evaluation process at the discretion of the Associate Dean for Student Affairs in consultation with the chair of the SPCC. A leave of absence does not extend the six-year MD Degree Completion timeline as stated in the Academic Progress and Promotion Policy. (link when available)
Meeting with the SPCC
1. The SPCC will request that the student meet with the committee in accordance with the Medical Student Dismissal and Due Process Policy. The student will be provided with a copy of this policy. At that meeting, the committee will review the reported concerns and will determine if a Fitness for Duty evaluation is required.
2. If the SPCC determines that a Fitness for Duty evaluation is required, the Associate Dean for Student Affairs will provide the pertinent information to the evaluator selected to perform the Fitness for Duty evaluation, including a description of the essential functions.
Fitness for Duty Evaluation
1. If the SPCC requires a student submit to a Fitness for Duty evaluation, the evaluator must determine whether the student:
  1. Poses a significant risk of substantial harm to the health and safety of the student or others that cannot be reduced or eliminated with or without reasonable accommodation; and/or
  2. Due to a known or suspected illness or injury is not able to perform the essential functions with or without reasonable accommodation.
2. The student must cooperate fully with the selected evaluator and must sign any necessary consent forms for the evaluation and communication of the results to the Associate Dean of Student Affairs and the SPCC.
3. The cost(s) for any required Fitness for Duty evaluation will be the responsibility of UNR Med. The cost(s) for any subsequent treatment shall be the sole responsibility of the student.
4. The evaluator will submit a written Fitness for Duty Evaluation Report addressed to the Associate Dean for Student Affairs which includes an evaluation of 3(a)(i) and 3(a)(ii) above and any relevant recommendations.
5. When the Fitness for Duty Evaluation Report is received, it will be shared with the student and forwarded to the Chair of the SPCC, who will share the determination of the evaluator with the Committee and may elect to share the report in its entirety with the Committee. The SPCC shall request the student meet with the committee to review the report and determine appropriate action consistent with the Medical Student Discipline, Dismissal, and Due Process Policy.
6. If the SPPC determines the student is not meeting essential functions in accordance with Section 3(a)(i) and 3(a)(ii), the SPCC shall take appropriate action including but not limited to: medical leave of absence; personal leave of absence; dismissal; denial of return to enrollment (i.e. for a former student who previously attended UNR Med and is seeking readmission).
Return to Duty
1. A student may return following an additional Fitness for Duty Evaluation that is submitted to the SPCC. The SPCC will consider the new evaluation and may make a written recommendation for the student to return, which may include limiting patient access.
Documentation The Fitness for Duty Evaluation Report and all written records regarding the decisions and determinations of the SPCC will be kept in the student's permanent file, which may consist of paper and electronic records, properly secured in the Office of Student Affairs. Once Student Affairs receives the evaluation, it is no longer protected by HIPPA, it is protected by FERPA.
1. If a Fitness for Duty Evaluation Report was issued more than six months ago, a new evaluation report may be required.
2. Once a Fitness for Duty Evaluation Report is received, the SPCC determines whether a student is meeting the essential functions in accordance with the Medical Student Discipline, Dismissal and Due Process Policy.
3. A student who refuses to submit to a Fitness for Duty evaluation will not be permitted to continue in the curriculum and may be subject to dismissal pursuant to the Medical Student Discipline, Dismissal and Due Process Policy.
4. Whenever there is reasonable cause to believe that life, limb, property or the maintenance of order are at risk, UNR Med may seek Emergency Removal of the student pursuant to Section 8 of the Medical Student Discipline, Dismissal and Due Process Policy. (link when available)