Policy Summary:

 Students who do not pass USMLE Step 1 by the Block 1 or Block 2 entry deadlines (set each year by the Department of Medical Education) will enter the M3 Curriculum the following academic year if eligible (contingent on passing USMLE Step 1). These students will be required to attend the Clinical Skills Refresher course as well as the M3 Clerkship Orientation offered just prior to their M3 entry.

 Per the standing Step 1 Policies, students who do not demonstrate readiness to sit for USMLE Step 1 ahead of the deadlines set by the Department of Medical Education are required to enroll in the Bridge to Clerkship course, and may repeat that course the following semester if they still have not successfully passed USMLE Step 1.

 Students enrolled in the Fall Bridge to Clerkship course who pass USMLE Step 1 in the Fall semester are eligible to take an Academic or Personal Leave of Absence in the Spring semester. These students, along with any students enrolled in the Spring Bridge to Clerkship course who pass USMLE Step 1 in the Spring semester (ahead of the prescribed deadline), will enter the M3 Curriculum the following academic year as outlined above.

 Students who miss the Block 1 and Block 2 entry deadlines due to extenuating circumstances that are non-academic in nature may request a deadline extension as per the standing Step 1 Policies.  Students granted an extension who pass USMLE Step 1 by their new deadline may petition the SAPC for delayed entry (defined as entry after Block 1 or 2) into the M3 curriculum. If the petition is approved, they will be allowed to enter clerkships in the next possible block after completing an Independent Study for M3 Clerkship Orientation and fulfilling all medical clearance tasks.

 Purpose/Rationale:   

 There is currently no policy to guide delayed entry – defined as entry after Block 1 or 2 – into the M3 curriculum. Previous students who have been allowed delayed entry into the M3 year have struggled according to several outcome measures, including clinical/shelf performance, MSPE summative, and Step 2 readiness.

 Students who already have academic challenges, including difficulties preparing for and passing USMLE Step 1, are not served well by delayed M3 entry. Proceeding directly from a delayed Step 1 pass to a mid-year M3 clerkship entry offers no time for reflection or recovery after a prolonged USMLE Step 1 preparation. Additionally, delayed entry students are being evaluated alongside peers who are now on their 3rd to 7th clerkships, an unfortunate setup for lower clinical performance. Delayed entry also disrupts the integrity of the M3 and M4 curriculum including timing of Clerkship Orientation, the M3 Summative OSCE, and M4 Introduction to Internship. Lastly, delayed entry does not expedite students’ graduation year, and often results in an M3-M4 Personal Leave of Absence or a disjointed/prolonged M4 Curriculum that is captured on residency applications (MSPE, transcript, etc.).

 Procedure:

Who:          

1) All M2 Students

2) Any student who has completed the M2 curriculum but has not passed USMLE Step 1

When:        

This policy informs the transition from the M2 to M3 curriculum

Logistics:   

 Implementation:

The Department of Medical Education and Office of Students Affairs will determine which students have passed USMLE Step 1 by the deadlines required to begin M3 clerkships in Block 1 or Block 2. Students who do not meet these deadlines will receive an email from the Associate Dean for Clinical Medical Education informing them that they are:

1.      Required to enroll in the fall Bridge to Clerkship course per the Step 1 Policies.

2.      Subject to the Delayed Entry policy and may enter the M3 Curriculum the following academic year if eligible (contingent on passing USMLE Step 1).

3.      Supported by an inter-disciplinary team from the Department of Medical Education, Office of Student Affairs, Learning Resource Center, and Office of Wellness as they prepare of Step 1 and transition to M3.

 Informing the students of the policy: 

The approved policy will be added to the Student Handbook. Every year the Associate Dean of Clinical Medical Education will inform students of this policy at M2 Orientation, with reminders at M2 Class meetings and in a M2 Spring semester email. The Office of Student Affairs will also include policy reminders in their M2 Career Advising Meetings and M2 Step 1 Preparation Series.

 Informing faculty and staff of the policy:

Faculty/staff will be informed at both a Medical Education Departmental meeting and at a Student Affairs departmental meeting.

 RELEVANT LCME STANDARDS:

9.9 Student Advancement and Appeal Process

 Other Issues: 

The Chair of the SAPC, which will be the body charged with hearing requests for exceptions to this policy, will be informed of this policy by the Associate Dean for Clinical Medical Education once it is approved by the Curriculum Committee.

 Keywords:    

M2

M3

Step 1

Clerkship

Delay

Delayed entry

Leave of Absence