Policies and Procedures

Closeup of notepad kept on table in empty conference room — Faculty of Medicine

Undergraduate Medical Education - UGME

Policies and Procedures

General

PSD Course/PSD OSCE

A student will be placed in the CSSP if he/she fails the PSD course (PSD OSCE or PSD tutor evaluations) or defers the PSD OSCE.

He/she will have a selected Preceptor for the Transition to Clerkship course to focus on history and physical examination skills prior to entering the first rotation.

In each subsequent rotation, a Preceptor will be selected who is interested in working with students on identified areas of concern, and will provide constructive, timely feedback. The student will not be permitted to participate in the Distributed Medical Education Program or in any community rotations unless permission is granted by the SPEC.

If the student passes the Year 3 Formative OSCE in March, he/she will be removed from the CSSP.

If the student on CSSP does not pass the Year 3 Formative OSCE, he/she will remain on the CSSP.

If the student passes the Year 3 Summative OSCE, he/she will be removed from the CSSP.

If the student does not pass the Year 3 Summative OSCE, the SPEC will review the student’s file and determine the subsequent course of action.

Year 3 Formative OSCE

If a student passes the PSD OSCE but fails the Year 3 Formative OSCE in March, the student will be placed on the CSSP and added to the academic concern list. The student will not be permitted to participate in the Distributed Medical Education Program or in any community rotations unless permission is granted by the SPEC. If the student passes the Year 3 Summative OSCE in September, the student will be removed from the CSSP. However, if the student fails the Year 3 Summative OSCE in September, the case will be brought to the SPEC who will review the student’s file and determine the subsequent course of action.

Year 3 Summative OSCE

If a student passes the PSD OSCE and the Year 3 Formative OSCE but fails the Year 3 Summative OSCE, the student will be placed on the CSSP while completing electives in Ottawa only and will be added to the academic concern list. The student will meet with the Clerkship Director and an intensive remediation program will be set up including one on one mentoring, review sessions on communication skills, and mock OSCEs. The student will retake the Year 3 Formative OSCE. Should a student fail the retake OSCE, the case will be brought to the SPEC who will recommend remediation, repeat of an academic year or withdrawal from the program.

Purpose

To clarify the policy on conflict of interest in clinical placements and to add the portion related to the Objectively Structured Clinical Examinations (OSCE) in Undergraduate Medical Education. The proposed changes are identified in the document below.

Policy

2.4.1 Pre-clerkship and 2.4.2 Clerkship

Conflict Of Interest In Clinical Placements

Students cannot be supervised in any clinical placements (i.e., core rotation, selective or elective) by a member of their immediate family, extended family including in-laws treating physician or others close to them who could compromise the objectivity of the student’s assessment. In addition, students are not permitted to do clinical placements with his or her treating physician. Students must immediately notify the Medical Education Office or Rotation Coordinators to request reassignment if their assigned placement is in violation of this policy. If a physician has treated a student in the past, they should make efforts to avoid any future situation that would put them in a position of evaluating that student.

Students are not permitted to participate in clinical placements at our affiliated clinical care facilities, including University of Ottawa Health Services, with a physician that has treated them in the past.

Conflict Of Interest During OSCE

The examiner cannot be a treating physician, a student’s family member or have a close relationship with the student. He or she must notify the Exam Center prior to the OSCE if they have a conflict of interest. If during the course of the examination, the examiner finds out he or she has a conflict of interest with a student, the examiner must recuse him/herself and the student is then examined at a separate track after the exam. If the examiner or the student perceives a potential conflict of interest, he or she must terminate the encounter and notify staff immediately. The student will then be permitted to complete the station with a different examiner at the end of the examination.

SENATE REFERENCE: 17:M05:09
EFFECTIVE: August 31, 2017
APPROVED BY: Undergraduate Curriculum Committee
DATE: October 20, 2016
APPROVED BY: Faculty Council
DATE: December 6, 2016
APPROVED BY: the Council of Undergraduate Studies
DATE: June 1, 2017
APPROVED BY: Executive Committee of the Senate
DATE: June 13, 2017

The Faculty puts great importance on support to the students to ensure their success in the medical program. Academic Counselling is provided to students in need after every summative examination in both Pre-clerkship and Clerkship.

Preclerkship

Preclerkship students are identified as needing academic counselling based on their examination results should their mark fall at or below 2 standard deviations from the class average. Students are notified by email of the need for mandatory academic counseling at the time their exam marks are released.

Students must schedule an appointment with their Preclerkship Director as soon as possible after receiving notice to discuss their performance to help identify issues that caused them difficulties with the exam and to identify resources to help them overcome these difficulties. At the meeting the student signs a confirmation letter indicating the date that the meeting has taken place.

Students who have been identified as needing counselling must also attend the examination review session. The Undergraduate Medical Education Office informs students of the date/time. Students have to confirm their participation with the coordinator for the relevant year.

Clerkship

Written examination performance requiring counselling:

Identifying the students: Clerkship students are identified as needing academic counselling based on their examination results should their mark fall at or below 2 standard deviations from the class average.
Informing the students: Students are notified by email by the UGME Office of the need for mandatory academic counselling when they receive their examination marks.
Meeting with Rotation Director: Students must schedule an appointment with their Rotation Director as soon as possible after receiving notice to:
- Review their examination
- Discuss their performance
- Help identify issues that caused them difficulties with the exam
- Identify resources to help them overcome these difficulties.

At the meeting, the student signs a confirmation letter indicating the date that the meeting has taken place and this is forwarded to the UGME Office.

Written examination failure

Identifying the students: Clerkship students are identified as needing academic counselling based on their examination results should their mark fall at or below 2 standard deviations from the class average.
Informing the students: Students are notified by email by the UGME Office of the need for mandatory academic counselling when they receive their examination marks.
Meeting with Rotation Director: In the event of a written examination failure, the clerkship student is required to undergo the same process outlined in the written examination performance requiring counselling above.
Meeting with Clerkship Director: The student must also meet with the Clerkship Director to
- Review their performance
- Identify potential issues contributing to difficulties
- Become oriented to supporting resources
- Review the process of remediation.

Clinical Rotation Failure

Discussion of clinical failure occurs anonymously at the clerkship promotions committee.
A remediation plan is proposed by the rotation director.
The remediation plan is reviewed, and/or modified and passed at SPEC and other supports are identified as needed.
All students requiring clinical remediation will meet with the clerkship director to review the clinical remediation plan and allocate academic supports if required.
All students also meet with the Rotation Director prior to implementation of the clinical remediation.

Preamble

Note: If students have any specific needs that would make it difficult to follow these procedures, they must contact the UGME Office as soon as possible in order to see whether arrangements can be made.

Examination dates are posted on the UGME website. Students must pay attention to the times of arrival and to the start and end times for each examination. No exceptions will be accepted without proper approval.

Pre-clerkship students will receive an email notification to inform them when the specific group assignment and scheduling of each group is available through the online calendar within two weeks of the examination day.

Students should arrive outside the examination room at least 15 minutes before the examination is scheduled to begin. The name of students arriving after the examination begins will be submitted to the SPEC. Students arriving more than 15 minutes after the examination begins will not be allowed in the examination room and will need to go directly to the UGME Office (room 2046). A member of the office will contact the faculty representative responsible for the examination in order to get instructions on how to proceed.

Before the examination

Written examinations will be placed on the examination tables prior to the students entering the room and be set up with appropriate spacing.

Ten minutes before the start of the examination, students will be permitted to enter the examination room in silence to take their assigned seat. Clerkship students will also be required to sign in while showing their ID badges to the Proctors before taking their seat.

When taking their seat:

Pre-clerkship students must follow the assigned seating when taking their seats;
Clerkship Francophone stream students must take their seat where examinations include a pink evaluation form while Anglophone stream students must take their seat where examinations include a blue evaluation form.

NOTE: Both sets of exams are in bilingual format.

When taking their seat, students must have their student card with them and place it on the table, face up.
Five minutes before the start of the examination, the students will be instructed to start filling in their name on the cover page only and student number on all sheets where it is requested.
Students will be instructed to start the examination when the appointed time is reached. With the exception of name and student number, nothing should be written on the examination until instructed to start.

With the exception of a basic calculator, students are prohibited from using electronic devices or any other communication tool that has not been approved beforehand. Any such device or tool must be shut off, stored and out of reach. Anyone who fails to comply with these regulations may be charged with academic fraud. It is the students’ responsibility to verify which electronic devices or tools are permissible for each examination. You may refer to item9.4 of the University’s Academic Regulations

All notes, books, bags, coats and any items not necessary to the examination must be placed in an area not within reach. Only writing implements, tissues, throat lozenges, twist-top drinks or other food items that do not make noise or disturb others during the examination are permitted. Exceptions for food items can be made for students with specific health or religious needs. Any requests for such arrangements must be submitted to your Specialist, Academic Administration at least two business days prior to the examination.

Students must answer the questions posed. If there is no right answer then the question will be eliminated. If there is more than one right answer, then the answer key will be adjusted. These decisions will be taken after the examination in consultation with the Director of Evaluations and based on student feedback taken from the survey included with your examination.

During the written examination, only one student at a time will be permitted to leave for the purpose of using the washroom and will be escorted by a Proctor. Out of respect for fellow classmates, please use washroom if only absolutely necessary. It is expected that students use the washroom before or after the examination.

Students are not allowed to leave the examination early. Students must remain seated and quiet until the end of the examination period. This is to prevent disturbing other students who are still completing the examination.

If the examination contains any problematic questions, they should be noted on the survey sheet provided with your examination. This information will then be tabulated and presented to the SPEC for analysis.

After the examination

At the end of the examination, students will be asked to put down their pens or pencils. No extra time will be provided at the end of the examination to complete it or to fill out your name and student number (this is to be done prior to starting the examination).

Students must put all components of their examination back together using the paper clip provided.

Examinations will not be picked up; each student must return their examination to the assigned Specialist, Academic Administration at the designated location within the examination room. When submitting their examination, it is the responsibility of the student to ensure that all components are attached.

If the room availability permits, additional time will be allotted to complete the examination evaluation once the examination has been returned. If needed, students can email more comments to the UGME office before the following Monday morning. These comments should be sent directly to your Specialist, Academic Administration.

When leaving the examination room, all papers must be returned to the Specialist, Academic Administration assigned whether or not they have been filled out.

Out of respect for anyone still writing an examination, students should be quiet when in or around rooms where examinations are taking place. Failure to do so may be considered as a lack of professionalism.

In the case of an alarm, or any situation where evacuation of the examination room is necessary, Proctors will ask students to gather in a specific area so that they will remain together in silence (no discussion of the examination is permitted). The group must stay in this location for the duration of the evacuation and await further instructions from the authorities involved. The faculty representative responsible for the examination will determine whether to resume or suspend the examination. If the examination is suspended, then the Faculty will decide on its rescheduling.

University Procedure on cancellation or postponement of examinations.

Examination and evaluation review (Evaluations completed by tutors and preceptors)

Students have a right to discuss their evaluations and feedback comments. They should contact their tutors, preceptors and/or rotation directors to set up an appointment within 10 working days of receipt of the evaluation.

Note that the marks report initially sent following an examination is preliminary. Marks become official after approval by the Student Promotion Executive Committee.

Examinations reviews

All requests for an examination review must be made within 10 working days following the release of the marks. In the event of a student writing a supplemental examination, the student may review the original examination no later than 10 working days prior to the supplemental exam.

Note that the marks report initially sent following an examination is preliminary. Marks become official after approval by the Student Promotion Executive Committee.

Students have a right to review their examination under supervision. Nothing is to be written on the examination itself, or taken away after the review period. During the review session, students are not permitted to work in groups or discuss with each other the marking of their examination. Students will not be able to request a reconsideration of their answer in light of a different interpretation of a question, nor can a student request remarking of their examination. Students can verify that their marks have been added properly. If errors in addition are noted, they will be corrected.

At the end of the review period, when all the arithmetic errors have been corrected, the cut-offs for counselling will be recalculated. Students will be informed that the official review period is over and that the marks are finalized. Individual students will be informed if their standing in the unit has changed.

SENATE REFERENCE: 2019:UGRD-MED:12
EFFECTIVE: April 3, 2012
REVISION: March 17, 2020
APPROVED BY: Undergraduate Curriculum Committee
DATES: October 25, 2011; January 23, 2020
APPROVED BY: Faculty Council
DATES: December 14, 2011; January 28, 2020
APPROVED BY: Council of Undergraduate Studies
DATES: February 16, 2012; March 5, 2020
APPROVED BY: Executive Committee of the Senate
DATES: April 3, 2012; March 17, 2020

Purpose

The purpose of this document is to provide a student-centred approach to consent for physical examination of students by peers and tutors that is respectful of students’ privacy and to provide a clear procedure for negotiating adverse events.

Scope

This document applies to all students and faculty involved in the teaching and learning of clinical skills in the MD Program curriculum. In this document, the term “peers” refers to MD Program students.

Guidelines

Examining peers is part of the Clinical skills training in the MD Program.
Students and tutors may examine head, neck, and limbs typically exposed with T-shirts and shorts. Abdomen and chest (anterior and posterior) and spine exposed by removal of top layer of clothing may only be examined with students’ explicit consent and in accordance with appropriate draping procedures.
Students and tutors will not be expected to examine breasts, the genitals or rectal area.
Students must obtain verbal consent from peers to be examined before each physical examination encounter. Any concerns regarding consenting to peer exam in general should be discussed with the Clinical Skills Directors at the beginning of the academic year.
Students may withdraw verbal consent to be examined at any time. Students are not required to disclose their reasons for withdrawing consent.
Students may decline to give consent to be examined by tutors and peers. Students are not required to disclose their reasons for refusing consent.
Students who refuse or withdraw consent for any component of the physical exam may discuss this decision with either their tutor or Clinical Skills Director. All parties will handle this discussion sensitively and confidentially.
Students may opt to pre-select partners from within the group with whom they are comfortable.
Tutors must not coerce students into consenting to be examined. They should only invite students to volunteer for demonstration purposes who have previously given consent. Any instances of perceived coercion or discomfort should be discussed with the Clinical Skills Directors.
Tutors will have access to ongoing faculty development opportunities to ensure they have clear, ongoing understanding of these guidelines.
Tutors shall not take a refusal of peer participation into account when considering the student’s academic performance.
In the event that peer participation for physical examination is not possible within the student’s group, other avenues to ensure that student learning is not compromised will be implemented (i.e., combining groups, use of standardized patients, etc.).
In the event of discovery of a suspicious finding, inappropriate behaviour, or a breach in confidentiality, tutors and students will follow the adverse event procedures outlined below.

Adverse events procedures

Discovery of a suspicious finding

During physical examination of students by peers and tutors it is possible that a new concerning or suspicious finding may be discovered, for example, discovery of a mass, a heart murmur, or elevated blood pressure. The goal is to enable the student to obtain timely medical attention.

The following steps will be taken:

The examining student confidentially informs the examined student of the concerning or suspicious finding.
The examining student determines whether the student is already aware of the concerning or suspicious finding.
Both students confidentially inform their tutor.
The tutor asks permission to perform the same physical examination.
If the tutor confirms the concerning or suspicious finding, the tutor recommends that the student seeks medical advice.
The tutor reminds both students of the duty of the examining student to maintain confidentiality regarding the incident.

Inappropriate behaviour

Inappropriate behaviour, is definedas inappropriate use of medical equipment, offensive language, or physical abuse during physical examination of students by peers and tutors. Appropriate steps must be followed if either Tutors directly witness inappropriate behaviour or are alerted to it by a student. The consequence for inappropriate behaviour will vary and will be determined on a case-by-case basis.

The following steps will be taken:

The tutor speaks to the student(s) behaving inappropriately.
The tutor informs the student that their behaviour is inappropriate and may be a breach of University or Faculty policy or standard.
For serious breaches of behaviour, the tutor contacts the course director regarding the incident.
The course director checks applicable policies and standards regarding the incident and takes required actions.
If a student has potentially been harmed by the inappropriate behavior, the tutor ensures that he or she seeks appropriate care (i.e. counseling).

Breach in confidentiality

Confidential information about a student may be revealed during history taking or physical examination. For example, students may reveal a history of medical issues, or physical examination may reveal surgical scars. It is possible in these situations that a breach in confidentiality may occur despite students being taught about the importance of confidentiality.

NOTE: Some students may willingly provide specific consent to have their physical findings used for the instruction of others, which would not breach confidentiality.

The following steps will be taken in the case of a breach in confidentiality:

The tutor takes the student(s) who breached confidentiality aside to speak with them.
The tutor informs the student(s) that sharing confidential information without consent is unacceptable and a breach of standards.
The tutor contacts the Clinical Skills Directors regarding the incident.
The Clinical Skills Director checks applicable policies and standards regarding the incident and takes required actions.
The tutor ensures the student whose confidentiality has been breached is informed and, if required, seeks appropriate care (i.e. counseling).

SENATE REFERENCE: 2020 UGRD-MED-04
EFFECTIVE: August 25, 2020
APPROVED BY: Undergraduate Contingency COVID-19 Committee
DATE: July 28, 2020
APPROVED BY: Faculty Council
DATE: August 25, 2020

General Information

The students must evaluate their teachers and the teaching program in a mature, constructive and respectful manner. A bilingual, centralized, Internet-accessible evaluation system (One45) is used for the evaluation of individual learning activities, courses as well as teachers. Students receive all evaluations, however, they are only obliged to complete the following:

evaluate the Faculty Member facilitating learning activities labelled as MANDATORY on their schedule and
evaluate the course when they are a member of the evaluation team which occurs at least twice each year.

Students are not required to complete the teacher evaluation forms since attendance at most lectures and laboratories is not mandatory. However, we strongly recommend that all students complete the individual teacher evaluations (lectures and laboratories) since this feedback is extremely important to the Faculty and will lead to quality improvement. Please rest assured that it is not possible to determine the authorship of any online evaluation. The anonymity of the student is guaranteed at all times. However, it is possible to monitor who has submitted their evaluations.

Students have until the due date listed in the evaluation system (One45) to submit a mandatory evaluation (see above for definition of what constitutes mandatory evaluations). Students will get notifications to complete their evaluation. If students do not submit their evaluation before the due date, they will be called to meet with the Pre-clerkship Director in order to explain why they have not completed the mandatory evaluations. The Director will then report back to the SPEC as needed to determine whether or not the student should be placed on internal probation, a note should be placed in the professionalism section of the MSPR, or whether other actions should be taken.

Clinical Preceptors

The students must evaluate their Clinical Preceptors and the teaching program in a mature, constructive and respectful manner. A bilingual, centralized, Internet-accessible evaluation system (One45) is used for the evaluation of individual learning activities, rotations and teachers. There are two mandatory evaluations. Every student must:

evaluate their Clinical Preceptors in each rotation
evaluate the overall quality, organization and teaching at the end of each six week clerkship rotation.

This feedback is extremely important to the Faculty and will lead to quality improvement. Students are also requested to voluntarily complete the teacher evaluation forms for the didactic sessions within each rotation.

Please rest assured that it is not possible to determine the individual authorship of any online evaluation. The anonymity of the student is guaranteed at all times. However, it is possible to monitor who has submitted their evaluations.

Students have until the due date listed in the evaluation system (One45) to submit a mandatory evaluation (see above for definition of what constitutes mandatory evaluations). Students will get notifications to complete their evaluation. If students do not submit their evaluation before the due date, they will be asked to meet with the Clerkship Director in order to explain why they have not completed the mandatory evaluations. The Director will then report back to the SPEC as needed to determine whether or not the student should be placed on internal probation, a note placed in the professionalism section of the MSPR, or whether other actions should be taken.

Examination and evaluation review

All requests for an examination and/or evaluation review session must be made within ten (10) working days from the day following the release of the marks and/or evaluations (i.e. for CBL or clinical rotations).

Please refer to the Examination and Evaluation Review Policy 2019:UGDR-MED:12.

Appeals

Appeal to the Faculty Council Appeals Committee

A student has the right to appeal the grade obtained in a course. A student may also appeal decisions regarding remediation, sanctions for unprofessional behaviours, requirement to repeat educational components, probation, suspension or withdrawal from the MD program as ratified by the Student Promotion Executive Committee (SPEC) or Faculty Council.

Student must submit their request to the Faculty Council Appeals Committee within ten (10) working days after receiving written notice of their final grade and/or decision they wish to appeal. The procedures of the Faculty Council Appeals Committee will apply and is describe under Bylaw 9.3 Faculty Council Appeals Committee.

While a student may appeal a Faculty Council decision regarding withdrawal of the program to the Faculty Council Appeals Committee, he/she will remain on leave from the program pending the results of the appeal.

Appeal to the Senate Appeals Committee

Prior to appealing to the Senate Appeals Committee, the student must have submitted an appeal to and received a formal decision from the Faculty of Medicine Faculty Council Appeals Committee. If not satisfied with that decision, the student may submit an appeal to the above- mentioned Senate Committee within 10 working days from the date he or she received the decision of the Faculty Council Appeals Committee.

The Senate appeals procedure is described here.

Please click here to see the Appeal process workflow.

SENATE REQUEST NUMBER: 2018:UGRD-MED:07
EFFECTIVE: March 20, 2018
APPROVED BY: Undergraduate Curriculum Committee
DATE: May 11, 2017
APPROVED BY: Faculty Council
DATE: June 13, 2017
APPROVED BY: Executive Committee of the Senate
DATE: March 20, 2018

The purpose of this policy is to provide partial reimbursement for students who are assigned by the Faculty to sites outside the region for PSD, Community Service Learning (CSL) and community week. This policy does not, at any time, apply to electives.

Students required by the Faculty to travel outside the Ottawa-Gatineau area (outside a 25-km radius of Roger Guindon Hall) receive a travel allowance based on the location of the clinical placement.

Within two weeks of termination of the clinical placement or at the end of each term for PSD assignments, students must submit their evaluation form as proof that they have completed their placement/PSD. When this evaluation is received, the person in charge at the UGME Office arranges to have a reimbursement cheque issued. Students generally receive reimbursement within ten working days after reception of their evaluation. If their evaluation is not received within the ten working days, the Faculty reserves the right to turn down the request for reimbursement.

Whenever possible, low-cost accommodations (e.g. $125 weekly or less) are identified in locations that are situated 100 km or more from Roger Guindon Hall and accommodation expenses are reimbursed directly by the Faculty. If no accommodations have previously been identified by the Faculty, a sum of $25 per day is allowed up to a maximum of $125 weekly (weekend excluded). In this case, the travel allowance is limited to one (1) round trip per week.

Students are responsible, where applicable, for enrollment fees at another faculty of medicine or college of physicians of another province (e.g. University of Manitoba).

As for more remote sites for which travel expenses are not already subsidized by programs such as the Northern Ontario School of Medicine (NOSM) program, the Eastern Regional Medical Education Program (ERMEP), etc., expenses corresponding to the most economical means of transportation shall be reimbursed.

Students travelling to another province for a rotation or to a rural or remote community in Ontario under the auspices of the Consortium national de formation en santé (CNFS) are subject to the CNFS’ Politique de remboursement des frais de déplacement pour stages en milieu clinique [policy on reimbursement of travel expenses for clinical clerkships].

All requests for an exception to this policy must be justified in writing and approved by the Vice-Dean, UGME. In all cases, the Faculty shall reimburse the student for the least costly alternative. Consequently, it is important to make arrangements well in advance of travelling to clinical sites with the person in charge of PSD or placements at the UGME Office.

For reimbursement of student travel and/or housing expenses, please use:

N.B.: The Faculty and the University assume no responsibility for damages to a personal vehicle used by a student for travel. Students must therefore check with their insurance company to determine whether they need to obtain additional insurance.

Preclerkship

Preamble

To successfully complete pre-clerkship, a student must pass the following courses:

Year 1: MED 1107 Community Week, MED 1200 Introduction Unit to the Profession, MED 1201 Foundations Unit, MED 1202 Unit I, MED 1302 Physician Skills Development (Part 1), MED 4101 Eportfolio on Core Competencies (Part 1)*
*no grade attributed until the end of the 4th year
Year 2: MED 2201 Unit II, MED 2202 Unit III, MED 2203 Unit IV, MED 2109 Mandatory Clinical Week, MED 2302 Physician Skills Development (Part 2), MED 4102 Eportfolio on Core Competencies (Part 2)*, CLI 2101 Transition to Clerkship Part 1**
*no grade attributed until the end of the 4th year
**new course effective spring 2021

Courses

Introduction Unit (MED 1200)

To pass the Introduction Unit, a student must attend all sessions and meet expectations on all mandatory assignments. Students must comply with the Attendance Policy in Pre-Clerkship. A student with 1 or more absences may be required to meet with the Director of Pre- Clerkship. The case of a student with a failure to meet expectations, including not attending 1 or more sessions, will be discussed by the Student Promotion Executive Committee (SPEC) who could recommend remediation or sanctions up to repetition of the academic year or dismissal from the program.

Foundations Unit (MED 1201), Unit I (MED 1202), Unit II (MED 2201), Unit III (MED 2202) and Unit IV (MED 2203)

To pass these courses, a student must complete all sections of the examinations and receive an overall unit grade of 60% or more, meet expectations on all mandatory assignments and meet expectations overall on Case-Based Learning (CBL) sessions.

A student who obtains a failing grade for a unit must write a supplemental examination. To be promoted to the next academic year, students must achieve an overall mark of 60% or more on the supplemental examination.

The case of a student with a failure in meeting CBL expectations or mandatory assignments will be discussed by the SPEC who could recommend remediation or sanctions up to repetition of the academic year or dismissal from the program.

Deferred and Supplemental Examinations of a Unit

The date and time of deferred and supplemental examinations are determined by the Undergraduate Medical Education Office.

Students may have a maximum total of 2 deferred assignments, deferred examinations, supplemental examinations or combination thereof in 1 academic year.

In the case of a deferred assignment or examination, the unit final grade will be released to the student once all mandatory components have been successfully completed.

In the case of a unit supplemental examination, to be promoted to the next academic year, students must achieve an overall mark of 60% or more on the supplemental examination.

The case of a student with a failure on a supplemental examination will be discussed by the SPEC who could recommend remediation or sanctions up to repetition of the academic year or dismissal from the program.

The grade obtained on the supplemental exam replaces the final examination grade in the course. Only the grade obtained after the supplemental exam appears on the student’s transcript.

However, a note on the transcript will indicate that this grade was obtained as a result of a supplemental examination.

Physician Skills Development (PSD) Courses

Physician Skills Development (Part 1)—MED 1302

To pass this course, a student must:

obtain an overall pass on PSD tutor and Community Preceptor Program evaluations; and
obtain a pass on the PSD Year 1 summative Objective Structured Clinical Examination (OSCE).

In the case of a deferred OSCE, the student must complete the year 1 OSCE the following academic year and obtain a passing grade.

A student who obtains a failing mark on the OSCE will receive a failure grade for the course. The student must complete the year 1 OSCE scheduled the following academic year and obtain a passing grade. This OSCE serves as the supplemental OSCE. The case of a student with a failure on the supplemental OSCE will be discussed by the SPEC who could recommend remediation or sanctions up to repetition of the academic year or dismissal from the program.

The grade obtained on the supplemental OSCE replaces the final grade in the course. Only the grade obtained after the supplemental OSCE appears on the student’s transcript. However, a note on the transcript will indicate that this grade was obtained as a result of a supplemental examination.

Physician Skills Development (Part 2)—MED 2302

To pass this course, a student must:

obtain an overall pass on PSD tutor and Community Preceptor Program evaluations; and
obtain a pass on the Year 2 PSD summative Objective Structured Clinical Examination (OSCE).

In the case of a deferred OSCE, the student must complete the year 2 OSCE the following academic year and obtain a passing grade.

A student who obtains a failing mark on the OSCE will receive a failure grade for the course. The student must complete the year 2 OSCE scheduled the following academic year and obtain a passing grade. This OSCE serves as the supplemental OSCE.

The case of a student with a failure on the supplemental OSCE will be discussed by the SPEC who could recommend remediation or sanctions up to repetition of the academic year or dismissal from the program.

For the overall PSD course (Part 1 and Part 2 combined), a maximum of one (1) deferred or supplemental OSCE is allowed to be promoted to year 3. The case of a student who surpasses this maximum will be discussed by the SPEC who could recommend remediation or sanctions up to repetition of the academic year or dismissal from the program.

For more information, please consult the University’s Policies and regulations website.

Transition to Clerkship Part 1 (CLI 2101)*

*completed at the end of year 2

To pass this course, the student must attend all sessions and obtain a pass on the preceptor evaluation. Failure to do so will result in a remediation plan recommended by the Clerkship Promotions Committee, to be completed in the summer prior to Transition to Clerkship Part 2. The case of a student with a failure of remediation will be discussed by the SPEC who could recommend remediation or sanctions up to repetition of the academic year or dismissal from the program.

Transition to Clerkship Part 2 (CLI 3301)*

*completed at the beginning of year 3

To pass this course, the student must attend all mandatory sessions and obtain a pass on the preceptor assessment. Students must successfully complete this course prior to starting their clinical rotations. If a student fails to meet the objectives of the course, their performance will be reviewed by the leader of Transition to Clerkship and presented to the Clerkship Promotion Committee as well as the SPEC. Recommendations may include remediation, repetition of an academic year or dismissal from the program.

Community Week (MED 1107)

To pass Community Week, a student must obtain a pass on the preceptor evaluation. The case of a student with a failure on the Community Week preceptor evaluation will be discussed by the SPEC and the recommendation may include remediation, repetition of an academic year or dismissal from the program.

Mandatory Clinical Week (MED 2109)

To pass Mandatory Clinical Week, a student must obtain a pass on the preceptor evaluation. The case of a student with a failure on the Mandatory Clinical Week preceptor evaluation will be discussed by the SPEC and the recommendation may include remediation, repetition of an academic year or dismissal from the program.

Electives (non-mandatory)

All elective placements must be pre-approved by the Faculty of Medicine. Please refer to the procedures and guidelines for planning electives on the University of Ottawa Faculty of Medicine Electives website.

Professionalism

A course, longitudinal component, elective or rotation may be failed despite adequate demonstration of knowledge and clinical skills due to a failure in the domain of professionalism. Any student registered in the MD Program is expected to adhere to the professional standards of the Faculty of Medicine and demonstrate professional behaviour within coursework and clerkship, as well as outside of the classroom and clinical setting when the student is clearly identifiable as a medical student. Any unprofessional behaviour in an official setting or communication will be brought to the attention of the Vice-Dean of UGME, and may lead to remediation and/or academic sanction, which may include internal probation, recording on the Medical Student Performance Record, failure of a course, longitudinal component, elective or rotation, or dismissal from the Faculty of Medicine, based on the recommendations of the SPEC.

Please see the Professionalism website for more information.

SENATE REFERENCE: 2019:UGRD-MED:09
EFFECTIVE: June 4, 2019
REVISION: September 13, 2022
APPROVED BY: Undergraduate Curriculum Committee
DATES: May 23, 2019; June 23, 2022
APPROVED BY: Faculty Council
DATES: June 4, 2019; August 29, 2022
APPROVED BY: Council of Undergraduate Studies
DATE: September 8, 2022
APPROVED BY: Executive Senate Committee
DATE: September 13, 2022

Accreditation standard 8.8

The undergraduate curriculum committee and the program’s administration and leadership implement effective policies and procedures regarding the amount of time medical students spend in required activities, including the total number of hours medical students are required to spend in clinical and educational activities during required clinical learning experience.

Purpose

The Undergraduate Medical Education Program (UGME) at the Faculty of Medicine at the University of Ottawa provides balance among academic learning events, self-study time, electives time and personal life of a student. This standard is intended to provide guidance in terms of the length of the school day and total weekly hours dedicated to educational and clinical activitie

Statement

In preclerkship, Year 1 and Year 2 of the curriculum, with the exception of the first 2 weeks of study (MED 1200: Introduction to the Profession) dedicated teaching activities are largely scheduled between 8:00 a.m. and 12:30 p.m., Monday to Friday. Clinical skills activities are scheduled between 1:30 p.m. and 5:00 p.m., one to two afternoons per week. Scheduling exceptions can occur in certain weeks because of mid-term evaluations, statutory holidays and other special circumstances. Regardless of the exceptions, the maximum number of hours students will be expected to be in dedicated/clinical teaching activities during preclerkship years 1 and 2 is 29.5 hours per week. There are normally no scheduled learning activities on Saturday and Sunday, although rare exceptions may occur.

An average of 10.5 hours of self-study/electives time is available on a weekly basis.

Self study/electives time will be protected to ensure that curricular activities do not impinge on the designated blocks of time. Exceptional use of any protected time (for example, rescheduling to accommodate a faculty member that was unable to teach due to extenuating circumstances) must be approved by the relevant preclerkship Director.

Non-curricular events cannot be scheduled during regularly scheduled curricular activities.

Oversight and monitoring

CCRC is responsible for implementing and addressing challenges to the policy.

Concerns from students, teachers or administrative staff members regarding breaches of this policy should be brought to the attention of the Unit Leader, initially, and if not resolved satisfactorily, then to the Preclerkship Director for review. Finally, appeals may be heard by the Curriculum Content and Review Committee (CCRC) if there is disagreement with the decision of the Unit Leader and Preclerkship Director.

SENATE REFERENCE: 17.M05.04
EFFECTIVE: May 19, 2017
APPROVED BY: Undergraduate Curriculum Committee
DATE: October 20, 2016
APPROVED BY: Faculty Council
DATE: December 6, 2016
APPROVED BY: Council of Undergraduate Studies
DATE: April 6, 2017
APPROVED BY: Executive Committee of Senate
DATE: May 18, 2017

Clerkship

Orders and notes

Orders and notes in a patient’s record and all related documentation must be clearly identified with MS3 or MS4 next to the student’s signature or according to the instructions for the particular rotation.

Hospital greens

Hospital greens are the property of the hospital and can constitute a health hazard when contaminated. Greens must not leave hospital premises under any circumstance. For further information, please refer to the Hospital Coordinator.

Clinical placement requirements record

Every student’s immunization record must be up to date and should comply with the Faculty of Medicine’s requirements, i.e. yearly TB testing and seasonal influenza vaccination. Students with medical exemptions must present the documentation to the Office of Clinical Placement Risk Management. Students will be withdrawn from clinical duties if their immunization record is found to be deficient. Time away from educational activities will have to be made up once the immunization record is found to be compliant with the Faculty regulations.

Appropriate appearance at clinical encounters

These guidelines were developed by students and Faculty Members in conjunction with community members in order to provide recommendations to students, residents and Faculty Members—both male and female—regarding their appearance while encountering patients. In addition to being appropriately dressed, there are other issues concerning appearance as well as health and safety regulations. The precise details will vary with each situation and often depends on the clinical setting—the key word is appropriate. Please be informed of the specific policies of each institution.

“Dress is the external reflection of your professional attitude toward your patient.” A professional demeanor contributes to patient trust and enhances confidence. It is an important factor to enhance patient compliance with medical recommendations. Remember that being hospitalized is a stressful event for a patient and family and that a health professional’s appearance and demeanor should be comforting and reassuring.

Suggestions

Be well groomed and clean. Body odor should be well controlled. Do not expose your shoulders, midriff, cleavage and upper thighs. Avoid provocative attire and any clothing with obvious commercial logos. Keep jewelry to a minimum, especially when it comes to visible piercing.

Long hair should be tied back during patient examinations. In addition, although pediatric patients may appreciate colored hair, some adults may have a different view.

It is suggested that males wear a shirt with a collar and be prepared to wear a necktie. Women should use their judgment when choosing a skirt so that its length complements their professional image. Baseball caps are not considered suitable head gear in a clinical milieu.

You should be prepared to wear your white coat. You should always wear your identification badge.

When in doubt, use your Preceptor as a guide. Seek advice, accept positive and constructive feedback, and modify your behaviour accordingly. Respect and consideration for the patient should be your concern.

Health and Safety Regulations in the hospital setting currently dictate that:

Perfumes and strong scents (from shampoo, hand creams, deodorants, etc.) are not permitted due to the possible sensitivity of patients and coworkers.
Shoes—not sandals—must be worn in clinical settings where exposure to body fluids is likely (surgical, obstetrics/gynecology, intensive care and emergency rotations for example). Shoes which are open in the back are acceptable, in most situations. For O.R. duties, check with each institution regarding appropriate footwear.
It is important to trim fingernails, as long or artificial nails can cause harm to patients and have been demonstrated to transmit infection.
Scrub suits (i.e., “greens”) are not to be worn outside of the hospital.
Expectations regarding appearance should be widely distributed to faculty, staff, residents and students. This information should be clearly stated at the onset of any new clinical situation. Hospital policy on this matter needs to be consulted; in case of discrepancies, the latter will prevail.

The onus, however, is on you to ascertain that your appearance is acceptable in any particular setting. In other words, ask ahead of time and/or think about what is “appropriate”—and professional—wherever you go, and you can’t go wrong!

Clinical placements within city limits

By choosing the University of Ottawa as your place of studies, please be advised that your clinical placements may be located anywhere throughout the city of Ottawa limits, as long as local public transportation is accessible with a regular schedule.

ELE 3951 - Enrichment Year- Post Year 3

This course allows students to take a year in between years 3 and 4 of Clerkship to supplement their medical training by pursuing unique opportunities that are not covered in the MD. Students will complete 48 weeks of supervised and evaluated training at sites approved by the Faculty of Medicine.

Students must submit a proposal and obtain permission from the Faculty at least six months prior to the beginning of their 4th year of study. This course cannot be repeated.

Please refer to official course description ELE3951 – Enrichment Year – Post Year 3.

ELE4931: Enrichment Year – Post Year 4

Definition

The enrichment year is a 5th year of medical school that students can apply for if they have not been matched to a postgraduate residency program and have not yet graduated.

Purpose

The purpose of an enrichment year is to allow students that have not been matched to a residency program to complete additional clinical and research experiences. The exposure to additional clinical experiences, which must be done in a variety of disciplines, will assist them with career exploration. The research experience will provide them with a research perspective that they may not have previously been exposed to and will assist in making them more competitive when applying in the CaRMS match.

The year is intended to support students who have made reasonable attempts to engage in the CaRMS matching process in good faith.

Eligibility

Participation in the enrichment year is voluntary. Acceptance to the enrichment year is at the discretion of the Vice-Dean of UGME, or delegate, and is subject to availability.

Current-year students must have actively participated in both the 1st and 2nd iterations of CaRMS and have been unsuccessful. This includes participation in:

Interviews
Submission of a rank order list

A candidate for the MD Program must complete all degree requirements within seven (7) academic years of the date of initial registration in the MD Program (including the enrichment year) to be eligible to graduate at spring convocation as per the time limit to complete degree policy. Senate reference: 11:M05:03.

Students will be ineligible for the enrichment year if they have failed to actively participate in the 1st and 2nd iteration of the CaRMS match.

Important Considerations

Availability of the enrichment year is at the sole discretion of the Vice-Dean UGME, or delegate.

Students who wish to participate in the enrichment year must have the written support of the Assistant Dean Student Affairs. The letter of support must accompany the student’s application.

Students who are participating in the enrichment year will defer their graduation from the MD Program until the completion of the enrichment year.

Students will not participate in any clinical or research activities of the enrichment year until they receive approval from the Vice-Dean UGME, or delegate.

Enrichment Year Requirement

Students must maintain registration at the University of Ottawa to ensure appropriate insurance coverage at all times.

All the rules, regulations, policies, and practices of the University and the Faculty of Medicine MD program will continue to apply during the period of registration.

Registration will be for the Summer, Fall and Winter semesters and tuition will be the same rate as incoming 4th year. It is important to note that OSAP does not recognize the Post YR4 Enrichment Program and as such financial aid will be limited.

Students will begin the enrichment year in the summer following the year 4 spring promotions meeting.

This enrichment year is a one-time opportunity and cannot be repeated.

The latest start date allowed will be July 1.

Students will be integrated into the upcoming 4th year programming and will be invited to participate in orientations, longitudinal curriculum, career nights, special meetings and OSCEs. LMCC preparatory sessions and materials will also be available if they were unsuccessful on the first attempt of the LMCC part 1 exam or have deferred writing until the fall.

Please refer to the course description ELE4931 – Enrichment Year – Post Year 4.

Electives will be registered with the MD program in the same manner as they are in the remainder of the MD Program.

Assessment during the enrichment year will be in the same manner as in the remainder of the MD Program.

The implications of an incomplete, unsatisfactory or fail evaluation or grade of an elective during the enrichment year will be the same as in the remainder of the MD Program. Consequences are outlined in the MD program policies and procedures in Clerkship Requirements for passing 4th Year Clerkship.

Students will, in good faith, apply to a range of post‐graduate medical specialty programs that will maximize their opportunity of matching to more than one discipline in the next CaRMS match.

Students must participate in the career advising process offered by the Student Affairs Office.

Student Affairs will continue to provide students with access to all its services including wellness and career advising during the enrichment year.

Students will be required to meet with the Assistant Dean, Academics, or delegate, every 12 weeks for a progress review and career counselling session.

Students who voluntarily withdraw from the enrichment year prior to completion will be subject to the University’s regulations and deadlines for dropping courses.

Application process

Students must submit to [email protected] a document of 1500 words maximum that addresses each of the following:

Reflection on 1st and 2nd iteration of the CaRMS match and factors that likely contributed to an unmatched status
Services utilized during the 1st and 2nd iterations of the CaRMS match
An outline of the planned Electives and Selectives, including clinical and non-clinical electives for the enrichment year highlighting the primary goals and objectives that participating in these clinical activities will help support your enrichment year
A planned strategy for next year’s CaRMS match
Identification of mentors and/or collaborators, within or outside of the Faculty, who will be supporting you through the enrichment year.

Deadline to submit the application is 2 weeks after the results of the 2nd iteration of the CaRMS match are released.

Once applications have been received, the selection committee, chaired by the Vice-Dean UGME or delegate, will review applications and submit a written letter of acceptance or refusal no more than 3 weeks after the results of the 2nd iteration of the CaRMS match are released.

Reimbursement

Students are eligible to receive up to 70% of the value of tuition in reimbursement for admissible expenses (i.e. transit fees, accommodation fees (not meals) and elective fees). Original receipts must be submitted to Justine Smyth ([email protected]).

Rationale

The proposal to mandate a Clerkship (3rd and 4th year of the MD program) rural/community rotation was requested to fulfill accreditation requirements and to meet current and projected societal needs. The Faculty is accountable to society to educate the appropriate numbers of generalists and specialists necessary to provide comprehensive health care to Canadians. Accreditation standards require that students have clinical experience in primary care in Family Medicine and the general specialty disciplines. Students must also understand health care delivery at all levels as part of the requirements for licensure. In addition, there is evidence that experience in rural/community practice settings attracts more students into Family Medicine, general medical and surgical specialties, and increases physician recruitment to these communities. The breadth of exposure and learning opportunities for medical learners in distributed and underserviced clinical sites may reach or exceed the objectives of the undergraduate medical education program. Ontario and the other provinces have an excellent resource of rural/community preceptors, and Distributed Medical Education (DME) networks.

Proposal

Commencing with the Class of Meds 2007, Clerkship students are required to complete a minimum of 4 consecutive weeks in a rural/community rotation prior to graduation. One rotation choice must be identified as a rural/community rotation. This is usually completed during one of the core 3rd year rotations, and less often during the 4th year. In order to be eligible to commence a core 3rd year DME placement, a student must not be on the active academic concern list. Any exception to the above designation can be approved only by the Student Promotion Executive Committee (SPEC).

Students will complete their rural/community placement in Ontario, except for students with the Consortium National de Formation en Santé (CNFS).

Rotations in Ontario DME networks have been developed for many core rotations. Students in 4th year may choose any clinical discipline that is available in the DME networks. The DME networks have greater capacity to place students in Family Practice settings than in specialty practices as most physicians in the community are Family Physicians. Consistent with the Mission Statement of the Faculty of Medicine of the University of Ottawa, a partnership relationship exists with the Eastern Regional Medical Education Program (ERMEP). The majority of Ottawa students will be placed within the ERMEP network. The other Ontario DME networks and medical school DME offices are: Rural Ontario Medical Program (ROMP), Northern Ontario School of Medicine (NOSM), and Schulich Office of Distributed Education.

SENATE REFERENCE: 2022-MED-UGRD-04
EFFECTIVE: January 15, 2009
REVISION: September 13, 2022
APPROVED BY: Undergraduate Curriculum Committee
DATE: January 2005; December 11, 2008; June 23, 2022
APPROVED BY: Faculty Council
DATE: December 5, 2006; December 17, 2008; August 29, 2022
APPROVED BY: Council of Undergraduate Studies
DATE: January 15, 2007; September 8, 2022
APPROVED BY: Committee of the Senate
DATE: January 15, 2009; September 13, 2022

Night call

The maximum number of hours per week spent in educational and clinical activities during clinical rotations is 55 hours, excluding call.

Night call is an essential mandatory educational component which should be viewed as an opportunity. It is hoped that the night call schedule in most rotations will average at least once per week for weeknights plus some weekend experience, and must not exceed one in four on average. Students are expected to spend the entire night in the hospital.

It is understood that for health and safety reasons, when post-call or post-night shift, a student will never be expected to drive or commute to a clinic, office, another hospital or to any teaching facility.

Students will be released from all duties including call by 5 p.m. on the two evenings prior to any rotation examination (Wednesday, Thursday) every 12 weeks, with the exception that students doing a shift during a rotation in emergency or emergency pediatrics will be released of all duties by 11 p.m. on the Wednesday prior to any rotation examination. Students may have to do a night call over the last weekend at the end of the first six-week rotation of a cycle. In such case, they will be relieved of duty at 5 p.m. on the Sunday to prepare for the start of the last six weeks of the rotation which begins the next morning. Students are not expected to perform night call on the last weekend of each 12-week rotation.

OSCE

The Teaching/Testing OSCE is scheduled on Monday; therefore, students will be released from call as of 11 p.m. on the preceding Saturday, and released from call as of 5 p.m. on the preceding Sunday. Students are released as of 3 p.m. on the day of the OSCE.

The last weekend between rotation blocks (every 12 weeks) should not be used for scheduling routine call. However, under special circumstances, where agreed by the student, it may be used to make up for call or clinical sessions that students missed during the regular rotation. In this event, the student should be released after 5 p.m. on the Sunday evening.

Obstetrics and gynecology

Following night call, students in this rotation must go home, provided they have handed over the care of the patients to their colleagues via in-patient rounds. Such handover shall not exceed one hour. When post-call, students are not expected to attend any other clinical activities including out-patient clinics, physicians’ offices or O.R. lists.

Other rotations with in-house call

Clerkship students shall be relieved of their duties after ensuring adequate handover of patient care responsibilities, and no new patient responsibilities will be assigned. The handover period will not exceed two hours following the end of the in-hospital call period. When post-call, students are not expected to attend any other clinical activities including out-patient clinics, physicians’ offices or O.R. lists.

Call from home

The handover period will not exceed two hours following the end of a night call from home if the student commences work in the hospital after midnight but before 6 a.m. or a student who works for at least four consecutive hours at least one hour of which extends beyond midnight. Otherwise the student will be expected to attend their usual duties following the end of the call. In addition, there will be no home call after 11 p.m. when a facility cannot provide a call room.

Evening call

At a facility that doesn’t provide call rooms, students are expected to finish their call no later than 11 p.m., including hand-over time. Under no circumstances will a student be requested to stay later than 11 p.m. in such a facility.

In rotations where night calls are scheduled to finish at 11 p.m., students are to leave the facility no later than 11 p.m. including hand-over. It is also expected that a student will attend clinical or academic activities on the following day as per the usual established schedule in that rotation. A minimal period of eight hours is to be allowed for rest between the end of such a call and the start of activities on the next day.

Clinical shifts

In the case of clinical shift work, such as in the emergency medicine part of the acute care rotation, students will be allowed to leave the hospital at 11 p.m. if they are expected to come back for compulsory activities on the next morning. A minimal period of eight hours is to be allowed for rest between the end of a shift and the start of activities on the next day. In addition, a student will never be expected to attend any activities on the same day after the end of a night shift.

This policy is based on the Professional Association of Residents of Ontario (PARO) regulations in effect July 1, 2009.

To pass 3rd year clerkship, and be promoted to 4th year, a student must pass the following course codes: CLI 3301, CLI 3102, CLI 3103, CLI 3104, CLI 3106, CLI 3107, CLI 3108, CLI 3109, CLI 3110, CLI 3111, MED4103*

*no grade attributed until the end of 4th year

Transition to clerkship part 1 (CLI 2101)

To pass this course, the student must attend all sessions and obtain a pass on the preceptor evaluation form. Failure to do so will result in a remediation plan recommended by the Clerkship Promotions Committee, to be completed in the summer prior to Transition to Clerkship Part 2. The case of a student with a failure of remediation will be discussed by the SPEC who could recommend remediation or sanctions up to repetition of the academic year or dismissal from the program.

Transition to clerkship part 2 (CLI3301)

To pass this course, the student must attend all mandatory sessions and obtain a pass on the preceptor evaluation. Students must successfully complete this course prior to starting their core clinical rotations or any electives. If a student fails to meet the objectives of the rotation, their performance will be reviewed by the lead, rotation director and presented to the Clerkship Promotion Committee. This will then be followed by the Student Promotions Executive Committee (SPEC). Recommendation may include remediation, repetition of an academic year or dismissal from the program.

Summative written examinations

All summative written examinations (supplemental or deferred) must be successfully passed in order to be promoted to Year 4. Outstanding written examinations will not prevent students from starting Year 4 electives.

Clinical performance

All clinical objectives with adequate clinical exposure must be met to pass the clinical component of a third-year core rotation to be promoted to Year 4. Students must complete all Year 3 components prior to starting Year 4 electives.

Clinical rotation mandatory components

All mandatory components of core clinical rotations must be completed and submitted to be promoted to Year 4. Outstanding mandatory components from Periods 7 and 8 will not prevent students from starting Year 4 electives.

Failure to complete outstanding summative written examinations, clinical performances or clinical rotation mandatory components prior to the last year 3 promotions meeting (see schedule), will result in immediate removal from Year 4 electives until all year 3 components are completed.

Core clinical rotations

Core clinical rotations are evaluated as pass/fail. To obtain a pass in a core clinical rotation, the student must submit all mandatory components of the rotation, pass the overall clinical performance evaluation and obtain a mark of 60% or more on the summative written examination. All three components must be successfully met to be promoted to Year 4.

Observed structured clinical examination (OSCE)

Students must pass the year 3 summative OSCE. Students are to challenge the exam at the the end of their third year. Students must pass the Year 3 Summative OSCE in order to graduate from the MD Program.

A student with a failure in the year 3 summative OSCE will be required to challenge the next spring Year 3 formative OSCE during their 4th year of medical school. This will be considered a supplemental OSCE. A failure of the supplemental OSCEwill be brought to the SPEC who may recommend remediation, repeating the academic year or dismissal from the program.

Professionalism

official communication will be brought to the attention of the Vice-Dean of UGME, and may lead to remediation and/or academic sanction, which may include internal probation, recording on the MSPR, failure of a course or rotation, or dismissal from the Faculty of Medicine, based on the recommendations of the SPEC.

Failure in two clinical rotations (either failure to submit mandatory components, failure of the clinical component or failure of the supplemental written examination), failure of the supplemental OSCE or Professionalism concerns will be discussed by the Student Promotion Executive Committee (SPEC) who could recommend remediation or sanctions up to repetition of the academic year or dismissal from the program.

SENATE REFERENCE: 2019:UGRD-MED:10
EFFECTIVE: June 4, 2019
REVISION: September 2022
APPROVED BY: Undergraduate Curriculum Committee
DATE: May 23, 2019; June 23, 2022
APPROVED BY: Faculty Council
DATE: June 4, 2019; August 29, 2022
APPROVED BY: the Council of Undergraduate Studies
DATE: September 8, 2022
APPROVED BY: the Executive Committee of the Senate
DATE: September 13, 2022

Purpose

This policy is to clarify failure during a core clinical rotation (Year 3 core rotations and Year 4 mandatory selectives). The policy establishes a clear guideline on what constitutes a failure with regards to a core clinical rotation as opposed to a summative written examination. For summative written examinations, please refer to policy of Summative Written Examination Policy—3rd Year Clerkship.

Professional programs, such as medicine, utilize experiential learning and clinical experiences to provide hands-on learning in a variety of clinical environments so that students can better understand the impact of the disease process on an individual, their family, and their community and, apply and consolidate their medical knowledge prior to their transition to residency. The longitudinal aspect of clerkship provides opportunities for direct observations and assessment in the clinical environment in graduated fashion to the end of their fourth year. As such, a high volume and variety of clinical experiences are required to ensure safe care of patients and the learner’s ability to meet the program objectives.

Policy

Year 3 Core Clinical Rotations

Core clinical rotations in 3rd year:

Family Medicine
Psychiatry
Internal Medicine
Acute Care (Emergency Medicine and Anesthesia)
Pediatrics
Mandatory Selectives
Surgery
Obstetrics and Gynecology

Core clinical rotations are evaluated on a Pass/Fail system. To obtain a pass during a core clinical rotation, the student must pass the overall clinical performance evaluation, complete all mandatory components for that rotation and obtain a mark of 60% or more on the summative written examination. Passing of the clinical performances are discussed below.

Year 4 Core Clinical Rotations

Core clinical rotations in 4th year:

Mandatory Selective in Surgery
Mandatory Selective in Internal Medicine

Core clinical rotations are defined as four (4) weeks of mandatory selectives in 4th year. Two (2) weeks in internal medicine and surgery respectively. Clinical rotations are evaluated on a Pass/Fail system and based on clinical performance only.

Clinical Performance

To pass the clinical component of the rotation, all clinical objectives and mandatory components must be achieved. This is evaluated during the core rotation by direct and indirect observations of the student and captured through a variety of rotation specific assessments, mandatory elements, and formative feedback. Progression through the rotation will be assessed by the Rotation Director at the mid-rotation assessment and at the final assessment with exception during Year 4 core rotations which only have the final assessment. Though a student may be achieving the rotational objectives by the mid-rotation mark, it is no guarantee that rotational objectives will be achieved at the end of the rotation. Students must be actively involved in their learning throughout the rotation.

A pass for clinical component will be accorded by the Rotation Director if it is assessed that the learner has demonstrated adequately the clinical skills required during the core clinical rotation and have had sufficient clinical exposure.

If there is inadequate evidence, conflicting assessments, missing mandatory components or failure to meet the clinical performance objectives despite adequate clinical exposure, a failure will be accorded.

If a learner was unable to complete the clinical rotation due to a leave of absence or health-related concerns, an “in progress” will be accorded until which time a reintegration plan is determined and the learner returns to their studies. This will allow the learner to be supported for a return to the clinical environment to ensure adequate clinical exposure to achieve the clinical rotational objectives.

Students with a clinical failure who have completed the rotation can write the examination at the scheduled time. However, if the learner fails the examination, they cannot use the clinical failure as grounds for an appeal.

All clinical remediation plans must be completed prior to the start of the 4th year. Students cannot be excused from clinical activities in ongoing clinical rotations to remediate outstanding elements of previous clinical rotations.

Failure of two (2) clinical rotations will automatically be discussed by the Student Promotion Executive Committee (SPEC). This may result in a delay in graduation. SPEC could recommend, but not limited to, repetition of the academic year or dismissal from the program.

Professionalism

A course, longitudinal component, elective or rotation may be failed despite adequate demonstration of knowledge and clinical skills due to a failure in the domain of professionalism.

Any student registered in the MD Program is expected to adhere to the professional standards of the Faculty of Medicine and demonstrate professional behaviour within coursework and clerkship, as well as outside of the classroom and clinical setting when the student is clearly identifiable as a medical student. Any unprofessional behaviour in an official setting or in an official communication will be brought to the attention of the Vice-Dean, Undergraduate Medical Education, and may lead to remediation and/or academic sanction, which may include internal probation, recording on the Medical Student Performance Record, failure of a course, longitudinal component, elective or rotation, or dismissal from the Faculty of Medicine, based on the recommendations of the SPEC.

SENATE REFERENCE: 14:M05:07
EFFECTIVE: August 19, 2014
REVISION: September 1, 2022
APPROVED BY: Undergraduate Curriculum Committee
DATE: November 19, 2013; June 23, 2022
APPROVED BY: Faculty Council
DATE: March 18, 2014; August 29, 2022
APPROVED BY: Council of Undergraduate Studies
DATE: September 8, 2022
APPROVED BY: Committee of the Senate
DATE: August 19, 2014; September 13, 2022

The written examinations at the end of each 12 week period contain multiple choice questions (MCQs) and clinical decision making questions (CDMQs). Both components will count towards the final mark.

The student who fails a written examination must write a supplemental written examination. Supplemental written examinations must be taken within 6 weeks after Promotion Committee’s decisions and results are released to the student.

NOTE: the student can apply for electives and obtain letters of good standing while supplemental written examinations are still pending, as long as all other requirements are met.

Permitted number of supplemental written examinations

A student may be permitted a maximum of 2 supplemental written examinations per academic year. Failure of a third written examination (either first attempt or supplemental) will lead to a review of the student’s file by the Student Promotions Executive Committee (SPEC). The Committee may recommend specific remediation, repetition of affected rotations, repetition of third year, or dismissal from the program.

Failure of a supplemental written examination

Following the failure of a supplemental written examination, SPEC may recommend remediation or dismissal from the MD Program. Remediation of a failed supplemental written examination may include repetition of the affected rotation or repetition of the third year program and a delay in graduation. In addition, failure of 2 supplemental written examinations, from different rotations, may result in dismissal from the program. Students will be excused from their clinical duties, excluding mandatory component sessions or activities, to write their exams. Supplemental examinations must follow University Policy I-9.6. The date and time of the supplemental examination will be determined by the UGME Operations office at the Faculty of Medicine based on the academic calendar.

Deferred examinations in third year

During Year 3, a student in good standing may be permitted to defer a maximum of 2 written examinations for reasons of health or a compelling personal reason.

To request a deferral of an examination, a written request must be submitted to the Supervisor Academic Services—Clerkship and Year 3 Specialist, Academic Administration. In consultation with the Clerkship Director and Vice-Dean UGME, the request will be reviewed. Additional documentation may be requested. Confirmation of the deferral will be communicated by the UGME office.

Deferred written examinations are to be written within 4 weeks of the original examination date unless the student is on a leave of absence. If the student is on a leave of absence, the deferred written examination date will be determined during the establishment of the re-integration plan for the student.

Combined total of deferred and supplemental written Examinations

The combined total of deferred and supplemental written examinations per student per year cannot exceed 4, without incurring a potential delay in graduation. Combined totals will lead to a review of the student’s file by the Students Promotions Executive Committee (SPEC). The committee may recommend specific remediation, repetition of affected rotations, repetition of third year, or dismissal from the program.

Timing of deferred and supplemental examinations

Supplemental written examinations must be written within 6 weeks of release of results to the student after the Promotions Committee meeting. The date and time of the supplemental examination will be determined by the UGME Operations office at the Faculty of Medicine based on the academic calendar.

Deferred written examinations must be written within 4 weeks of the original examination date unless the student is on a leave of absence. Students must advise the Year 3 Specialist, Academic Administration in writing 2 weeks prior to the chosen date and time.

Exception: if there are outstanding clinical components or a clinical remediation plan has been developed, the student may only write their supplemental or deferred examination after the completion of the clinical course component. Timelines will be reviewed in conjunction with the rotation director, the clerkship director and the UGME clerkship operations team.

Students will be excused from their clinical duties, excluding mandatory component sessions or activities to write their exams. Supplemental exams must follow University policy I-9.6. The grade obtained on the supplemental exam replaces the final examination grade for the rotation. However, a note on the transcript will indicate that this grade was obtained because of a supplemental exam.

SENATE REFERENCE: 2022-MED-UGRD-06
EFFECTIVE: February 3, 2015
REVISION: September 13, 2022
APPROVED BY: Undergraduate Curriculum Committee
DATE: January 8, 2015; June 23, 2022
APPROVED BY: Faculty Council
DATE: February 3, 2015; August 29, 2022
APPROVED BY: Council of Undergraduate Studies
DATE: September 8, 2022
APPROVED BY: Executive Committee of the Senate
DATE: September 13, 2022

General

Academic Fraud Policy arrow_drop_down

Academic Standing Regulation arrow_drop_down

Good standing/Academic Concern List

Academic Support Procedure arrow_drop_down

Access to Academic Record Policy arrow_drop_down

Access to Academic Record Procedure arrow_drop_down

Clinical Skills Support Program Procedure arrow_drop_down

PSD Course/PSD OSCE

Year 3 Formative OSCE

Year 3 Summative OSCE

Communicating grades and returning assessed work Policy arrow_drop_down

Conflict of interest in clinical placements Policy arrow_drop_down

Purpose

Conflict Of Interest In Clinical Placements

Conflict Of Interest During OSCE

Counselling and Academic Advising Procedure arrow_drop_down

Preclerkship

Clerkship

Examination Procedure arrow_drop_down

Preamble

Before the examination

After the examination

Examination and Evaluation Review Policy arrow_drop_down

Examination and evaluation review (Evaluations completed by tutors and preceptors)

Examinations reviews

Examination and Evaluation Review Procedure arrow_drop_down

Language of Instruction Regulation arrow_drop_down

Letter of good standing Procedure arrow_drop_down

Physical examination of students by peers and tutors Policy and procedures arrow_drop_down

Purpose

Scope

Guidelines

Adverse events procedures

Professionalism Policy arrow_drop_down

Program and Faculty Evaluation Regulation arrow_drop_down

General Information

Clinical Preceptors

Revision of Grades and Appeal Policy arrow_drop_down

Examination and evaluation review

Appeals

Student Transfers Policy arrow_drop_down

Transfers into the University of Ottawa program

Transfers within Faculty of medicine programs

Time Limit to Complete Degree Policy arrow_drop_down

Travel Accommodation Policy arrow_drop_down

Undergraduate Studies Regulation arrow_drop_down

Preclerkship

Passing Grade for Undergraduate Medical Education Program Policy arrow_drop_down

Justification

10.1 Official grading system

Requirements for Passing Pre-clerkship Policy arrow_drop_down

Preamble

Courses

Time Spent in Educational Activities and Clinical Activities in Preclerkship Policy arrow_drop_down

Accreditation standard 8.8

Purpose

Statement

Oversight and monitoring

Clerkship

Clinical Setting Regulation arrow_drop_down

Orders and notes

Hospital greens

Clinical placement requirements record

Appropriate appearance at clinical encounters

Clinical placements within city limits

Enrichment Year courses arrow_drop_down

ELE 3951 - Enrichment Year- Post Year 3

ELE4931: Enrichment Year – Post Year 4

Lottery and scheduling Regulation arrow_drop_down

Mandatory Clerkship Rural/Community Rotation Policy arrow_drop_down

Rationale

Proposal

Night Call and Shift for Clerkship Students Policy arrow_drop_down

Night call

OSCE

Obstetrics and gynecology

Other rotations with in-house call

Call from home