Standards for Professionalism for VP&S Students

Overview/Rationale 

Granting of the MD degree signifies that the holder is a physician prepared to enter postgraduate education for the practice of Medicine and to care for patients.  

Medical students who fail to maintain appropriate professional behavior and/or adequate academic performance will be subject to review, potential disciplinary action where relevant, and possible dismissal from the Columbia University Vagelos College of Physicians and Surgeons (VP&S).  

Professionalism is a key determinant of a physician’s ability to provide safe, high-quality care to patients, and protecting the safety of patients is the overriding concern of the faculty of medicine at VP&S.  

At VP&S, the Student Competency committees, (e.g. Fundamentals Faculty Committee and Clinical Faculty Committee) oversee the progress of students through the curriculum for the Classes of 2025, 2026 and 2027.  For the Class of 2028 they make recommendations to the Academic Review Committee who determines the progress of students thought the curriculum. These committees are charged with determining a medical student’s suitability for the practice of medicine 

Accreditation Standards

LCME Accreditation Standard: 3.5 Learning Environment/Professionalism

A medical school ensures that the learning environment of its medical education program is conducive to the ongoing development of explicit and appropriate professional behaviors in its medical students, faculty, and staff at all locations and is one in which all individuals are treated with respect.

Stakeholders

Medical Students and Faculty

Domains of Professionalism

To grant the MD degree, the faculty of VP&S must be assured that students demonstrate ability in the general competencies of a physician. We reference specific professionalism VP&S Medical Education Program Objectives (MEPOs) that draw from the ACGME/ABMS and AAMC foundational competencies, along with annotations specific to VP&S below each descriptor:

VP&S MEPO DOMAIN #5. Professionalism: Students develop professional identities that demonstrate a commitment to professional and personal responsibilities exemplified by adherence to the highest standards of leadership, advocacy and integrity, consistent with the VP&S Honor Code, VP&S values, CUIMC Cares Code of Values, clinical site policies and procedures, and those of the profession.  

5.1 Adheres to ethical behavior in all realms of professional life and commitment to integrity, advocacy, and leadership  

• Students must treat others with fairness and respect, work collaboratively, and help fellow students whenever appropriate in their shared pursuit of learning and optimal patient care.  

• Students must assure the accuracy and completeness of their contributions to the medical record and must make a good-faith effort to provide the best possible patient care.  

• Students must be willing to admit errors and must not purposefully mislead others.  

• Students are bound to know, understand, and preserve professional ethics and have a duty to report any breach of these ethics by other students or health care providers through the appropriate channels.  

• Students must not cheat, plagiarize, use unauthorized materials, misrepresent their work, falsify data, or assist others in the commission of these acts.  

• Students must not copy notes in the medical record, copy notes from house staff or faculty, paraphrase an author’s ideas, or work without proper citation.  

• Students must protect the security of confidential, sensitive, and protected patient information (digital and paper-based).  

• Students must only access patient Electronic Medical Records and other Protected Health Information (PHI) for patients they are following, cross covering, or have directly encountered with their team as part of their clinical clerkships and, electives, and selectives. They are permitted continued access after the patient is discharged from the hospital, transferred to another service or when the student rotates off service, as part of the student’s medical education at VP&S.  

• Students must be knowledgeable about and abide by HIPAA policies and utilize only Columbia University email systems for patients and Columbia matters. They must not auto-forward Columbia University email to Gmail and other unapproved email systems. Students must encrypt portable devices, e.g., laptops and USB drives, etc., used to store patient or individual research data, and encrypt data files with Protected Health Information if stored on a portable device that is not encrypted.  

• Students must not take photos or videos of patients except for purposes of documentation in the medical record, no further action is needed if these are uploaded to the electronic medical record.  However, if immediate upload is not available then ,prior written consent of the respective institution, and when possible, of the patient is needed. Such images must not leave Columbia University Medical Center on a student’s electronic device and may not be transmitted in any way other than from one approved email system to another approved email system and only to those caring for the patient. 

• Students must not post images or other patient information on social networking sites, the internet, or anywhere else.  

5.2 Demonstrates initiative, responsiveness, reliability and accountability  

• Students must be willing to admit errors and must not purposefully mislead others.  

• Students must abstain from using any substance in a manner that could compromise patient care. They must never use alcohol or drugs in public wearing clothing or ID that identifies them as student physicians.  

• Students must protect the public from an impaired colleague and assist a colleague whose capability is impaired because of ill health. Students are thus obligated to report persons of the health care team whose behavior exhibits impairment or lack of professional conduct or competence or who engage in fraud or deception. Such reports must conform to established institutional policies.  

• Students must be punctual, reliable, and conscientious in fulfilling their professional duties, including attendance at required lectures, small groups, and at examinations, timely completion of assignments, and fulfillment of all parts of all clinical courses.  

• Students must maintain a neat and clean appearance with dress and attire that is accepted as professional.  

• Students must not use offensive language, gestures, or remarks with sexual overtones.  

• Students must abstain from romantic involvement with patients or their family members while serving on a patient’s medical team, and abstain from romantic involvement with residents and faculty in positions of authority while serving in a student role. Sexual misconduct including sexual harassment and sexual assault are unacceptable behaviors and are reported to the Columbia University Title IX office.  

• Students must strive to maintain composure under pressure of fatigue, professional stress, or personal problems.  

• Students must seek supportive services when appropriate.  

• Students must always be supervised in the clinical environment and seek additional supervision if they find themselves inadequately supervised because of lack of knowledge and/or insufficient experience. Students are expected to recognize when they need additional consultation and supervision in the clinical setting and seek it accordingly.  

• Students must seek feedback and actively participate in the process of evaluating their teachers (faculty as well as house staff). Students are expected to respond to feedback by appropriate modification of their behavior. When evaluating faculty performance, students are obliged to provide prompt, constructive comments. Evaluations should maintain the same considerate, professional tone expected of faculty when they evaluate student performance.  

• Students authoring research reports must be well-enough acquainted with the work of any co-workers that they can vouch for the integrity of the study and validity of the findings and must have been active in the research itself.  

• While in public, students represent the medical profession, Columbia University and VP&S and are expected to comport themselves responsibly.  

• Students must not refuse to participate in the care of a patient based on the patient’s race, religion, ethnicity, socioeconomic status, gender, age, marital status, sexual orientation, or gender identity.  

• Students must not refuse to participate in the care of a patient solely because of medical risk, or perceived risk to the student. Students retain the right of “conscience exemption” from performance of or participation in procedures or practices that violate their core moral, ethical, and/or religious beliefs. Patient care assignments for students with medical conditions placing them at undue risk will be addressed in an individualized manner.  

• Students must abide by all VP&S and Columbia University policies and procedures, as well as all Hospital policies where they are assigned, and be familiar with the policies. Students must obey all local, state, and federal laws at all times.  

5.3 Demonstrates awareness of the importance of balancing the varied demands and opportunities of professional life to promote personal wellbeing  

Violations of these standards are considered to be very serious breaches of professional conduct.  

Documentation of Concerns about Professionalism  

Faculty and staff who observe a student behave in a way that raises concerns about professionalism are expected to address the behavior by doing one or both of the following, depending upon the nature of the behavior and what would be most helpful to the student, within one month:  

• Provide verbal or written feedback to the student with specific suggestions for improvement  

• Complete a “Professionalism Concern Report(link is external and opens in a new window),” review it with the student in person and submit it to the  associate dean for student affairs, support and services.  

• Report the event to course or clerkship directors  

• Report the event to the Associate Dean of Student Affairs, Support and Services  

The professionalism MEPO is taught and assessed throughout the curriculum, with students receiving feedback and support to meet expectations. In cases of egregious infractions, a Professionalism Concern Report may be filed, and the student may be referred directly to the Student Competency Committees or the Associate Dean of Student Affairs, Support and Services  for further review and appropriate action.  

Examples of areas of concern that would prompt the completion of a “Professionalism Concern Report(link is external and opens in a new window)” if they are observed as an enduring pattern include, but are not limited to:  

• Failure to complete assignments on time  

• Failure to complete required evaluations and surveys  

• Excessive tardiness  

• Lack of response to official communications  

Examples of uncommon but serious areas of concern that would prompt the completion of a “Professionalism Concern Report(link is external and opens in a new window)” if they are observed even in isolation include, but are not limited to:  

• Mistreatment of others  

• Dishonest practice  

• Violation of patient privacy  

• Failure to complete required hospital credentialing procedures  

• Failure to complete USMLE exam(s) by the required deadlines  

Students receiving one or more “Professionalism Concern Reports” will meet with the senior associate dean for student affairs, support and services to review the reported lapse in professionalism and discuss strategies for addressing the reported lapse and preventing future lapses.  

Students may contest a Professionalism Concern Report by:  

• Discussion with the reporting faculty member, who may choose to retract the report within the academic semester of its filing.  

• Review with the senior associate dean for student affairs, who may choose to affirm or retract the report after consultation with both parties.  

Professionalism Concern Reports will be disclosed in the Medical Student Performance Evaluation at the discretion of the Associate Dean of Student Affairs, Support and Services as guided by the following standards:  

• Isolated concerns that are not deemed egregious may not be reported.  

• Isolated concerns in the Fundamentals Curriculum that are not deemed egregious will be reported only if there are additional concerns reported in the Clinical Curriculum.  

• Concerns in the Clinical Curriculum that are not deemed egregious will be reported only if there are two or more such concern reports submitted. 

Administrative Evaluation  

The Office of the Vice Dean in collaboration with the Associate Dean for Student Affairs, Support and Services, acting either on behalf of a faculty committee or on its own behalf may request, at any time, an administrative evaluation of a VP&S student by a consulting psychiatrist or other mental health professional chosen by VP&S. This evaluation serves to address academic, personal, and/or behavioral concerns that may have been brought to the attention of the Dean’s Office. A failure to comply with a request for an administrative evaluation may affect a student’s academic status within VP&S. The detailed content of the evaluation is confidential and is not accessible to the student. Recommendations and a summary from the evaluation are communicated by the evaluator to the Associate Dean for Student Affairs, Support, and Services, who then discusses them with the student. Summary information may be shared by the Associate Dean with faculty and/or administration as appropriate.