TECHNICAL STANDARDS FOR ADMISSION, ACADEMIC PROGRESSION, AND GRADUATION

Introduction

Students are expected to develop a robust medical knowledge base and the requisite clinical skills, with the ability to appropriately apply their knowledge and skills, effectively interpret information, and contribute to patient-centered decisions across a broad spectrum of medical situations and settings.

The technical standards presented in this document are prerequisite, non-academic requirements for admission, progression, and graduation from the University of South Florida Morsani College of Medicine MD program. Delineation of technical standards is required for the accreditation of U.S. medical schools by the Liaison Committee on Medical Education (LCME) in Element 10.5.

10.5 Technical Standards

"A medical school develops and publishes technical standards for the admission, retention, and graduation of applicants or medical students in accordance with legal requirements."

All required courses in the curriculum are designed to develop the essential skills necessary to become a competent physician.

Historically, undergraduate medical education in the U.S. has been structured as a broad general training, which is intended to produce "undifferentiated physicians." Graduates of medical school must have the knowledge and skills to function in a broad range of clinical situations and to render a wide spectrum of patient care. The Morsani College of Medicine intends for its students and graduates to become competent and compassionate physicians through an undifferentiated medical degree and who can enter residency training (graduate medical education) while meeting all requirements for medical licensure.

The Florida Board of Medicine defines the “practice of medicine” as the diagnosis, treatment,

operation, or prescription for any human disease, pain, injury, deformity, or other physical or mental condition. Therefore, USF Morsani College of Medicine continues to educate “undifferentiated physicians” to meet state licensure requirements.

Criminal background checks and urine drug screens will be conducted as part of the process of admission, participation, promotion, and/or graduation.

For purposes of this document and unless otherwise defined, the term “candidate” means candidates for admission to the MD program as well as enrolled medical students who are candidates for promotion and graduation.

Equal Access to the Morsani College of Medicine’s Educational Program

The University of South Florida is committed to the principles of equitable and accessible education and to providing reasonable accommodations to students with disabilities. The University of South Florida Morsani College of Medicine endeavors to provide reasonable accommodations for otherwise qualified individuals with disabilities who apply for admission and are enrolled as medical students.

Candidates with disabilities are encouraged to contact the office of MD Admissions early in the application process who can further direct the candidate on the USF accommodation process.

It is the responsibility of a candidate with a disability, or a candidate who develops a disability, who may require accommodations to meet these technical standards, to self-disclose to Student Accessibility Services and request accommodations once admitted. Steps on how to apply for accommodations can be found here.

Should, despite reasonable accommodation (whether the candidate chooses to use the accommodation or not), a candidate’s existing or acquired disability(ies) interfere with patient or peer safety, or otherwise impede their ability to complete USF MCOM’s educational program and advance to graduation, residency training, or licensure, the candidate may be denied admission or may be separated or dismissed from the program.

Candidates will be responsible for providing or arranging transportation between their residence and locations for assigned clerkships and courses.

Technical Standards

A candidate for the MD degree must have abilities and skills in five domains: 1) observation; 2) communication; 3) clinical skills; 4) intellectual-conceptual, integrative, and cognitive skills; and 5) behavioral attributes, social skills, and professional expectations. The candidate must continue to meet these technical standards throughout their enrollment.

Fulfillment of the technical standards for graduation from medical school does not guarantee that a graduate will be able to fulfill the technical requirements of any specific residency program.

Technological compensation can be made for some disabilities in these domains, but a candidate must be able to perform in a reasonably independent manner. The use of a trained intermediary would mean that a candidate’s judgment must be mediated by someone else’s power of selection and observation. Therefore, a trained intermediary cannot be used to assist candidates in accomplishing curricular requirements in the five domains specified above.

Observation

Candidates must be able to acquire information from demonstrations and participate in experiments of science, including but not limited to such things as dissection of cadavers; examination of specimens in anatomy, pathology, and neuroanatomy laboratories; and microscopic study of microorganisms and tissues in normal and pathologic states. Candidates must be able to obtain and interpret information through a comprehensive assessment of patients, correctly interpret diagnostic representations of patients’ physiologic data, and accurately evaluate patients’ conditions and responses. They must be able to perform a complete physical examination to integrate findings based on this information and to develop an appropriate diagnostic and treatment plan. These skills require the use of vision, hearing, and touch or the functional equivalent.

Examples:

Representative examples of materials/occasions requiring observational / perceptual abilities beginning in years 1 and 2 include, but are not limited to: books, diagrams, discussions, physiologic and pharmacological demonstrations, microbiologic cultures, gross and microscopic studies of organisms and tissues, chemical reactions and representations, photographs, x-rays, cadaver dissections, live human case presentations, and patient interviews.

Examples from year 3 and 4 include but are not limited to: physical exams; rectal and pelvic exams; examinations with a stethoscope, otoscope, fundoscope, sphygmomanometer, and reflex hammer; verbal communication and non-verbal cues (as in taking a patient's history or working with a medical team); live and televised surgical procedures; childbirth; x-rays, MRIs, and other diagnostic findings; online computer searches and virtual clinical cases.

Communication

Candidates must be able to communicate effectively and efficiently with patients, their families, health care personnel, colleagues, faculty, staff, and all other individuals with whom they come in contact. Candidates must be able to obtain a medical history in a timely fashion, interpret non-verbal aspects of communication, and establish therapeutic relationships with patients. Candidates must be able to record information accurately and clearly; and communicate effectively and efficiently in English with other health care professionals in a variety of patient settings.

Examples:

Examples of areas in which skillful communication is required beginning in years 1 and 2 include, but are not limited to: answering oral and written exam questions, eliciting a complete history from a patient, presenting information in oral and written form to preceptors and patients, participating in sometimes fast-paced small-group discussions/interactions, participating in group dissections, participating in pathology labs, and interacting with and responding to course administrators and directors.

Examples of areas in which skillful communication is required in years 3 and 4 include, but are not limited to: participating in clinical rounds and conferences; writing patient H&Ps (histories and physicals); making presentations (formal and informal) to physicians and other professionals; communicating daily with all members of the healthcare team; talking with patients and families about medical issues; interacting in a therapeutic manner with all patients, including psychiatric patients; providing educational presentations to patients and families; participating in video-recorded exercises and synchronous distance learning; interacting with and responding to clerkship administrators and directors; writing notes, papers and completing assignments on a web-based educational platform.

Clinical Skills

Candidates must, after a reasonable period of training, possess the capacity to perform physical examinations and diagnostic maneuvers. They must be able to respond to clinical situations in a timely manner and provide general and emergency care and function in outpatient, inpatient, and surgical venues. These activities require some physical mobility, coordination of both gross and fine motor neuromuscular function and balance and equilibrium. Candidates must meet applicable safety standards for the environment and follow universal precaution procedures.

Examples:

Examples of activities/situations requiring candidates' motor/tactile function beginning in years 1 and 2 include, but are not limited to: participating in classes, small groups, patient presentations, review sessions, dissections, laboratory work, and microscopic investigations; using a computer; performing a complete physical exam - including observation, auscultation, palpation, percussion, and other diagnostic maneuvers; performing simple lab tests; using light microscopes; performing cardiopulmonary resuscitation.

Examples of experiences requiring motor/tactile function in years 3 and 4 include, but are not limited to: accompanying staff on rounds and conferences; competently performing specific procedures, such as, venipuncture, endotracheal intubation, Foley catheter insertion, and nasogastric tube insertion; taking overnight call in the hospital; performing physical, neurological, gynecological, pediatric, and obstetric examinations (with the appropriate instruments); dealing with agitated patients in emergency situations; maintaining appropriate medical records; acting as second assistant in the operating room (retracting, suturing, etc.); wearing appropriate equipment, such as a gloves, gown, and mask, as called for by the clinical situation.

Intellectual-Conceptual, Integrative, and Cognitive Skills

Candidates must effectively interpret, assimilate, and understand the complex information required to function within the medical school curriculum, including, but not limited to, the ability to comprehend three-dimensional relationships and understand the spatial relationships of structures; effectively participate in individual, small- group, and lecture learning modalities in the classroom, clinical, and community settings; learn, participate, collaborate, and contribute as a part of a team; synthesize information both in person and via remote technology; interpret causal connections and make accurate, fact- based conclusions based on available data and information; formulate and test hypotheses that enable effective and timely problem-solving in diagnosis and treatment of patients in a variety of clinical settings and health care systems.

Examples:

Examples of applied cognitive abilities beginning in years 1 and 2 include, but are not limited to: understanding, synthesizing, and recalling material presented in classes, labs, small groups, patient interactions, and meetings with preceptors; understanding 3-dimensional relationships, such as those demonstrated in the anatomy lab; successfully passing oral, written, and laboratory exams; understanding ethical issues related to the practice of medicine; engaging in problem solving, alone and in small groups; interpreting the results of patient examinations and diagnostic tests; analyzing complicated situations, such as cardiac arrest, and determining the appropriate sequence of events to effect successful treatment; working through genetic problems.

Examples of required cognitive abilities in years 3 and 4 include, but are not limited to: integrating historical, physical, psychosocial, and ancillary test data into differential diagnoses and treatment plans; understanding indications for various diagnostic tests and treatment modalities - from counselling to medication to surgery; understanding methods for various procedures, such as lumbar punctures and inserting intravenous catheters; being able to think through medical issues and exhibit sound judgment in a variety of clinical settings, including emergency situations; identifying and understanding classes of psychopathology and treatment options; making concise, cogent, and thorough presentations based on various kinds of data collection, including web-based research; knowing how to organize information, materials, and tasks in order to perform efficiently on service; understanding how to work and learn independently; understanding how to function effectively as part of a healthcare team.

Behavioral Attributes, Social Skills, and Professional Expectations

Candidates must demonstrate the maturity and emotional stability required for full use of their intellectual abilities. They must accept responsibility for learning, exercising good judgment, and promptly complete all responsibilities attendant to their curriculum and to the diagnosis and care of patients. Candidates must display characteristics of integrity, honesty, attendance and conscientiousness, empathy, a sense of altruism, and a spirit of cooperation and teamwork. They must understand and demonstrate understanding of the legal and ethical aspects of the practice of medicine and function within both the law and ethical standards of the medical profession. Candidates must be able to interact with patients and their families, health care personnel, colleagues, faculty, staff, and all other individuals with whom they come in contact in a courteous, professional, and respectful manner. The candidate for the MD degree must accept responsibility for learning, and exercise good judgment. Candidates must be able to contribute to collaborative, constructive learning environments; accept constructive feedback from others; and take personal responsibility for making appropriate positive changes. Candidates must have the physical and emotional stamina and resilience to tolerate physically taxing workloads and function in a competent and professional manner under highly stressful situations, adapt to changing environments, display flexibility, and manage the uncertainty inherent in the care of patients and the health care system. Candidates must abide by all state, federal, and local laws, as well as all University of South Florida codes of conduct. Candidates must maintain sobriety in all academic and clinical environments, and refrain from the illegal use of substances at all times.

Examples:

Examples of professional behavior beginning in years 1 and 2 include, but are not limited to: showing up for required experiences on time and prepared; handing in assignments on time; refraining from plagiarizing or cheating; treating faculty, staff, and other students with respect; making an effort to understand prejudices and preconceptions that might affect patient interactions or collegial relationships (especially in the areas of race and ethnicity, sexual orientation, gender, disability, age, and religious difference); developing successful working relationships with preceptors, staff, and peers by accepting constructive feedback.

Examples of professional behavior in years 3 and 4 include, but are not limited to: maintaining a professional demeanor on service (e.g., white coat, name tag, appropriate attire, neat appearance, respectful speech, sobriety); representing oneself accurately; appreciating and preserving patient confidentiality; responding sensitively to patients' social and psychological issues; understanding social biases and stigmas, and not reinforcing them; developing empathic listening skills; advocating for patients when appropriate; using hospital/clinic resources responsibly; showing up prepared and on time for rounds, lectures, conferences, and procedures; getting advice when handling ethical dilemmas; taking constructive feedback from attending physicians and residents with open-mindedness and the intention to improve; contributing to the effectiveness, efficiency, and collegiality of healthcare teams. Candidates must accept responsibility for learning, exercising good judgment, and promptly completing all responsibilities attendant to the diagnosis and care of patients. They must be able to work effectively, respectfully, and professionally as part of the healthcare team, and to interact with patients, their families, and health care personnel in a courteous, professional, and respectful manner.

Ethical and Legal Standards

Candidates for admission

Enrolled students are required to disclose any misdemeanor or felony charge or conviction in any jurisdiction (other than minor traffic offenses) to the Associate Dean for Student Affairs within 48 hours of the occurrence. Driving under the influence (DUI) or driving while impaired (DWI) are not minor traffic offenses for purposes of this disclosure. Failure to disclose occurrences as set forth above can lead to corrective or disciplinary action up to and including dismissal from the Morsani College of Medicine.

Enrolled students (candidates for the MD degree)

Enrolled students are required to disclose any misdemeanor or felony charge or conviction in any jurisdiction (other than minor traffic offenses) to the Associate Dean for Student Affairs within 48 hours of the occurrence. Driving under the influence (DUI) or driving while impaired (DWI) are not minor traffic offenses for purposes of this disclosure. Failure to disclose occurrences as set forth above can lead to corrective or disciplinary action up to and including dismissal from the Morsani College of Medicine.

Annual Declaration

Each year, all candidates must sign and return the form “Declaration of Meeting Technical Standards for the University of South Florida Morsani of Medicine” to the MCOM Office of Student Affairs. Failure to sign and return the form could result in being removed from enrollment and prevent promotion or graduation.  Falsification of a form is a violation of the Honor Code and could lead to dismissal from the program.  Each year, the MCOM Office of Student Affairs will notify candidates of the deadline for filing the declaration, but it is the candidate’s responsibility to complete, sign, and return the form by the deadline

Students with Disabilities

The Americans with Disabilities Act (ADA)

The University of South Florida is committed to the principles of equitable and accessible education and to providing reasonable accommodations to students with disabilities. The University of South Florida Morsani College of Medicine endeavors to provide reasonable accommodations for qualified individuals with disabilities who apply for admission and are enrolled as medical students.

Students Accessibility

USF does not ask candidates to provide disability information as part of the admission process. On occasion, a candidate identifies a disability that may impact his/her ability to meet the MCOM Technical Standards for Admission, Progression and Graduation. When this occurs, the candidate for admission should contact the office of MD Admissions.

Candidates for Admission

• Candidates with disabilities who are offered admission should begin discussions with the office of MD admissions as soon as the offer is received.

Candidates for Academic Promotion or Graduation

• Enrolled candidates who develop a disability or condition must provide current information to Student Accessibility Services documenting the general nature and extent of the disability, the functional limitations that would need to be accommodated, and the accommodations that are being requested.
• For students to receive additional time for completing USMLE Step 1 and 2CK, approval must be granted by the National Board of Medical Examiners (NBME). Requests to the NBME must be accompanied by appropriate documentation from the MD/PhD counselor with their recommendation and the diagnostic procedures used to make their determination.

It is the candidate’s responsibility to provide sufficiently current information documenting the general nature and extent of the disability, the functional limitations that would need to be accommodated, and the accommodations that are being requested.