Professionalism is a core competency for UCSF medical students and is fundamental to the practice of medicine.

Students are expected to demonstrate adequate professional and personal attributes both within and outside the boundaries of a course or clerkship. If inadequate professional behaviors are noted outside of course work or clinical experiences, students will be subject to receiving a "Physicianship Evaluation" from the central educational administration. Concerns will be summarized and the form will be completed by the Associate Dean for Curricular or Student Affairs, rather than course or clerkship directors. Therefore, this category of physicianship evaluation is called "Institutional Physicianship." The evaluation describes areas in which improvement in professional performance is needed, and is parallel to and includes the standard physicianship evaluation criteria: ability to meet professional responsibilities; ability to improve and adapt; and ability to establish adequate relationships with faculty and administrative personnel.

The following examples describe the kinds of behavior that would warrant an institutional physicianship evaluation: a student falsifies financial information in order to procure student loans; a student does not respond in a reasonable manner to multiple communications from the Offices of Curricular or Student Affairs; a student does not meet the requirements that are in place to progress to clinical responsibility, including but not limited to receiving required immunizations, scheduling and completing USMLE Step 1 and Step 2 by the required dates.

Rapid feedback to students is a goal of this evaluation process and will be prioritized whenever information becomes available. An institutional physicianship evaluation will be completed and submitted after attempts to give the student feedback about these issues have been unsuccessful. Such feedback, though strongly encouraged, is not required in order to submit an institutional physicianship evaluation. The Associate Dean for Curricular or Student Affairs will meet with the student to discuss ways in which unprofessional behavior can be improved, thus allowing the student adequate opportunity to make appropriate changes. To document this process, the student will sign and date the form and may respond to the evaluation by providing additional information

If the student disagrees about the merits of the submission of an institutional physicianship evaluation, s/he may discuss the evaluation with his or her Advisory College Mentor, another Associate Dean, or may request a review by the Student Welfare Committee, an ad hoc committee of students and faculty appointed by the Faculty Council. In all cases, if the evaluation is found invalid, the concerns that are noted will be considered resolved. Thus, the grievance process for the institutional physicianship evaluation is similar to the process used to grieve physicianship forms that are submitted by course and clerkship directors.

The academic consequence of receiving an institutional physicianship evaluation is the same as receiving a physicianship evaluation from a course or clerkship director. If a first or second-year student receives one or more physicianship evaluations, s/he meets with the associate dean for counseling and remediation. Reference to these sessions is not made in the Medical Student Performance Evaluation (MSPE). However, if a student receives two or more physicianship evaluations in the Essential Core and subsequently receives one or more physicianship evaluations in the third or fourth years, or receives two or more physicianship evaluations in years 3 or 4, then issues concerning the student’s professional behavior are mentioned in the MSPE. Should a student receive a second physicianship evaluation in years 3 or 4 after the MSPE has been transmitted, the school will notify residency program directors of the ongoing concerns about performance in the domain of professionalism.

Students who receive two or more physicianship evaluations in years 3 or 4 (or more than 1 physicianship evaluation in the Essential Core and then an additional one in years 3 or 4) will be placed on academic probation and can be referred to the Academic Standards Committee (ASC) for review of the deficiencies.

If you have questions about the institutional physicianship process or evaluation criteria, please contact Associate Dean Papadakis at (415) 476-1216.

July 2003