6.5: Chart of Responses to Student Issues

Based on Stanford University School of Medicine academic policies, the following actions will or may be taken by the CP3 in the stated situations. The committee may, however, prescribe another course of action in its discretion, and depending upon the individual student circumstances.

Pre-clerkship Deficiencies

All pre-clerkship academic deficiencies (e.g., Failure (F), Marginal Pass (MP), Continuing (N), Incomplete (INC)) must be corrected within 12 months of receipt (or otherwise within a time limit specifically set by the course director or the CP3 in the individual case) and prior to beginning any clinical clerkship.

Pre-clerkship - Failure (F)

A failure (F) in a pre-clerkship course must be corrected within 12 months of receipt (or otherwise within a time limit specifically set by the course director or the CP3 in the individual case) and prior to beginning any clinical clerkship.
If no remediation occurs prior to the next offering of the course, the student will be required to retake the course.
Students may be required to sit for the USMLE Step 1 examination before beginning any clinical clerkship. When failing a course of five or more units, students may be required to take and pass USMLE Step 1 prior to beginning any clinical clerkship.
More than one failure (F) in pre-clerkship courses may result in the student being given a prescribed and restricted curriculum (including the discontinuation of activities such as extracurricular activities, RA-ships and TA-ships, laboratory research, community service, etc.) for a time period specified by the CP3.
Three failures (F) in pre-clerkship courses of five or more units may be considered grounds for dismissal from the Stanford School of Medicine MD Program.
If a failure (F) in a pre-clerkship course remains uncorrected beyond the prescribed period of time for remediation:
- The student may be required to appear before the CP3 and could be considered for dismissal.
- An administrative hold may be placed until the deficiency has been corrected.

Pre-clerkship - Marginal Pass (MP)

A marginal pass (MP) in a pre-clerkship course must be corrected within 12 months of receipt (or otherwise within a time limit specifically set by the course director or the CP3 in the individual case) and prior to beginning any clinical clerkship.
Students may be required to take USMLE Step 1 prior to beginning any clinical clerkship.
More than one marginal pass (MP) in pre-clerkship courses may result in the student being given a prescribed and restricted curriculum (including the discontinuation of activities such as extracurricular activities, RA-ships and TA-ships, laboratory research, community service, etc.) for a time period specified by the CP3.
Three marginal passes (MP) in pre-clerkship courses may be considered grounds for dismissal from the Stanford School of Medicine MD Program.
If a marginal pass (MP) in a pre-clerkship course remains uncorrected beyond the prescribed period of time for remediation:
- The student may be required to appear before the CP3 and could be considered for dismissal.
- An administrative hold may be placed until the deficiency has been corrected.

Pre-clerkship - Continuing (N)

A continuing (N) in a pre-clerkship course must be corrected within 12 months of receipt (or otherwise within a time limit specifically set by the course director or the CP3 in the individual case) and prior to beginning any clinical clerkship.
More than one continuing (N) in pre-clerkship courses may result in the student being given a prescribed and restricted curriculum (including the discontinuation of activities such as extracurricular activities, RA-ships and TA-ships, laboratory research, community service, etc.) for a time period specified by the CP3.

Pre-clerkship - Incomplete (INC)

An incomplete (INC) in a pre-clerkship course must be corrected within 12 months of receipt (or otherwise within a time limit specifically set by the course director or the CP3 in the individual case) and prior to beginning any clinical clerkship.
More than one incomplete (INC) in pre-clerkship courses may result in the student being given a prescribed and restricted curriculum (including the discontinuation of activities such as extracurricular activities, RA-ships and TA-ships, laboratory research, community service, etc.) for a time period specified by the CP3.
If no remediation occurs prior to the next offering of the course, the student may be required to retake the course.

Clerkship Deficiencies

All clerkship academic deficiencies (e.g., Failure (F), Marginal Pass (MP), Continuing (N)) must be corrected within 9 months (or otherwise within a time limit specifically set by the clerkship director or the CP3 in the individual case) and prior to being promoted to Eligible for the MD Degree.

Clerkship - Failure (F)

A failure (F) in a clerkship must be corrected within 9 months of receipt (or otherwise within a time limit specifically set by the clerkship director or the CP3 in the individual case) and prior to being promoted to Eligible for the MD Degree.
If a student fails a required clerkship, remediation requirements will be set by the clerkship director.
Students will appear on the CP3 agenda for discussion and possible setting of a remedial curriculum.
Two failures (F) in any clerkships – either failing one clerkship twice or failing two different clerkships – ordinarily will be considered grounds for dismissal from the MD program.
Three failures (F) (or combination of marginal passes (MP) and failures (F)) in clerkships ordinarily will be considered grounds for dismissal from the MD program.
If a failure (F) in a clerkship remains uncorrected beyond the prescribed period of time for remediation:
- The student may be required to appear before the CP3 and could be considered for dismissal from the MD program.
- An administrative hold may be placed until the deficiency has been corrected.

Clerkship - Marginal Pass (MP)

A marginal pass (MP) in a clerkship must be corrected within 9 months of receipt (or otherwise within a time limit specifically set by the clerkship director or the CP3 in the individual case) and prior to being promoted to Eligible for the MD Degree.
Students with a marginal pass (MP) in any clerkship are required to meet with the clerkship director to set timely requirements for achieving an unqualified passing grade.
Students will appear on the CP3 agenda for discussion and possible setting of a remedial curriculum.
Three marginal passes (MP) (or combination of marginal passes (MP) and failures (F)) in clerkships ordinarily will be considered grounds for dismissal from the MD program.
If a marginal pass (MP) in a clerkship remains uncorrected beyond the prescribed period of time for remediation:
- The student may be required to appear before the CP3 and could be considered for dismissal from the MD program.
- An administrative hold may be placed until the deficiency has been corrected.

Clerkship - Continuing (N)

A continuing (N) in a clerkship must be corrected within 9 months of receipt (or otherwise within a time limit specifically set by the clerkship director or the CP3 in the individual case) and prior to being promoted to Eligible for the MD Degree.
Students will be reviewed and discussed by the CP3 and may be required to provide a written remediation plan.
Graduating students must remediate no later than six weeks prior to the expected graduation date.
In the event of a final exam failure, students are required to contact the clerkship director to set a timeline for retaking the exam.
A student who has an uncorrected N grade in more than one clerkship at any time will be placed on the CP3 agenda and required to provide a written plan for correcting the non-passing grades.
A student with more than one uncorrected N grade may be restricted from enrolling in subsequent clerkships or participating in the residency Match until at least one N grade has been corrected.

Required Examinations

USMLE Step 1 - Failure

Students who fail their first or second attempt of the USMLE Step 1 examination will be reviewed and discussed by the CP3.
Students ordinarily will be withdrawn from clerkships at the end of their current enrolled clerkship and may not begin any additional clerkships (except Pathology) until the USMLE Step 1 examination is retaken and satisfactorily passed.
Students may be required to take and pass the USMLE Step 2 CK (Clinical Knowledge) examination no later than the first week of January of the expected graduation year.
Students who fail their third attempt of the USMLE Step 1 examination will be reviewed by the CP3 and may be considered for dismissal from the Stanford School of Medicine MD program.
The USMLE allows a maximum of four (4) attempts of the USMLE Step 1 examination. Students who fail their fourth attempt will be reviewed by the CP3 and dismissed from the Stanford School of Medicine MD program.

USMLE Step 2 CK - Failure

Students who fail their first attempt of the USMLE Step 2 CK (Clinical Knowledge) examination will be reviewed and discussed by the CP3.
Students must retake and pass USMLE Step 2 CK no later than the first week of May of the expected graduation year.
If a student fails USMLE Step 2 CK in the quarter prior to expected graduation, they may have the option of taking, but must pass, an internal equivalency examination in order to graduate.
Students may not graduate and may be placed on administrative hold for a set period of time, after which they may be dismissed from Stanford University School of Medicine MD program if they:
- fail Step 2 CK (Clinical Knowledge) twice and fail the internal examination; or
- fail Step 2 CK (Clinical Knowledge) three times.

Clinical Performance Examination (CPX) Series

Failure to Participate In or Demonstrate Minimum Competency in the Clinical Performance Examination (CPX) Series
Students who fail the Mini-CPX or CPX will be reviewed and discussed by the CP3.
Students will be required to remediate their performance as determined by CPX Series administration. A remediation may include, but is not limited to, participation in the Student Guidance Program and a reassessment of clinical skills.
The student may be given a prescribed and restricted curriculum (including the discontinuation of activities such as extracurricular activities, RA-ships and TA-ships, laboratory research, community service, etc.) for a time period specified by the CP3.
Remediation must be completed prior to being promoted to Eligible for the MD Degree.

Scholarly Concentrations

Failure to Declare a Scholarly Concentration

Failure to Declare a Scholarly Concentration by the Stated Deadline
The student may be reviewed and discussed by the CP3.
The student may be given a prescribed and restricted curriculum (including the discontinuation of activities such as extracurricular activities, RA-ships and TA-ships, laboratory research, community service, etc.) for a time period specified by the CP3.
An administrative hold may be placed until requirements are met.

Failure to Make Satisfactory Progress

Failure to Make Annual Satisfactory Progress (as Determined by the Scholarly Concentration Director)
The student may be reviewed and discussed by the CP3.
The student may be given a prescribed and restricted curriculum (including the discontinuation of activities such as extracurricular activities, RA-ships and TA-ships, laboratory research, community service, etc.) for a time period specified by the CP3.
An administrative hold may be placed until requirements are met.

Failure to Complete a Scholarly Concentration

Failure to Satisfactorily Complete the Scholarly Concentration Commitment
Students who do not receive preliminary approval of completion from their Scholarly Concentration director at least six months prior to expected graduation may be reviewed and discussed by the CP3.
The Concentration director will define a plan, tailored to the student’s deficiencies, which must be completed in the six months between the CP3 review and expected graduation.
The student may be given a prescribed and restricted curriculum (including the discontinuation of activities such as extracurricular activities, RA-ships and TA-ships, laboratory research, community service, etc.) for a time period specified by the CP3.
An administrative hold may be placed until the deficiency has been corrected.
The MD degree will not be conferred without satisfactory completion of the Scholarly Concentration as certified by the Concentration director.

updated March 2022

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