Evaluation of Students in the Clinical Year

It is essential for professional development that students adopt and exhibit self-directed responsibility for their mastery of knowledge and skills. Students are required to pass all requisite didactic and clinical course work with a minimum grade of “C” for courses utilizing the letter grading system, or “Pass” for courses utilizing the Pass/Fail system. Students must complete class work in its entirety. No PA course credits from another institution may transfer into the didactic or clinical year.

During the program, any performance below “C” in any course utilizing the letter grade system or a grade of “Fail” in any course utilizing the Pass/Fail system is interpreted as significant deficiency in the subject.

Students performing poorly in the didactic phase of the program should contact the Didactic Coordinators and the course instructor as soon as possible to solicit their help and recommendations to remediate deficiencies. Students performing poorly in the clinical phase of the program should contact the Clinical Coordinators and the clinical preceptor as soon as possible to solicit their help and recommendations to remediate deficiencies.

Faculty members are expected to provide reasonable assistance and direction to aid in this remediation process. The methods and extent to which faculty assist students with review and remediation of deficient material is at the discretion of the individual faculty member.          

To satisfactorily complete a course, the student must earn a grade of “C” or better in courses using the letter grading system or, a “Pass” in courses utilizing the Pass/Fail system. Additionally, students must maintain an overall cumulative GPA of 3.0 or higher throughout the duration of their enrollment clinical year. Each course grade may be based on multiple examinations, assignments, and a comprehensive final exam. Each exam may consist of multiple choice, matching, essay and clinical competency skills testing. Demonstration of clinical competency skills testing will be proctored by program faculty and/or their designee and must be completed as assigned by the course instructor or a designated faculty member. 

Achieving & Maintaining Good Academic Standing in the PA Program

A student must achieve and maintain the required course grade and Cumulative semester Grade Point Averages (GPAs) to remain in good academic standing and graduate from the PA Program. Performance in courses is commonly assessed by written and/or practical examinations, oral presentations and/or research papers. In designated courses throughout the program, grades will be recorded as a raw score and a percentage. At the end of each course the percentage scores will be converted, to a grade, A through F, for each of the core PA courses. The grading scale can be found under “grading scale” below.

Grading Scale: Grades will not be changed with the exception of mathematical errors.

Progression Throughout the PA Program

The following policies apply to student progression in the CUNY School of Medicine PA Program:

• Students are required to complete the designated professional curriculum, as designed, in the full-time sequence specified.

• Progression will be a function of successfully passing all required courses, with a grade of 70% or greater, in each semester, achieving a minimum semester and cumulative GPA of 3.0, continuing to meet all technical standards, and meeting all other program policies/standards in each semester.

• Didactic Phase

  • Each semester’s course work is to be considered pre-requisite to the next semester.

  • Students are expected to complete each semester on time as a cohort.

  • Failing to receive a passing grade in didactic phase coursework, following all offered exam remediation opportunities, will prevent students from progressing to the next semester.

• Clinical Phase

  • Clinical Phase Coursework includes Supervised Clinical Practice Experiences (SCPEs), Clinical Technical Skills, PAEA exams, and the Summative Course.

  • As with the Didactic Phase, coursework will be full-time in the sequence designated and as assigned at the beginning of the clinical phase of training.

  • Although, at the discretion of the Director of Clinical Education, there may be a necessity to change the order of the Supervised Clinical Practice Experiences (SCPEs), there is no possibility to change the order of didactic, research, or summative course work.

  • Failing to receive a passing grade in SCPE coursework, will either require SCPE course remediation (i.e., course repeat) or result in dismissal.

  • Remediation for Supervised Clinical Practice Experience (SCPE) courses will automatically result in delay of graduation.

  • Students are responsible for any associated tuition and fees related to SCPE course remediation.

  • Students are permitted to remediate only one SCPE via course repeat.

  • Any repeated SCPE course will take place after the summative phase of the student’s program and, as such, will automatically result in delay of graduation. The student is responsible for any additional tuition and fees related to the additional course or coursework.

  • If a second SCPE course is failed, students will be eligible for dismissal, and will  be referred to Course and Standing.

  • Students must achieve a score of 70% or greater on the End of Curriculum MCQ exam, the Clinical Technical Skills OSCE, and the Summative OSCEs to graduate. Failure to achieve a final grade of 70% or greater in any of these will require remediation and reassessment.

  • Failing to meet all technical standards and/or student conduct policies/standards, as outlined in this CUNY School of Medicine PA Program Student Handbook, and the CUNY School of Medicine PA Program student Clinical Handbook, will result in automatic referral to the Course and Standing Committee and Academic and/or Behavioral Probation and subsequent consequences up to and including dismissal from the program.

At the end of each semester, the Course and Standing Committee will meet to discuss each student’s level of success. Students who do not attain and maintain a 3.0 semester GPA, do not achieve a passing grade in individual courses, or have student conduct issues during the semester, will receive a letter/email from the Committee and/or Department Chair/Program Director notifying them of their evaluation within the Course and Standing Committee and their individual progression status. In such cases, progression status can include:

• For clinical phase coursework:

  • At risk for academic probation or dismissal

  • At risk for professional probation or dismissal

  • Academic probation or dismissal

  • Professional probation or dismissal

 Remediation of At-Risk Clinical Students

Any student receiving grade/s less than 80.0% or scoring ‘non-competent’ on any graded component will be viewed by the program as ‘at risk’.  At risk clinical students will be required to complete the following:

1. For the first incident of ‘at risk’ performance: the student must meet with the Remediation Specialist to develop a unique student success plan (e.g. develop study calendar, Learning Center referral, retrieval learning assignments).

2. For continuing incidents, the student may appear before the Course & Standing Committee.

Clinical Phase Evaluation

The Clinical Coordinators are responsible for monitoring and coordinating the evaluation of the progress of each student in the clinical phase of the CUNY School of Medicine Physician Assistant Program. Students receive clinical experiences in both primary care and specialized (medical, behavioral, and surgical) rotations to better prepare them for the wide range of patient problems which they may encounter after graduation. Students in the clinical phase of the program are evaluated in a variety of ways by their clinical preceptors and program faculty during their clinical rotations. Feedback is provided to the students daily by the preceptors while students are actively participating in the care of patients. During the clinical phase, evaluation is intended to address achievement of competency in knowledge, interpersonal, clinical and technical skills, professional behaviors, and clinical reasoning and problem-solving abilities required for PA practice. 

Clinical students must satisfactorily complete all clinical rotations as assigned. Grades in clinical course work reflect a student’s cognitive, technical, attitudinal and behavioral performance and are based upon preparation, skill, attitude, and attendance, as well as patient management. Successful completion of a clinical rotation requires timely completion of credentialing documents and requirements, attainment of objectives and learning outcomes, compliance with rotation and program assignments within the rotation period, attendance at all scheduled activities of the clinical service, applicable key experience measures and competencies, and attainment of passing scores on preceptor evaluations, end-of-rotation examinations, and other faculty assessments which can include OSCEs (Objective Structured Clinical Examinations) and practical examinations. 

The CUNY School of Medicine Physician Assistant Program’s Clinical Coordinators will review the evaluations from the clinical preceptors/instructors and have final authority in assigning grades for all the clinical rotations and courses. Patient safety, proper professional conduct, and the progressive demonstration of achieving learning outcomes and independence of thought at all clinical sites is expected.

An overall minimum grade of “C” is required for satisfactory completion of each clinical rotation course. The grade for each of the ten clinical rotations will be based on multiple components including the evaluation from the primary preceptor, faculty evaluations of the student, end-of-rotation exam (an assignment will replace an end-of-rotation exam for the geriatrics, critical care and clinical elective rotations), and clinical logging requirements in the clinical tracking system. Please refer to the discipline-specific clinical rotation syllabus for further details regarding expectations of students for each rotation.

Any other circumstance that causes a student not to successfully complete a rotation will require the student to meet with the Course and Standing Committee.

All evaluations not turned in and grades not calculated by the end of the rotation are reported as “INC” (Incomplete) to the Registrar’s office. Late grades will be turned in to the Registrar’s office with a change of grade form once the necessary evaluation(s) have been received. All evaluations must be returned to the Clinical Coordinators’ office prior to conferment of diplomas/graduation.

Comprehensive Exams

Successful completion of the program requires satisfactory completion of a comprehensive summative evaluation near the conclusion of the clinical training period. The summative evaluation consists of written examination, clinical performance, and professionalism components. This is administered near the conclusion of the clinical training period. The evaluation includes assessment of medical knowledge, interpersonal and communication skills, clinical and technical skills, professionalism behaviors, clinical reasoning, and problem-solving abilities in patient care. This evaluation is designed to assess competency in the program’s defined learning outcomes, as well as to determine eligibility for graduation from the program.

There are five distinct components of the graduate candidate’s summative evaluation. Each must be successfully completed in order to earn a passing grade. Minimum passing scores on the components of the summative experience are as follows:

• The Summative multiple-choice examination– Score must be greater than 70%.

• Objective Structured Clinical Examinations (OSCE’s) – score must be greater than 70%.

• Clinical Technical Skills OSCE-score must be greater than 70%

• Clinical Performance – Scores must be greater than or equal to 70% in each area assessed on the clinical performance examination (medical knowledge, interpersonal and communication skills, clinical and technical skills, professionalism behaviors, clinical reasoning, and problem-solving abilities in patient care)

• Final Professional Behavior Evaluation– Each student needs to be deemed “Competent” in each domain of professional behavior on the program’s final professionalism behavior evaluation

Students who do not receive a satisfactory grade on any part of the comprehensive summative experience will be required to remediate.  Students will be required to remediate areas of deficiency and repeat the summative evaluation in which they were not successful. The student will not be eligible for program completion or graduation activities until they receive a satisfactory performance on each component of the summative experience. If the student fails the component a second time, they will be referred to the Course and Standing Committee for further review.

End of Curriculum Examinations/Summative Experience Components

There are four examinations that are taken throughout the clinical year:

• The End of Curriculum Exam – a 300-question comprehensive multiple-choice examination given at the end of the Clinical Year.  This exam is meant to highlight areas of weakness and a remediation plan will be personalized to the student.  The Summative exam must be passed with a grade of 70%.  Any student who does not achieve a 70% or greater on the End of Curriculum exam will be required complete a comprehensive individualized remediation plan under the supervision on their advisor.  Students will need to achieve a grade of greater than 70% on the reassessment of the End of Curriculum Exam prior to graduation.  The End of Curriculum multiple-choice exam is given within 4 months of graduation.

• Summative OSCE– a comprehensive, simulated complex patient case.  This is to include a full history and physical, assessment and plan, including clinical documentation and a grade of 70% or greater should be achieve to pass this component.  This test is developed by the faculty and based on the NCCPA Blueprint.  Like the clinical exams, students not meeting the benchmark will meet with the Remediation Specialist to develop a correction plan.  The Summative OSCE is given within 4 months of graduation.

• Clinical Technical Skills OSCE – a comprehensive final assessment of clinical and technical skills. The Clinical Technical Skills OSCE is given within 4 months of graduation.

• PACKRAT– a standardized exam developed by PAEA, modeled on the PANCE is given once or twice a year.  This exam is also based on the NCCPA Blueprint. Results are reported both by organ system (cardiology, pulmonology, etc.) and by critical thinking area (history taking skills, therapeutics, management, etc.). Students will be required to meet with the Clinical team/Remediation Specialist to discuss their strengths and weaknesses, performance and improvement.  Students not achieving the benchmark will meet with their advisors.

Grading Scale: Grades will not be changed with the exception of mathematical errors.

Clerkship Grading Components

Standards of Clinical Performance:

• Clinical Competency

  • Quarterly analysis of preceptor evaluations

  • Areas of assessment include but are not limited to:

    • Medical knowledge

    • Interpersonal skills

    • Clinical and technical skills

    • Professional behaviors

    • Clinical reasoning and problem-solving abilities 

    • Overall performance

• Preceptor Feedback

  • Feedback from preceptors from any source (e.g., in person, phone, email, written correspondence) should indicate that the student is meeting the minimum competencies.

• Clinical Experiences

  • Students must complete electronic submissions as outlined in the discipline-specific syllabus.

  • Discipline-specific learning outcome requirements and other clinical patient experiences for students to successfully complete the clinical education portion of the PA Program are detailed in each rotation syllabus. Students are responsible for fulfilling the requirements prior to graduation and tracking their progress using the digital platforms provided.

The Clinical Coordinator and/or Clinical Site Manager may visit each student during any of the three clinical semesters.  The progress and site will be discussed with the student as well as the preceptor/s.  The medical notes entered in Typhon will also be evaluated. The grade for each clerkship is based on three types of evaluations: The preceptor evaluations, the End-of-Rotation Examination (EORE), and the Clinical Coordinator evaluation.

End of Rotation Examination

Clinical year students will take an online comprehensive rotation-specific examination at the end of each rotation. The examinations consist of 120 multiple choice questions derived from the clerkship learning objectives. Students are expected to read throughout the clerkship, concentrating on the signs, symptoms, pathophysiology, physical findings, diagnostic tests and management of the disease states found in the learning objectives.  End-of-rotation examinations have the same format as the PANCE exam, as they are case-based; clinical reasoning is emphasized over recalling esoteric clinical facts.  The eight tasks 1) History Taking & Performing Physical Examination, 2) Using Diagnostic and Laboratory Studies, 3) Formulating Most Likely Diagnosis, 4) Health Maintenance, Patient Education, and Preventive Measures 5) Clinical Intervention 6) Pharmaceutical Therapeutics 7) Applying Basic Science Concepts, and 8) Professional Practice serves as a conceptual frame for End of Rotation Examinations. In order to pass the examinations, a student must earn a grade of no less than 70%. While End of Rotation examinations cannot be reviewed question by question, students receive feedback in the form of content deficits within the seven tasks.  This analysis will afford students the opportunity to identify and rectify deficits in content knowledge. No student is permitted to take the day off before a Call Back Day in order to study or complete assignments. If the Clinical Coordinator is informed that such an absence occurred, the student will receive ten (10) points off final grade for the rotation.

The End of Rotation exam (EORE) consists of 120 multiple-choice questions. 100 of these questions are scored, and the other 20 questions are unscored pre-test items which are used to gather statistics. The exam is divided into two sections of 60 questions each. Each exam incorporates current, relevant test questions that follow rotation specific content, the corresponding PAEA Blueprint and corresponding Topic Lists. The exams focus on assessing

the relevant knowledge gained during specific clinical practice experiences. The exam content is reflective of the specific Blueprints and Topic Lists identified for that clinical practice experience or rotation. Questions are typically presented in vignette format so that the exam can better assess students’ capacity for problem solving and critical thinking.  Time - Students have 60 minutes to complete each of the two sections. Time may not be carried over from the first section. Once a section is completed students cannot go back to any questions in that section.  

The students will take their End of Rotation (EOR) exam in-person (unless otherwise scheduled remotely via monitorEDU), which will be scheduled at the conclusion of the clinical rotation.  If exams are scheduled remotely, students are responsible for payment to monitorEDU.  The EOR exam comprises 50% of the final grade. The End of Rotation Exam is provided by the Physician Assistant Education Association (PAEA) and is based on the National Committee on Certification of Physician Assistants (NCCPA) blueprint for the Physician Assistant National Certification Exam (PANCE). While students expand their skills in the supervised clinical setting, they are expected to do additional reading and research on the topics listed in the PAEA Exam Topic List, https://paeaonline.org/assessment/end-of-rotation/blueprints-and-topic-lists . The Exam Topic List is provided through the PAEA website and provides specifics on what types of diseases or conditions will be covered on the test.

Students must satisfactorily complete the appropriate EOR exam with a score of 70% or better. Failure of the EOR exam will require students to remediate the relevant topics in the PAEA EOR report and submit to the Clinical Coordinator 2 weeks from assignment.  After remediation the student will receive a MAXIMUM score of 70%. 

For our purposes, the exam scores will be converted using a student Z-score and the minimum acceptable adjusted grade is 70%. Please refer to PAEA for further information on the Z-score.

• How to Find The Z-Score

  • The following formula establishes the student Z-score for a particular test:

    • Z-Score = (Student EOR Score - National average for that exam)/Exam SD

• Using the Z-Score to Convert the EOR Test Grade

  • Since 70% Is the lowest passing grade on a test, the following formula Is used to establish a grade via a student Z-score:

    • Adjusted Grade = 85 + (z-score x 10)/100

  • The chart below on the left is a summary of z-scores, adjusted grades, and resulting letter grade.

  • The national data for the exam is presented below on the right. The data in this chart includes projected mean (μ) and standard deviation (σ). 

 Students are required to complete an evaluation of the course and instructor(s) at the conclusion of the course.

NOTE: Grades may be withheld pending course/instructor evaluation completion. 

Clinical Clerkship Project for Geriatrics, Critical Care and the Clinical Elective

 Rotations without end of rotation examinations (Critical Care, Geriatrics and Clinical Elective) will require a PowerPoint Presentation as well as a Paper on a challenging case with at least 3 Peer Review study references.  The case MUST BE an atypical presentation or a complicated case.  PowerPoint Presentations and Paper MUST BE submitted by 12 midnight the day BEFORE the scheduled Call Back.  The use of the Call Back Day for these presentations is up to the Clinical Coordinators and it is subject to change.

Case Presentations:  Rotations without end of rotation examinations (Geriatrics, Critical Care, and Elective rotations) will require a PowerPoint Presentation as well as a Paper on a challenging case with at least 3 Peer Review study references. The case MUST BE an atypical presentation or a complicated case. Presentations/Paper must be submitted by 12 midnight the day before scheduled Callback.  The use of the Call Back Day for these presentations is up to the Clinical Director and it is subject to change.

• Evaluation of presentations will be based on the following six criteria:

  • Complexity of subject choice.  The student is expected to choose a challenging case for this presentation.

  • Content, including mastery of the topic and the ability to respond to inquiries;

  • Creativity;

  • Time management;

  • PowerPoint presentation including clarity of the slides, presentation format, and comprehensiveness.

  • Case Presentation and Peer Review Paper consist of 50% of the grade for the rotation.

Format of PowerPoint Presentation and Paper:

I.               History taking an Performing a Physical Examination

II.             Using Diagnostic and Laboratory Studies

III.           Formulating Most Likely Diagnosis, including 3 Differential Diagnoses

IV.          Managing Patients

V.            Health Maintenance, Patient Education, and Preventive Measures

VI.          Clinical Intervention

VII.        Pharmaceutical Therapeutics

VIII.      Applying Basic Scientific Concepts

IX.          Professional Practice

Evaluation of Power Point presentation/paper will be based on the following criteria:

Physician Assistant Written Case Presentation

Name:

Rotation:

Date:

Rotation Site:

Preceptor:

History

Physical Exam

History and Physical out of 30 points

Assessment

 Plan and Management

Assessment and Plan out of 30 points

 Pathology Discussion of working diagnosis

Pathology Discussion of working diagnosis out of 20 points 

Medical Citation

Medical Citation out of 10 points

Spelling and Grammar

Spelling and Grammar out of 10 points

Late Submission

Comments and Total Grade

 Failure of any End of Rotation examination/project more than once will result in failure of the clinical rotation course due to unsatisfactory clinical and medical knowledge competency.  Please refer to Appendix B for further details.

Preceptor Evaluations

Each student is evaluated by the preceptor twice, at the end of week 2 and again at the end of week 5. The week 2 evaluation is formative and unblinded; the week 5 evaluation is blinded. The week 2 evaluation gives the student the opportunity to address areas of weakness or deficiency prior to completing the rotation and is not counted in the final grade. The Week 5 evaluations are clerkship specific, account for 50% of the grade and will be accounted for in the computation of the FINAL preceptor evaluation grade. The preceptor will evaluate the student on performance and professionalism. The Preceptor evaluations account for 30% of the final grade. Any students scoring below a 70% in the overall preceptor’s evaluations will have to repeat the rotation and any scoring below a 3 (“Competent with support”) as evaluated by preceptors on discipline-specific Learning Outcomes will be addressed accordingly to complete remediation. Failure of any Preceptor Evaluation will result in failure of the clinical rotation course due to unsatisfactory clinical competency. 

Preceptor evaluations are submitted via the Typhon logging system.  IT IS THE STUDENT’S RESPONSIBILITY TO FOLLOW UP WITH THE PRECEPTOR OF RECORD TO ENSURE THAT THE EVALUATIONS ARE SUBMITTED. 

Clinical Coordinator Evaluations

These evaluations have several components, refer to the table below for breakdown.  The total percentage of the grade for the Clinical Coordinator Evaluations is 20%.

Self-Assessment with Clinical Exams: Pre and Post Rotation Exams in AMBOSS/HIPPO & Aquifer cases. 

To refine medical knowledge and test-taking skills, students will be assigned pre and post rotation exams to identify areas of strengths and weaknesses.  Students are required to take the Pre-Rotation Exam prior to the start of their clinical rotation in AMBOSS  (these vary in questions 75-100 questions combined) and are to take the Post Rotation exam the weekend before the PAEA EOR exam.  Students are required to do practice questions from areas of weakness identified in the Pre-Rotation exam within AMBOSS, Scholar RX and board prep questions in HIPPO. Virtual Clerkships at Aquifer will be available for students to complete clinical cases in their particular rotation as well as real patient cases in their clerkships.  Resources utilized during the clinical year are subject to change at the program’s discretion.  

Student Evaluation of Clerkships

 Each student is required to complete a rotation evaluation upon completion of the rotation. These evaluations help the faculty make decisions regarding the clinical year for future classes. Therefore, thoughtful input, suggestions and constructive criticisms help the continual assessment and improvement of the program.  During the Clinical Phase, students are not allowed to contact Clinical Preceptors once the clinical clerkship is completed to discuss week 2 or week 5 evaluations or final grades once posted/submitted. If there is a grade issue or a student does not agree with a preceptor evaluation, students should contact the Clinical team and/or Academic Advisor, and Associate Dean/Program Director.

 If these requirements are not met, the Course and Standing Committee will decide if remediation will occur, resulting in a delay of graduation.

Presentations and Paper

Clinical clerkships without end of rotation examinations (Geriatrics, Critical Care, and Elective rotations) will require a PowerPoint Presentation as well as a Paper on a challenging case with at least 3 Peer Review study references. The case MUST BE an atypical presentation or a complicated case. Presentations/Paper must be submitted by 12 midnight the day before scheduled Callback.  The use of the Call Back Day for these oral case paper/Power point presentations is up to the Clinical Director and it is subject to change. The students submitting a Case Presentation/Paper, must be ready to present their power point cases in front of their peers during the scheduled call back. The student/s will be selected at the discretion of the Clinical Coordinator.

• Evaluation of presentations will be based on the following six criteria:

  • Complexity of subject choice.  The student is expected to choose a challenging case for this presentation.

  • Content, including mastery of the topic and the ability to respond to inquiries;

  • Creativity;

  • Time management;

  • PowerPoint presentation including clarity of the slides, presentation format, and comprehensiveness.

  • Case Presentation and Peer Review Paper consist of 50% of the grade for the rotation.

Rotation Grades

The grade is made up in the following proportions: Internal Medicine, Emergency Medicine, Surgery, Pediatrics, Women’s Health, Primary Care and Psychiatry, Geriatrics, Critical Care and the Clinical Elective.

Preceptor Evaluation at Week 5: 30%

Clinical Coordinator Evaluation at Week 5: 20%

End of Rotation Exam/PPP and Paper at Week 5: 50%

Failure to meet the designated grade in any of these areas will result in failure regardless of the total grade average.  In order to receive a passing grade in any clerkship, all of the following conditions must be met:

• A grade of 70% or better on the final clinical preceptor evaluation

• A grade of 70% or better on the End of the Rotation exam.

• A grade of 70% or better on the Clinical Coordinator evaluation.

• A grade of 70% or better on the Preceptor Evaluation of the PA student 

End-of-Rotation Examination Failure

 Students that fail an End of Rotation Examination (<70%) will be given the opportunity to remediate.  A remediation plan will be implemented by a faculty member and will be tailored on an individual basis.  This remediation plan will be determined by the faculty and will be due 2 weeks later.  Students who complete this remediation will receive a grade of 70% for this component.                                                                                 

Failure to complete the remediation on the date scheduled will result in a grade of zero.

Students are permitted to remediate end of rotation exams no more than twice (2) during the clinical year.  Failing a third end-of-rotation exam will result in appearance before the Committee on Course and Standing and SCPE failure. 

Clerkship Failure

 Should a student fail a SCPE, the student will appear before the Committee on Course and Standing.  The student will be required to repeat the clerkship at the end of the curriculum, resulting in a delay of graduation.  All financial costs associated with repeating a clerkship will be the responsibility of the student. Only one clerkship can be failed and repeated.  A second clerkship failure will result in dismissal from the Program.

Delayed Clinical Clerkships

In the event that a student is delayed in rotation(s) (i.e., due to delayed start, failure, and/or leave of absence) graduation will be delayed.

Leave of Absence

A student may be granted a Leave of Absence only in the case of personal illness, family emergency or other circumstance beyond the student’s control.  A request for leave must be made in writing to the program director.  A leave taken without consent from the program director may result in dismissal from the program.  Students are granted only one Leave of Absence during the clinical phase of the program.

Professional Causes for Dismissal during the Clinical Year

Besides academic performance, there are professional reasons for dismissal during the clinical year. These include:

• Violation of the standard of conduct at clinical sites:  Each clinical site has its own policies and procedures to which students must adhere.  Failure to adhere to these policies and procedures may result in the student’s dismissal from the Program.

• False Reports:  Submitting data regarding a patient’s history or physical examination that was not personally elicited, including reporting a finding as normal when unsure of the finding may be cause for dismissal from the Program. Falsely representing the involvement of a physician or other preceptor in the assessment or management of a patient may also result in dismissal.

• Sexual harassment or misconduct including dating a patient, or communicating derogatory statements regarding the racial, ethnic, sexual orientation, disability, or any physical characteristic of a patient or colleague may be cause for dismissal from the Program

• Violations of HIPAA: any violation of privacy and confidentiality of a patient may result in dismissal.

• Cheating on any test or assignment.

Call Back Day Activities

 During designated dates, students will return to campus for Call Back Day activities. These activities typically introduce new information relevant to the clinical year, or review basic material commonly seen in clinical clerkships, such as reviewing and testing Clinical Technical Skills, reviewing pharmacology, review of systems, reviewing EKGs, preparing for life after graduation, etc. Students are, therefore, expected to attend each Call Back Day, arrive at class on time, and be in attendance for the full day.

Call Back activities may include Self-Assessment with Clinical Exams: MOCK EOR Exams in Exam Soft & Pre and Post Rotation Exams in AMBOSS/HIPPO/Scholar RX, systems-review lectures, PANCE board preparation and tests, and clinical lecture series.

Typhon Tracking System

 Students are required to maintain a procedure and patient log for all rotations via the Typhon Group Physician Assistant Tracking System, an electronic tracking system. This system serves as a vehicle for compiling information regarding clinical clerkship experiences. Students are required to log information regarding each patient seen on a daily basis. Failure to log patient encounters on time will result in a three (3) point deduction from the overall rotation grade. Each additional submission failure will result in an additional three (3) point deduction and referral to the Course and Standing Committee. 

The Typhon System defines a logging week as Sunday to Saturday. At the end of a logging week, the system will close. Edits cannot be made after this time.  The Clinical Coordinators will spot check these logs.  Students will be contacted if inadequate patient care experiences or omissions in documentation are found.  It is the student’s responsibility to review all comments and make corrections when indicated in their Typhon logging systems. Students must keep copies of Typhon logs for personal records.  The program will not provide copies of rotation documents.

While the Clinical Coordinator will discuss ways to maximize clinical opportunities for the remaining time in the clerkship, it is the student’s responsibility to find opportunities to meet the procedure requirements. Difficulty in meeting these requirements should be brought to the attention of the Clinical Coordinator. Failure to complete any procedure requirement by the end of the year will result in referral to the Course and Standing Committee and a delay in graduation.

Rotation Specific Logging Requirements

Students must log each patient encounter during the clinical year. Include all the patients that students see daily with a minimum of 5 daily notes, which may include, HPI, soap note, procedure notes, progress notes, pre-op, post-op notes and procedural notes.

In addition, medical notes and clinical procedures must be logged in the following numbers:

Required Clinical Year Procedures/Examinations

HIGHLY Recommended Clinical Year Procedures/Examinations

Professional Portfolio

The Typhon system has a feature to create a professional portfolio.  Beginning a professional portfolio challenges student to think critically about their patient care experiences by engaging in reflective practice.  It also teaches students to set goals for achieving professional milestones for career advancement by documenting seminal events in clinical, professional, and personal growth as they occur. The information logged on the professional portfolio can be easily transferred to a CV, blog, web page or other media.

Utilizing the Typhon Group Healthcare Solutions Physician Assistant Student Tracking System (PAST), students will create an online portfolio consisting of six components: 

• Home Page (Introductory Page), which consist of name, picture, address, CCNY e-mail, and an introduction.

• Reflections:  Five (5) entries at different points of the clinical year, each two or more paragraphs, that describe the academic, clinical, professional and personal journey during your time in the PA Program:

• The first will describe your entry into Physician Assistant Program.

• The second will describe your transition from the didactic to the clinical year. The third, fourth, and fifth will describe growth experiences at various points in the clinical year.

• Interesting patient:  These three (3) additional reflections center on a patient care experience that highlights the benefits of health care services, health care policy and education aimed at disease prevention and health maintenance.  These reflections might also address how the encounter impacts critical thinking and future practice.  Each submission is from two paragraphs to one page in length.

• Clinical Year:  This page includes links to Rotation and Dates; Preceptor evaluations, Typhon Logs; Medical Notes; BCLS and ACLS certification documents.

• Research Paper

• CV

This portfolio will be active for five years from the first day of the Program. Maximal use of this system verifies clinical education experiences, which will be useful to future employers.

Disciplinary Action

Students are bound by the content of the policies within this handbook, the Academic Handbook as well as the policies of the City College of New York and the CUNY School of Medicine.  Students who do not uphold such policies will be given a verbal warning, this will be followed by a written warning and if a third repeat infraction occurs, students will be referred to the Committee on Course & Standing for breach of the standards of professionalism.