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Professionalism

Overview

Part of the academic requirements for medical students is professionalism. The development of ideal professional values, attitudes, skills, and behaviors during the passage from medical student to practicing physician involves a number of processes that begin on the first day of medical school and continue throughout a physician’s career. The processes which shape a medical student’s professional growth are numerous. Some are explicit, and others implicit; they include aspects of the formal and informal curricula of medical school. Specific contributing factors include both positive and negative role models, classroom learning, and complex interactions with faculty, residents, patients, patients’ families, other health care providers, clerical personnel, and peers. All these factors influence students who enter medical school with diverse personal and cultural backgrounds. Although these multiple influences are complex, the academic environment, which defines a medical school, must attempt to control them so as to positively direct the medical students’ professional development. Wayne State University School of Medicine must create an environment which fosters the professional development of its students, correcting and remediating behaviors, where possible, deemed to be unprofessional. Appropriate professional behavior is expected by the student both on and off campus.

 

Professional Values and Attributes.

The following values and attributes are at the core of the Professionalism standards for medical students at the School of Medicine:

Professional Responsibility: Sound medical practice and good medical care of patients are the student’s and the physician’s highest priority. The student shall be internally motivated at all times and in all settings to place the patient’s concerns before his or her own. He or she will always help to create a positive learning environment, be appropriately dressed (see the WSUSOM dress code), be punctual and prepared, and attend all required activities in their entirety. The student is to be reliable and honest in completing all tasks. Students should consistently demonstrate ethical behavior, honesty, responsibility, reliability and respect in the classroom and in the clinical and research settings.

Competence and Self-Improvement: It is the expectation that students will be committed to the learning and mastery of medical knowledge, skills, attitudes, and beliefs. The motivation for this learning is the optimal care of future patients. The student will know the limits of his or her abilities and appropriately seek help to improve the care of patients while continuously expanding his or her knowledge base. This commitment extends to life-long learning; an acknowledgement that what begins in the university community never ends as long as the physician is committed to the practice of medicine. Students should recognize personal limitations and biases and find ways to overcome them. Additionally, students should identify challenges to professionalism and develop strategies to maintain professional behavior when adherence to professional standards is threatened in the classroom, clinical or research settings.

Respect for others and professional relationships: Medical students always respect their patients as individuals. Student-patient interactions are guided by the “golden rule”. That is “do unto others as you would have them do unto you and your family.” There is respect for the patient’s dignity, privacy, cultural values, and confidentiality. Students demonstrate sensitivity, respect, compassion, emotional support, and empathy at all times—to patients, patients’ families, other health care team members, and peers. In this context, a fundamental component of professionalism is altruism; putting the best interests of patients and colleagues over self-interest. Respect and altruism are attributes that must extend outside of the classroom or clinical setting as the student is a constant representative of the School of Medicine and of the profession itself. Students should engage in respectful dialogue with peers, faculty clinical supervisors and patients to enhance learning and resolve differences.

Honesty including academic integrity: Medical students are committed to honesty at all times. This commitment extends from the classroom or laboratory in the preclinical curriculum to the ward, office, examination room, or operating room in his or her training environment. Absolute honesty in written notes entered into patient’s records and in oral presentation of findings is expected; medical findings are true, complete, and verifiable. Honesty during test taking is required for both written and practical examinations. This attribute includes the responsibility for reporting the dishonesty of others. As with other core values, honesty is not limited to the School of Medicine and its affiliated teaching sites because the public expects honesty in its physicians as much as the School of Medicine expects it in its students.

Personal responsibility: The student is responsible for maintaining his or her own health and wellness. Drug and alcohol abuse are prohibited. Tobacco use is strongly discouraged. Students are expected to seek care as needed to maintain physical and mental health. The student should freely access his or her counselor for help in managing health or personal issues that are negatively impacting academic performance in medical school. Students need to be proactive in recognizing those of their peers who are affected by drug abuse, alcohol abuse, or other personal issues detrimental to health, well-being, and/or safety, their safety, or the safety of patients. Students with such concerns about their peers should notify a Medical School counselor, a faculty member, or administrator.

Social responsibility: Societies place physicians in positions of power and authority. Physicians and medical students must always conduct themselves in a manner to be worthy of that trust. Medical students must demonstrate concern for and responsiveness to social ills and other factors which detract from the medical, cultural, spiritual, and emotional health of society.

Physicians are held in high esteem by society and they are expected to exhibit professional behavior. Professionalism at the Wayne State University School of Medicine is a longitudinal curriculum that promotes professional growth across the four years of medical school. Wayne State University medical students are expected to model those behaviors during their education and training. Wayne State medical students who violate the professionalism standards set forth herein will be referred to the Professionalism Committee. Any student brought before the Professionalism Committee will be given notice and an opportunity to be heard by the Professionalism Committee.

Appropriate, law-abiding behavior is expected as is adherence to the general policies regarding behavior and conduct stipulated by the Wayne State University Student Code of Conduct.

 

Professionalism Committee Functions and Procedures

Reports of Unprofessional Behavior

Any person may report unprofessional behavior of students, faculty, or staff. [CLICK HERE] Although the report may be anonymous, it must be timely and contain adequate information to permit fact finding by the appropriate assistant dean.

The report must be made within a reasonable time after the alleged unprofessional behavior has occurred or within a reasonable time after the SOM learns of the unprofessional behavior.

 

Referral of Student Code of Conduct Violations to the Dean of Students Office

It will be the responsibility of the appropriate Assistant Dean to refer cases that violate the Wayne State University Student Code of Conduct to the University Dean of Students Office. The Dean of Students Office will investigate cases and render a decision to the Chair of the School of Medicine Promotions Committee. Cases that do not fall under the Wayne State University Student Code of Conduct will be referred to the appropriate Assistant Dean to determine if a referral to the Medical School Professionalism Committee is indicated.

 

Fact-Finding Procedures for Student with Reported Unprofessionalism Behavior

Upon receipt of the charges, the appropriate Assistant Dean shall initiate an investigation. Within ten school days following the fact-finding conference, the Assistant Dean in consultation with the Associate Dean for Undergraduate Medical Education shall decide:

  • Take no further action
  • Recommend remediation – If remediation is recommended, the student may accept or decline the recommended remediation. If the student elects to accept the recommended remediation, he/she must do so in writing within ten (10) school days. If the student declines the recommended remediation, then the student will participate in a formal hearing before the School of Medicine Professionalism Committee. The School of Medicine Professionalism Committee serves as the Hearing Panel.
  • Refer to the Professionalism Committee for a formal hearing
  • Refer the case to the University to be investigated further through the Student Code of Conduct procedure.
  • At this level, there is no appeal for a student referred to the Professionalism Committee for a formal hearing or to the University Student Code of Conduct.

Record Keeping

The Assistant Dean who was involved with the fact-finding process and Chair of the Professionalism Committee shall keep a record of the investigation and disposition of the case. The investigation and disposition of cases may be entered in the Comments section of the Student Tracking Advising Retention System (STARS).

 

Professionalism Committee

The School of Medicine Professionalism Committee is responsible for monitoring medical student professionalism behavior and for promoting the development of professionalism. All reports of unprofessionalism will be handled in one of two ways: (a) It will be referred to the Student Conduct Officer (SCO) of the University with an appropriate academic charge letter (breach of professionalism standards) if the behavior falls into one of the Prohibited Conduct categories under Section 4.0 of the SCOC (Note: Not all unprofessional behavior will fall under one of these Prohibited Conduct categories); or (b) referred directly to the Professionalism Committee for review and decision (where the conduct falls within the Professionalism Core Values set forth on p 70 above but does not fall into one of the Prohibited Conduct categories under the SCOC.

In instances where the student in brought before the Professionalism Committee for a hearing, the Committee may also take into consideration any charge of prohibited non-academic misbehavior brought against that student, where the charge was sustained and where that behavior involves the professionalism standards of the School of Medicine.

The Vice Dean for Medical Education will appoint the Chair of the Professionalism Committee.

The Professionalism Committee composition will be as follows:

  • Chairperson appointed by the Vice Dean for Medical Education (who serves as the Chair of the Promotions Committee).
  • Eight faculty members appointed by the Executive Committee of the Faculty Senate. Faculty members are appointed for 2 or 3 year terms.
  • Four students, one from each the four classes appointed by the Student Senate. Student Senate shall appoint an alternate from each of the four classes.

The faculty must comprise the majority of the quorum. A majority vote of the faculty members is required to pass all motions. Student committee members cast an advisory vote. The Chair will cast a deciding vote in the event of a tie. The Associate Dean for Undergraduate Medical Education will serve in the capacity of Professionalism Committee Chair in the event that the Chair must be recused from a case.

The Chair of the Professionalism Committee shall direct and coordinate matters involving professionalism issues and the consequences for a breach of professionalism and shall be available to answer questions concerning the procedure to be followed in implementing a hearing before the Professionalism Committee.

 

Hearings before the Professionalism Committee

Students brought before the Professionalism Committee for a hearing will be provided with written notice of a hearing at least ten school days prior to the hearing. All notices to students regarding reports of violation of the Professionalism Curriculum shall be sent by e-mail to the student. This notice shall contain the following:

  1. The reason(s) for the hearing;
  2. The nature of the evidence submitted;
  3. The time and place of the hearing;

The Chair of the Professionalism Committee shall be available to answer questions concerning the School of Medicine Professionalism Curriculum due process. The Chair of the Professionalism Committee will provide students the opportunity to review all documents that are provided to the Professionalism Committee ten (10) school days before the hearing.

A student may bring an advisor or an attorney to a formal hearing. The student must notify the Chair of the Professionalism Committee at least five (5) school days prior to the hearing if he/she desires the presence of an advisor. However, a student’s advisor may not participate in the hearing and the Chair of the Professionalism Committee has the right to dismiss this person for disrupting the hearing. A charging party shall appear before and provide oral testimony to the panel. Any member of the Professionalism Committee may ask the charging party for clarification before that party is dismissed from the hearing by the Chair. The student will have an opportunity to appear before the Professionalism Committee following an appearance by the charging party.

The student has the right to decline an appearance but the hearing will proceed in the student’s absence. Any member of the Professionalism Committee may ask the student for clarification before the student is dismissed from the hearing by the Chair. The Chair of the Professionalism Committee will communicate a decision to the student within 10 school days after the hearing

Any questions regarding Professionalism should be directed to Chair of the Professionalism Committee:

Assistant Dean for Basic Sciences
Academic and Student Programs
mpjacks@med.wayne.edu
313-577-1450 (Office)
313-577-1457 (FAX)

 

Sanctions

The School of Medicine Professionalism Committee may impose, but is not limited to, the following sanctions:

  • Disciplinary probation with term and contingencies stipulated by the Committee
  • Required participation in the development and delivery of the School of Medicine Professionalism Curriculum
  • Notification of national organization and Wayne State chapter that student’s membership privileges have been revoked for a term stipulated by the Committee
  • Referral to the Wayne State University Dean of Students Office for a Student Code of Conduct violation. The Dean of Students Office will investigate cases and render a decision to the Chair of the School of Medicine Promotions Committee
  • Referral to the School of Medicine Promotions Committee
  • Administrative assignment for all clinical training
  • A notation of disciplinary action in the Medical Student Performance Evaluation letter

 

Reconsideration of Decisions of the Professionalism Committee

If as the result of a formal hearing process, a sanction is imposed, the student or representative(s) of the organization may request the Chair of the School of Medicine Promotions Committee reconsider the decision on the record. A written Request for Reconsideration must be signed and submitted by the student or representative himself/herself (not by an advisor or an attorney) to the Chair of the Professionalism Committee within twenty (20) school days of the hearing panel’s final decision and must present new evidence for reconsideration.

The Chair of the School of Medicine Promotions Committee may affirm, reverse or modify the decision or may convene the Promotions Committee to review the case. The Chair of the Promotions committee may also refer the case to the University Student Code of Conduct process. The Chair of the Promotions Committee shall notify the student and the Chair of the Professionalism Committee of the decision in writing, within 10 school days.

 

Interim Suspensions from Clinical Activities

Whenever there is evidence that the continued presence of a student at a clinical training site poses a substantial threat to patients or others then the Assistant Dean for Clinical Education in consultation with the Associate Dean for Undergraduate Medical Education may immediately suspend that student until a full investigation can be conducted.

 

Reporting Unprofessional Behavior to Clerkship Directors

Due to the potential risk of harm to patients there is an increased vigilance for students entering clinical rotations. Some cases of unprofessional behavior reported to the Assistant Dean of Student Affairs, Pre-Clerkship Education, or Clinical Science Education will be reported at the monthly Clerkship Directors’ meetings. The Clerkship Directors will have the discretion to relocate the student to a clinical campus that will permit monitoring. This will include removing a student from the clinical campus lottery who is matriculating to third year.

 

Referral to the Student Code of Conduct Officer and Procedure for Informal Disciplinary Conference

Students who are referred to the Student Conduct Officer (SCO) of the University with an appropriate academic charge letter (breach of professionalism standards) due to behavior which falls into one of the Prohibited Conduct categories under Section 4.0 of the SCOC (Note: Not all unprofessional behavior will fall under one of these Prohibited Conduct categories) will undergo a fact-finding hearing pursuant to Section 11.0 of the Code. If the SCO determines there is a sufficient basis to forward the charge for further proceedings, the SCO will refer the matter back to the SOM where the Assistant Dean of Student Affairs shall meet with the student and educate them regarding the disciplinary procedure. The student will be notified that he/she may either meet with the Vice Dean of Medical Education for an Informal Disciplinary Conference pursuant to Section 13.0 of the Student Conduct Code or choose to have the decision and/or sanction of the Chair of the Professionalism Committee heard by a formal Hearing Committee pursuant to Section 14.0 of the Student Conduct Code (see above for the details regarding the Professionalism Committee).

The Vice Dean for Medical Education will convene the Informal Disciplinary Conference. Students or student organizations subject to, or electing to participate in, an Informal Disciplinary Conference shall be accorded all of the procedures provided for in Section 14.0 of the Student Code of Conduct. A decision of the Vice Dean for Medical Education in an Informal Disciplinary Conference is a final decision and no reconsideration or appeal is allowed.

 

Record Retention

The Office of Student Affairs for the School of Medicine shall maintain files in the name of the student respondents for matters brought before the Professionalism or Promotions Committees. These files will also include any records relating to matters of “academic misconduct” or “non-academic misconduct” that are processed through the Student Code of Conduct. Except where litigation or administrative proceedings are pending regarding the matter, if a student is found not to be in violation of the charges, his/her files shall be destroyed. The files of students found in violation of any of the charges against them will be retained as a disciplinary record for the duration of time specified in the sanction, but no less than five years. If the sanction includes a Transcript Disciplinary Record pursuant to Section 5.10 of the Student Code of Conduct, disciplinary records shall be retained permanently if the transcript entry is permanent, or, if the entry is for a specified period of time, for five years after the end of that period. Disciplinary records may be retained for as long as litigation or administrative proceedings are pending regarding the matter.

 

Oath of Academic Integrity

Entering students commit to this oath prior to beginning coursework.

As a part of a community of medical students, I know that my instructors and fellow students have placed their trust in my academic and professional integrity. I recognize the importance of helping each other as we struggle. Dishonesty within a medical school, however, affects not only the student, but also the reputation of the institution, and potentially our future patients.

In view of this, I hereby vow to pursue my studies with integrity and conscience. I will not accept dishonesty among my peers and pledge to honor that trust that my instructors and fellow classmates have placed in me.

As a future physician, my patients and colleagues will entrust to me matters of a sensitive and confidential nature. In some circumstances, their very lives will depend upon my integrity. I will respect their faith in me and will maintain the level of dignity and honesty that medicine demands. From this day forward, I will keep honor in this profession.

 

Declaration of Commitment

Entering students recite the following declaration at the White Coat ceremony, prior to beginning coursework.

I solemnly pledge myself to consecrate my life to the service of humanity;

I will give to my teachers the respect and gratitude which is their due;

I will develop my skills with conscience and dignity;

The health of my patients and myself will be my first considerations;

I will respect those things that are confided in me;

I will maintain by all the means in my power, the honour and the noble traditions of the medical profession;

My colleagues will be my comrades;

I will not permit considerations of religion, nationality, race, party politics, sexual orientation or social standings to intervene between my duty, my peers, and my patients;

I will maintain the utmost respect for human life and I will not use any medical knowledge contrary to law;

I make these promises solemnly, freely and upon my honor.

Adopted from Declaration of Geneva and the International Code of Medical Ethics.

 

Oath of Commitment

Graduating senior students recite the following oath at commencement.

I do solemnly swear by all that I hold most sacred that according to my ability and judgment I will in every particular this my oath and covenant:

I pledge to dedicate myself to the service of humanity and to honor the noble traditions of the medical profession. To hold them who have taught me this art as equal to my parents and to live my life in partnership with them. To give to my teachers the respect and gratitude which is their due; to regard my colleagues equally with my brethren; and to teach this art by precept, by lecture, and by every other mode of instruction, to those who practice the healing arts.

As a physician, I will maintain the ultimate dignity of life while guiding its arrival, protecting its course, and easing its natural passage from this world; I will offer to tose who seek my aid not only my knowledge and skills, but my warmth and compassion as well; whatever the lives of those I shall see or hear, either in my practice or outside of my practice, which should not be made public, this I hold in silence, believing that such things should not be spoken.

I will conduct myself with honesty and virtue; with conscience and dignity will I live my life and practice my art. In all circumstances, I will consider every individual as equal without regard to race, creed, or gender, refusing no one my help. I will abstain from every act of injustice and corruption. Above all else, I will do no harm (Primum Non Nocere).

I freely take this oath and will maintain the noble traditions of my profession, always tempering my science with the warmth and humility of the true physician.

 

Code of Conduct in Gross Anatomy Laboratories

The Uniform Anatomical Gift Act of the State of Michigan permits the dissection of the human body for educational purposes. The Body Bequest Program of Wayne State University provides bodies for a student’s education, prior to the body’s final interment. The following code of conduct will apply at all times in the Human Gross Anatomy laboratories:

  • Dissection of the human body will be performed with dignity and respect.
  • Students assigned to a cadaver will be responsible for the proper conduct of the dissection according to the dissection guide and faculty instruction.
  • All identifying information about the cadaver is confidential.
  • Students may not dissect or alter cadavers assigned to other students.
  • Human tissues, including prosections, bones, and skeletons, may not be removed from the laboratories.
  • Neither the cadaver nor any part thereof may be photographed, videotaped, or digitized.
  • Neither the cadaver nor any part thereof may be positioned or displayed in an inappropriate, comical, or obscene manner.

 

Dress and Grooming Standards

The WSUSOM does not have an explicit dress code for classroom activities. A student is expected to have an appearance that inspires confidence in one’s self and one’s medical school when interacting with patients and the public.

On the other hand, a set of dress and grooming standards have been developed for medical students while in clinical settings. Unless stated otherwise, students should dress professionally and wear a clean white lab coat during all patient encounters (including standardized patients). All students are expected to maintain personal appearance standards that are consistent with the image of a health care professional, and comply with all infection control, legal, and safety requirements.

 

Objective

To promote a neat, clean, professional, and business like appearance consistent with preserving and enhancing the image of the Wayne State University School of Medicine, while assuring that attire is not hazardous or offensive to patients and employees.

 

Scope

All Wayne State University School of Medicine students assigned to inpatient or outpatient (including ambulatory sites, private offices, etc.) patient care areas.

 

Policy

All students shall maintain personal appearance standards that are consistent with the image of a health care professional, and comply with all infection control, legal, and safety requirements.

 

Universal Personal Appearance Standards

  1. Clothing should be of appropriate size and fit permitting freedom of movement. All personal clothing should be clean, neat, and of appropriate length with finished hems. Thighs, breasts and cleavage must be covered. Tucking pant legs into socks is not permitted.
  2. Undergarments must be worn at all times, and color and/or design must not be visible through clothing. Socks or hosiery must be worn. Bare legs and feet are not acceptable.
  3. A short white coat with appropriate School of Medicine identification (embroidery) is to be worn at all times during patient care activities, unless the student’s duties require wearing other items such as scrub clothing in the operating or delivery room.
  4. Hair is to be neat and clean. Long hair must be so styled and/or restrained so as not to interfere with work performance, safety and infection control. Hair may not obscure vision or come in contact with patient or other surfaces. Head coverings mandated by religious beliefs are acceptable. Mustaches and beards must be clean and neatly trimmed.
  5. Fingernails must be kept short (i.e., not to exceed 1/4 inch past the fingertip) and clean. Chipped nail polish or enhancements such as jewels may not be worn. Nail enhancements of any kind (e.g., wraps, acrylics, gels and stones) may not be worn in the Operating Rooms, Same Day Surgery, Intensive Care Units (for example, ICU, BMT, Burn unit, NICU, PICU, pheresis), step-down ICU units, or other areas where invasive procedures are routinely performed or when procedures require a surgical scrub. (CDC Guideline for Hand Hygiene in Health-Care Settings. MMWR 51(RR16); 1-44: 2002).
  6. Jewelry must not create a hazard to self or others, and should be kept to a minimum. Visible adornment with tattoos or body paint is not acceptable. No visible ornamental piercing except for ears. No bracelets are to be worn by students while engaged in patient care activities.
  7. School of Medicine and/or appropriate Hospital Identification (Badges) must be worn at all times, on the upper chest or shoulder area, while on duty. Full name and photo must be visible. Badge holders/lanyards must not interfere with patient care activities and be worn above waist level.
  8. Shoe covers, where required, must be removed when leaving the patient care area.
  9. Makeup should be appropriate for office daytime wear. Perfume and scented after-shave lotion must not be worn due to the health risk to others.
  10. Personal headphones or personal cell phones are not to be used or worn while on duty in direct care of patients. Personal beepers may be worn, but must be on vibrating (non-audible) mode and must not be visible.
  11. Non-Direct Care Activities: Unless otherwise directed, casual business wear may be worn while in orientation, or at other educational offerings. This includes appropriate shoes/hose. However, if a portion of the day is spent in the clinical area, the above guidelines regarding dress and grooming then apply.
  12. Off-Site Functions: Wayne State University School of Medicine Clinical Student Dress and Grooming Standards must be adhered to when employees or contract employees represent the DMC at any outside conferences, community outreach functions, and other professional/educational events.
  13. The following types of clothing are not permitted:
    • Jeans or clothing of denim-like material
    • T-shirts (without hospital approved design or logos)
    • Sweatshirts, sweatpants, or jogging suits
    • Exception: Staff may wear sweatshirts with hospital approved logo-site specific. Personal Trainers at RIM wear RIM Logowear warm-up suits.
    • Shorts or Capris
    • Tank or tube tops
    • Military fatigues
    • Stretch pants, spandex, stir-up pants
    • See-through or revealing clothing
    • Exercise apparel
    • Mini-skirts or mini-dresses (mid-thigh) or slit above mid-thigh
    • Leather
    • Excessive or inappropriate jewelry
    • Sunglasses
    • Open toe shoes or sandals

 

Specialty Areas

  1. Approved hospital-provided and laundered scrubs are to be worn in designated areas only. These include, but are not limited to, the Burn Center (DRH), Labor and Delivery, LDRP, Dialysis and Perioperative areas.
  2. Refer to site or department policy for students assigned to the Rehabilitation Institute of Michigan, and Psychiatric or Chemical Dependency areas.

 

When Standards Are Not Met

  1. Each student is responsible for maintaining an appearance consistent with this policy. It is the responsibility of School of Medicine Administration, in conjunction with resident and attending faculty along with administration of all assigned health care institutions, to assure compliance with these guidelines.
  2. Resident and Faculty, or the student’s counselor from the Office of Student Affairs, are expected to counsel students who wear inappropriate or unsafe clothing.
  3. Students repeatedly arriving at work in apparel deemed unacceptable or unprofessional will be sent home for more appropriate attire. Students may then be required to make up time missed from clinical activities.
  4. If the student does not respond to counseling, he or she may be suspended and referred to the Professionalism Committee for further action.
  5. Faculty and resident physicians to whom students are assigned may make exceptions to the above policy for specific purposes and events.


 

Social Media Policy

Preamble

The use of social media has increased in all industries including health care and biomedical research. This policy is intended to be used as a guide to encourage School of Medicine (SOM) medical and graduate students who use social media to protect themselves from the unintended consequences of such practices and to maintain public trust. The term “social media” should be broadly understood for purposes of this policy to include but not be limited to blogs, wikis, microblogs, message boards, chat rooms, electronic newsletters, online forums, and social networking sites. The SOM is a principled organization, and as such, has an interest in its medical and graduate students being above reproach in the eyes of their peers and the public. This document is crafted to help the medical and graduate students navigate the continually changing world of social media.

Participating thoughtfully in social networking and other similar Internet opportunities can support personal expression, enable individuals to have a professional presence online, foster collegiality and camaraderie within the healthcare and biomedical research professions, and provide opportunity to widely disseminate public health messages, scientific observations, and related communications. However, social networks, blogs, and other forms of communication online also create new challenges to interpersonal relationships. Medical professionals, including those still in training, should weigh a number of considerations when maintaining a presence online:

Policies:

Privacy and Confidentiality

  1. SOM medical and graduate students must be cognizant of, and adhere to, standards of patient privacy and confidentiality in all environments, including online, and must refrain from posting potentially identifiable patient information on personal accounts or websites, when valid, written permission was not given by the patient. Posting any patient information, photos, commentary, content or images may be a breach in confidentiality that could be harmful to the patient and may be a violation of federal privacy laws, including but not limited to provisions within the Health Insurance Portability and Accountability Act (HIPAA). Furthermore, while HIPAA is a United States federal law, the ethical principles that underlie it extend to patients seen outside the country as well.
  2. Sensitive information such as medical records or proprietary information is never to be transmitted by social media.

 

Professionalism

  1. Professional conduct [http://asp.med.wayne.edu/professionalism.php#Overview] must be adhered to at all times, including during the use of social media. The public holds physicians and biomedical research scientists to a high standard of professional conduct.
  2. When writing online as representatives of the SOM about experiences as health professionals, biomedical researchers, or associates of the SOM – medical and graduate students must reveal any existing conflicts of interest and be honest about their credentials.
  3. SOM medical and graduate students may not use their professional position to develop personal relationships with patients, whether online or in person. SOM medical and graduate students are discouraged from interacting with current or past patients on personal social networking sites such as Facebook.
  4. SOM medical and graduate students who do not maintain the school’s professional code of conduct are subject to disciplinary action. The SOM reserves the right to ask SOM medical and graduate students to edit, modify, review or delete any posting that violates the school’s professional code of conduct. SOM medical and graduate students assume all risks related to the security, privacy and confidentiality of their posts.

 

Copyright

  1. Wayne State University or SOM logos, trademarks, images, or related representations may not be used publicly unless granted permission in writing from the Executive Director, Office of Marketing and Publications, Wayne State University. Furthermore, original or modified lecture/laboratory material may not be shared outside of the Wayne State University SOM community.

 

Guidelines:

  1. SOM medical and graduate students should recognize that actions online and content posted may negatively affect their reputations and those of their colleagues at the SOM among patients and colleagues, may have consequences for their medical, teaching, and/or research careers, and could undermine public trust in the medical and biomedical research professions. One should always remember that he or she is representing the medical and biomedical research communities.
  2. To maintain appropriate professional boundaries, SOM medical and graduate students should consider separating personal and professional content online. For professional use, SOM medical and graduate students are strongly encouraged to use their med.wayne.edu email addresses. The med.wayne.edu email address is required for all communication with the SOM.
  3. When using the Internet for social networking, SOM medical and graduate students should use the maximum privacy settings to safeguard personal information and content, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, SOM medical and graduate students should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and content posted about them by others is accurate and appropriate. One should assume that everything he or she writes, exchanges or receives on a social media site is public.
  4. SOM medical and graduate students acting in a public capacity are an ambassador of the SOM while in that capacity. Controversial subjects should be discussed thoughtfully, respectfully, and in a professional manner.
  5. SOM medical and graduate students should take caution not to post information that is ambiguous or that could be misconstrued or taken out of context.
  6. SOM medical and graduate students should be aware that content posted in any format (g., video, song, and etc.) may be taken out of context by others and used for an unintended purpose. Posting online is public and permanent and can be used by anyone without prior request to the original posters. Always consider how people outside of your target group will review the content.
    1. SOM medical and graduate students are encouraged to avoid posting material on school group sites that could be seen as marginalizing to any individual or group; for example, regarding gender, race, religion, social background or sexual orientation.
    2. SOM medical and graduate students are encouraged to avoid posting comments about the health, weight, attitude, or lifestyle choices of SOM faculty members, trainees, academic staff members, and medical and graduate students.
  7. When SOM medical and graduate students see content posted by colleagues that appears unprofessional, they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. If, in the opinion of the observer, the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the observer should report the matter to the Vice Dean of Medical Education.
  8. SOM medical and graduate students should familiarize themselves with relevant Federal, state, and local laws governing online activities. Any issue of concern on social media (including threats, violence, suicide, slander, cyberbullying, etc.) should be reported immediately to the Wayne State University Police Department (phone #:313 577-2222) and/or SOM administration. When uncertain whether these laws are followed, please refer to a school administrator before posting.

*Adapted from the AMA Policy on Social Media, Opinion 9.124 – Professionalism in the Use of Social Media and “Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice” Federation of State Medical Boards [2012] Retrieved 2015, January 28 from http://library.fsmb.org/grpol_policydocs.html

 

Student Mistreatment

The purposes of this policy are to outline expectations of behaviors that promote a positive, supportive, learning environment for Wayne State University School of Medicine medical students and other learners and to identify grievance procedures to address alleged violations. This policy offers a definition of appropriate expectations, provides examples of unacceptable treatment of medical students, and describes the procedures available to report incidents of mistreatment in a safe and effective manner.

Wayne State University School of Medicine is committed to maintaining an educational and professional environment that is free of all forms of harassment and discrimination. The School of Medicine strives to create a safe and supportive learning environment that reflects the Institution’s values: professionalism, respect for individual rights, appreciation of diversity and differences, altruism, compassion and integrity. Mistreatment of medical students is unacceptable and will not be tolerated.

The policy applies to all members of the School of Medicine community including all students, administrators, faculty, staff, clinical teaching faculty, medical personnel, guest lecturers, and volunteers. All members of the School of Medicine community must adhere to this mistreatment policy and report violations. Mistreatment of students can occur by other medical students, university employees and non-university employees. All three types of mistreatment will be addressed in this policy.

Retaliation is strictly prohibited against persons who in good faith report, complain of, or provide information in a mistreatment investigation proceeding. Retaliation includes behavior on the part of the accused or the accuser and other related persons, including, but not limited to, acquaintances, friends and family members. Individuals who believe they are experiencing retaliation should immediately contact the Assistant Dean of Student Affairs or a WSUSOM counselor so that prompt remedial action can be taken.

Students are educated on this policy during Year 1, 2, 3 and 4 Orientation sessions. Students will also receive quarterly emails reminding them of the policy. As part of our process residents, faculty (full time, part-time and volunteer) and staff will also be informed annually. The assistant Dean of Basic Sciences educates Year 1 and 2 faculty and staff through the course directors. The assistant Dean of Clinical Education educates Year 3 and 4 residents, faculty and staff through the clerkship directors and clinical campus medical education directors. All clinical campus affiliates also provide education for their faculty and staff through on line prevention training of both sexual harassment and work place violence. All employees of all participating hospitals must complete these educational modules as a requirement of their employment. Students also receive education on the University Student Code of Conduct Policy as well as the LCME standards as it pertains to student mistreatment at http://medicine.osu.edu/students/life/handbook/Documents/13-Abuse%20Policy12-13v1.pdf

 

Examples of Mistreatment

Students should use this Mistreatment Policy to address discriminatory, unfair, arbitrary or capricious treatment by faculty, staff, students, clinical teaching faculty and medical personnel. The school adheres to the professional standards of behavior established by the Association of American Medical Colleges and the Wayne State University Nondiscrimination Policy (referenced in III.c.) http://oeo.wayne.edu/pdf/affrm_actn_policy.pdf. Students are expected to report behavior which interferes with the learning process. Students should consider the conditions, circumstances and environment surrounding the behavior. Examples of discriminatory, unfair, arbitrary or capricious treatment include, but are not limited to: *

  1. Physical
    1. Physically mistreated causing pain or potential injury
    2. Pushed/slapped hand (“get out of the way communication”)
    3. d to other forms of physical mistreatment used to express frustration, make a point or get attention
  2. Verbal
    1. Accused
    2. Threatened/intimidated
    3. Yelled at/snapped at
    4. Degraded/ridiculed/humiliated/sworn at/scolded/berated
    5. Exposed to inappropriate conversation/comments (of nonsexual and nonracial nature)
  3. Sexual harassment
    1. Making sexual comments, innuendo, jokes, or taunting remarks about a person’s protected status as defined in the University’s Nondiscrimination Policy Statement. (referenced in III.c.)
    2. Making sexual advances, requests for sexual favors, and other verbal or physical conduct or communication of a sexual nature as per the University Sexual Harassment Policy, http://bog.wayne.edu/code/2_28_06.php.
    3. Ignored because of gender
    4. Stalking of a sexual nature; i.e. persistent and unwanted contact of any form whether physical, electronic or by any other means.
  4. Ethnic
    1. Exposed to racial or religious slurs/jokes as defined in the University’s Nondiscrimination Policy Statement. (referenced in III.c.)
    2. Stereotyped
    3. Neglected/ignored (because of student’s ethnicity)
  5. Power
    1. Dehumanized/demeaned/humiliated (nonverbally)
    2. Intimidated/threatened with evaluation or grade consequences
    3. Asked to do inappropriate tasks/scut work
    4. Forced to adhere to inappropriate work schedules
    5. Neglect/ignored

*list adapted from Fried et. al, Academic Medicine, Sept 2012

Please note: When one party has any professional responsibility for another’s academic or job performance or professional future, the university considers sexual relationships between the two individuals to be a basic violation of professional ethics and responsibility; this includes but is not limited to sexual relationship between faculty and student or between supervisor and student, even if deemed to be mutually consenting relationships. Because of the asymmetry of these relationships, “consent” may be difficult to assess, may be deemed not possible, and may be construed as coercive.

 

Reporting Mistreatment:

Medical students who themselves experience or observe other students experiencing possible mistreatment are encouraged to discuss it with someone in a position to understand the context and address necessary action. Those who believe they have experienced mistreatment, sexual harassment or discrimination by an administrator, faculty, staff member, student or a teaching hospital or clinic employee can pursue one or more avenues for resolution. Suggested steps for medical students include:

  1. DISCUSS it with a Wayne State University School of Medicine (WSUSOM) Counselor in the Office of Student Affairs, the Assistant Dean of Student Affairs, the Assistant Dean of Basic Science, the Assistant Dean of Clinical Education, the WSUSOM clerkship/course director, hospital system clinical campus Director of Medical Education, or the Office of Ombuds on main campus. These staff will meet with the student and hear the details of the alleged incident. Students are encouraged but not required to try to resolve the matter by involving a WSUSOM counselor and the Assistant Dean of Student Affairs.
  2. FILE a School of Medicine Report:
    1. File a report with the Assistant Dean of Student Affairs using the http://studentaffairs.med.wayne.edu/form-mistreatment.php
    2. File an anonymous report via the School of Medicine Care Report Program using the http://studentaffairs.med.wayne.edu/form-mistreatment.php.
  3. Formally REPORT it:
    1. If the event involves severe mistreatment by another student, the Office of Student Affairs at the School of Medicine will assist the student in filing charges under the University Student Code of Conduct Process http://doso.wayne.edu/student-conduct/suit/carereport.htm as per University Policy.
    2. If the event involves a WSU administrator, faculty or staff, and involves sexual harassment or discrimination the student must also report the incident to the Office of Equal Opportunity http://oeo.wayne.edu/pdf/discrimination_and_complaint_process_final_old.pdf who will investigate and respond accordingly. Refer to University Policy 2005-03 Discrimination and Harassment Complaint Process.
    3. If the event involves a WSU administrator, faculty or staff, and does not involve sexual harassment or discrimination the student may also report the incident to the Office of Equal Opportunity.
    4. If the event involves clinical faculty/medical personnel (non-university employee) at a clinical campus, the student may also report the event to the Human Resources Department of that Hospital.

    All complaints should be filed within 30 business days of the event. A School of Medicine Care Report includes the following:

    • Your name (optional)
    • Your email (optional)
    • Your phone number (optional)
    • Date of the event
    • Time of the event
    • Location
    • Statement and description of the alleged event
    • Name(s) of person(s) involved
    • Witnesses, if any
    • Other facts considered to be relevant

     

    Rights of the Accuser and Accused:

    • To confidentiality
    • To have the allegations investigated in a thorough and timely manner
    • To be informed of the outcome of the process
    • To modify a schedule as indicated

    If the student is not satisfied with the outcome of their complaint, the student should meet and discuss the issue with the Vice Dean for Medical Education

    Medical Students requesting complete anonymity should be made aware that doing so may interfere with the University’s ability to investigate the concern and their ability to receive information about the follow up investigation.

     

    The University’s Nondiscrimination Policy Statement is:

    “The University, as an equal opportunity/affirmative action employer, complies with all applicable federal and state laws regarding non-discrimination and affirmative action. In furtherance of this policy, the University is also committed to promoting institutional diversity to achieve full equity in all areas of University life and service and in those private clubs and accommodations that are used by University personnel. No off-campus activities sponsored by or on behalf of Wayne State University shall be held in private club facilities or accommodations which operate from an established policy barring membership or participation on the basis of race, color, sex (including gender identity), national origin, religion, age, sexual orientation, familial status, marital status, height, weight, disability, or veteran status. Affirmative action procedures, measures, and programs may be used to the extent permitted by law to establish, monitor and implement affirmative action plans for all budgetary units and the University as a whole.”


     

    Responding to Concerns of Mistreatment

    All complaints will be considered thoroughly and promptly. Every effort will be made to resolve complaints in an expeditious, discreet and effective manner. The University, including the School of Medicine, will attempt to maintain confidentiality to the extent possible within legitimate conduct of an investigation and/or as required by law. Every effort will be made to avoid negative repercussions as a result of discussing an alleged offense and/or filing a complaint.

    If a student reports mistreatment through the School of Medicine Student Care Report, the Assistant Dean of Student Affairs will automatically be provided with written notice of reported concerns of mistreatment and will conduct an initial inquiry into the circumstances of the alleged mistreatment. The Assistant Dean of Student Affairs will assist the student in filing a report with the appropriate office. When another student is involved and the Student Code of Conduct Policy has been activated, the University Student Conduct Officer will render a corrective action plan after discussion and collaboration with the Chair of the Professionalism Committee and/or the SOM Assistant Dean of Student Affairs.

    Aggregate and de-identified data on reports of mistreatment of Medical Students will be shared with the Vice Dean for Medical Education, The Student Senate, and the WSUSOM Curriculum Committee on an annual basis.

     

    No Retaliation

    Retaliation is strictly prohibited against persons who in good faith report, complain of, or provide information in a mistreatment investigation proceeding. Retaliation includes behavior on the part of the accused or the accuser and other related persons, including, but not limited to, acquaintances, friends and family members. Individuals who believe they are experiencing retaliation should immediately contact the Assistant Dean of Student Affairs or a WSUSOM counselor so that prompt remedial action can be taken..

     

    References


     

    Student Confidentiality and Access to Sensitive Information

    Purpose

    The purpose of this policy is to outline the approach of Wayne State University School of Medicine towards the handling of sensitive information such as academic records, health information and evaluation of students who seek medical/psychological care.

     

    Confidentiality

    Wayne State University School of Medicine follows appropriate standards of confidentiality in the management of private student information. Wayne State University School of Medicine’s policies pertaining to student access to records and the protection of confidentiality comply with Wayne State University (parent institution) and the Family Educational Rights and Privacy Act of 1974 (FERPA), governing access to, and confidentiality of, student educational records. For more information regarding Wayne State University’s Privacy of Academic Records Policy, please refer to: http://reg.wayne.edu/students/privacy.php

     

    Rights under FERPA for Postsecondary Institutions

    The Family Educational Rights and Privacy Act (FERPA) affords students certain rights with respect to their education records:

    1. The right to inspect and review the student’s education records.
    2. The right to request the amendment of the student’s education record that the student believes is inaccurate, misleading, or otherwise in violation of the student’s privacy rights under FERPA.
    3. The right to provide written consent before the University discloses personally identifiable information from the student’s education records, except to the extent that FERPA authorizes disclosure without consent.
    4. The right to file a complaint with the U.S. Department of Education concerning alleged failures by the University to comply with the requirements of FERPA. The name and address of the Office that administers FERPA is:
      Family Policy Compliance Office
      S. Department of Education
      400 Maryland Avenue, SW
      Washington, DC 20202

     

    Student Information and Academic Records

    With certain defined exceptions, under FERPA, an academic record is: Any record, maintained by an institution or agent of the institution where a student can be personally identified. A student has right to expect that educational records will be kept confidential and will be disclosed only with his or her permission or as allowed by law (including electronic records). Information regarding an individual’s academic performance, external examination results (e.g. USMLE) and financial status will be kept confidential and handled carefully to prevent it from becoming known to unauthorized individuals.

    The Wayne State University School of Medicine uses various secure electronic information systems, such as MySOM, Banner, STARS, E*Value, etc. for storing information regarding student academic performance, course registration, academic performance, biographical data, appointment information and financial aid and student account information regarding charges and payments. Paper files kept at Wayne State University School of Medicine include the academic file and the health file.

     

    Health Information

    Health information is stored separately from a student’s academic records and kept in a locked area in the Registrar’s Office. Access to the health files is limited to authorized Student Affairs personnel.

     

    Review and Amend Records

    Students have the right to inspect and review their educational records, seek amendment of the records they believe to be inaccurate or in violation of their privacy rights, and consent to disclosures of personally identifiable information contained in their records (except to the extent that the law authorizes disclosure without consent). Students who wish to amend an inaccurate or misleading record may:

    1. Discuss any changes with the School of Medicine Assistant Dean for Student Affairs or Office of Records & Registration
    2. Request that records are reviewed by Wayne State University Registrar (main campus). The school is required, by law, to respond within 45 days of the request receipt. Requests through this channel should be addressed to:

      Wayne State University Academic Records
      Wayne State University
      5057 Woodward, Fifth Floor
      Detroit, MI 48202

    Grade Appeal Process

    For information on appealing a grade, please refer to the grading policies available on the Academic and Student Programs website: http://asp.med.wayne.edu/grading.php# Appealing Grades

    Exceptions and Disclosure without Consent

    FERPA identifies a category of information as “directory information” that institutions may usually release without student permission. Wayne State University has designated the following items as Directory Information: Name, address, phone number, age or date of birth, E-mail address, major field of study, degrees, honors, and awards received, and participation in sports and activities. In addition, under the FERPA exceptions, Wayne State University may disclose a student’s educational records without consent under the following instances:

    • To school officials with a legitimate educational interest. A school official is a person employed by the university in an administrative, supervisory, academic or support staff position (including law enforcement personnel & health system staff) or a person or company with whom the university has contracted as its agent to provide a service instead of using university officials. (Examples of this include collection agencies and the National Student Clearinghouse.)
    • To comply with judicial order or lawfully issued subpoena (after appropriate notice to the student)
    • To appropriate parties in a health or safety emergency, such as Wayne State Public Safety.
    • To officials of another school, in which a student seeks or intends to enroll
    • In connection with financial aid for which the student has applied or received, if the information is necessary to determine eligibility for aid, the amount of the aid, the conditions for the aid, or to enforce the terms and conditions of the aid
    • To certain government officials in connection with state or federally supported education programs
    • To accrediting organizations
    • To attorneys representing Wayne State University
    • To organizations conducting certain studies for or on behalf of the University (with certain conditions)

     

    Releasing Information

    Release of Health Records: The student provides the authorization for release of Immunization/Immunity/Health Test Records by signing off on the appropriate form. Student Records: Students may authorize specific people or entities to have access to their education records by filling out an Authorization to Release Academic Records form and returning it to the Records and Registration Office: http://reg.wayne.edu/pdf-forms/ferpa.pdf

    Please note: Students who do not wish to have their match information in the Match Outcome Public Record and/or do not wish to participate in Commencement and therefore do not want their matching information in the Commencement Booklet must notify the Assistant Dean of Student Affairs by 3 pm on Friday of Match Week.

     

    Conflict of Interest – Faculty or Staff Providing Medical Care to Students

    Wayne State seeks to avoid actual and perceived conflicts of interest in accordance with the LCME standards. Faculty or staff members who provide any medical care including but not limited to psychiatric, psychological and/or professional counseling to students should take care not to assess student academic performance or take part in the decisions regarding student advancement and/or graduation, and should not attend meetings where student grades are discussed. Students are to report any conflict of interest issues to the Assistant Dean of Student Affairs and Career Development.

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