Professionalism

As representatives of the medical profession and Rush University Medical Center (RUMC), Rush Medical College (RMC) students are expected to act in an appropriate, professional manner at all times and in all areas of their lives. Professionalism is the most important component of medicine’s contract with society. “The physician professional is defined not only by what he or she must know and do, but most importantly by a profound sense of what the physician must be” (Jordan Cohen, MD, former President of the Association of American Medical Colleges).

These sets of behaviors define professionalism (See Swick reference below). As physicians in training, RMC students are expected to:

• Treat both patients and colleagues with kindness, compassion, and respect, both in person and via social media and other digital platforms. 
• Respect and preserve patient confidentiality in all interactions, as appropriate for patient care: with both patients and colleagues, through the electronic health record and other digital platforms, and in person.
• Attend and participate in scheduled instruction and clinical activities in an engaged, punctual and reliable manner, as outlined in the Rush Medical College Teacher-Learner Relationship document.
• Accept constructive feedback openly and without hostility and accept responsibility for missteps. Students are expected to reflect on how to improve performance upon receiving such feedback.
• Recognize personal limitations in both academics and patient care and seek help from faculty and peers as appropriate.
• Provide constructive feedback and evaluation about the learning environment and experiences.
• Address witnessed errors, rule violations, and unprofessional behavior in a direct and respectful manner.  Report such behaviors to appropriate authority as indicated.
• Adhere to the ethical standards of our profession as described by the American Medical Association.
• Act as models of honesty and integrity at all times, in all interactions with patients, faculty, and colleagues.
• Complete all course and administrative requirements in a timely fashion as described by the Office of Medical Student Programs, course directors, and faculty.
• Abide by the Rush Medical College Student Honor Code.
• Dress and conduct themselves appropriately to the activity in which they are participating, in a manner becoming of a member of the Rush community.
• Refrain from using illicit substances, in accordance with the law. Avoid using legal substances to the point of impairment or dependency

References:

• Association of American Medical Colleges: Assessment of Professionalism Project https://www.aamc.org/download/77168/data/professionalism.pdf
• Cohen JJ. “The work ahead”: AAMC’s president address, November 6, 2005. http://www.aamc.org/newsroom/reporter/july06/word.htm.
• Swick, HM, Toward a Normative Definition of Medical Professionalism. Academic Medicine 2000; 75: 612-616.
• Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA.2002;287(2):226-235.
• Kirk, Lynne, Professionalism in medicine: definitions and considerations for teaching, Proc (Baylor Univ Med Cent). 2007 Jan; 20(1): 13-16.
• Medical Professionalism in the New Millennium: A Physician Charter ; 2002, the ABIM Foundation, the ACP Foundation and the European Federation of Internal Medicine. http://www.abimfoundation.org/Professionalism/Medical-Professionalism.aspx

The following policy statement was passed by the RMC Committee on Curriculum and Evaluation (CCE)
and the Committee on Student Evaluation and Promotion (COSEP):

Confidentiality

Students are bound by the code of physician-patient confidentiality. Do not discuss patient issues outside of the clinical setting. Do not discuss patient issues in public areas. Patient lists or other paperwork containing patient information must be concealed in public places and must be disposed of properly (e.g., secure shredder). Use of EPIC is for patient care only.

As a student you may be provided access to patient records. Electronic records are managed through EPIC, Rush University Medical Center’s electronic health record application. Although all patient records are available through EPIC, you should only access records for patients to whom you are assigned or to whom you have been granted permission through your supervising faculty. The Privacy Office regularly audits access to patient records and any instance of inappropriate access will be immediately referred to the University for disciplinary action.

Academic Honesty

Students are required to adhere to the following statements regarding academic honesty:

1. Rush University (RU) Honor Code, found on the Rush University portal
2. RU statement on Academic Honesty and Student Misconduct
3. RMC Teacher-Learner Relationship. Refer to Appendix F - Teacher Learner Relationship  

Social Media

RMC students are subject to the Rush University Medical Center social media policy (http://inside.rush.edu/policies/Lists/Master%20Policy/DispForm.aspx?ID=2278)

Attire and Appearance

For any interaction with a patient, real or simulated, students must dress in accordance with the most conservative expectations of patients. When seeing patients, students may not wear denim, open-toe shoes, gym shoes, sheer clothing, shorts, or other inappropriate clothing. Students should wear their short white coat and adhere to the following guidelines for dress:

• Business attire is required
• Be clean and well groomed; strong fragrances should be avoided
• When on call, students wearing scrubs must do so according to the RUMC Scrub Policy
• Always wear your identification badge. If lost or stolen, please contact Rush University Medical Center Security for a replacement

Attendance Policy 

Philosophy: The Importance of Attendance

During pre-clerkship training (i.e., years 1 and 2 of the RMC curriculum) attendance at mandatory sessions is considered paramount. Full engagement in mandatory activities, including attendance, is a core principle promoting the professional development of health care professions students and is in line with the expectations for students as they mature into fully-functioning, independent health care providers. Being present and engaged for faculty-led educational sessions a) positively impacts personal learning (i.e., one’s ability to learn from peers, faculty, and staff), b) strengthens team dynamics (e.g., group participation and interactions) and the learning environment for all, and c) fosters the development of sound work ethic and habits expected of physicians. In accordance with this philosophy, all pre-clerkship students are expected to adhere to the following policies. In addition to this document, this expectation is outlined in the Rush Teacher-Learner Relationship document as well as the Professionalism section of the Rush student handbook with the explicit expectation to:

Attend and participate in scheduled instruction and clinical activities in an engaged, punctual and reliable manner, as outlined in Appendix F - Rush Medical College Teacher-Learner Relationship document.

Policy

Expectations and allowable vs. excused absences:

Attendance is required for all learning sessions marked as “mandatory/required” within the learning management system. Prompt, on-time, arrival at each learning session is expected. It is also expected that students participate in the entirety of each learning session. Sessions which are categorized as mandatory are subject to the attendance policy expectations as outlined herein.

For any pre-clerkship course which is 6 weeks or longer in duration, students are allowed to miss a total of any 2 mandatory sessions without penalty and with no expectation to complete the associated session evaluations. However, there may be an expectation to complete missed/assigned work.

For any pre-clerkship course which is less than 6 weeks in duration, students are allowed only 1 absence from a mandatory session without penalty and with no expectation to complete the associated session evaluation. Again, there may be an expectation to complete missed/assigned work.

Formal prior approval of these allowed absences per course is not required. However, it is expected that you will demonstrate responsible professionalism by notifying all pertinent individuals of your absence in advance (such as the faculty facilitator and pertinent student team members).

Any learning session absences beyond the number of allowed absences (as outlined herein and in each course syllabus) will only be excused for emergencies, personal health related issues, or other issues as deemed appropriate by the Assistant Dean of Pre-Clerkship Education (see #6 below). Unexcused absences (beyond the allotment of allowed absences as specified above) will trigger the submission of an Early Concern Note (ECN) by course or administrative leadership.

How to reschedule an event or request an excused absence:

1. A request for a planned/anticipated excused absence or a request to reschedule any required class, assigned clinical experience, or assessment must be submitted a minimum of two weeks prior to the scheduled event (see #7 below for additional information regarding simulation events). Requests submitted earlier than 2 weeks are recommended to ensure timely completion of the review and approval process. Students should notify appropriate individuals of unexpected absences as soon as it is reasonable to do so (See #6 below). All petitions for excused absences (whether planned or unexpected) are to be submitted to this link.
2. Requests will be reviewed by the Assistant Dean of Basic Science Education, the Assistant Dean of Clinical Education, and the Associate Dean of Student Affairs. The administrative leadership will respond to the students’ request within one week of receipt of the request.
3. Once an excused absence or a rescheduling of an event has been approved, the student should discuss with the course director how to make up for any missed work or other experience.
4. If a student’s request for an excused absence or rescheduling is denied, the student may appeal to the Senior Associate Dean. The appeal request must occur within one week of the original notification to the student of denial of a request for an excused absence or rescheduling. The outcome of this appeal as determined by the Senior Associate Dean will be final.
5. Unexcused absences and habitual tardiness (i.e., more than 2 tardies) are considered examples of unprofessional student behavior, and will be documented in the form of an Early Concern Note completed by course or administrative leadership. This will be done in accordance with the procedures in the Committee on Student Evaluation and Promotion (COSEP) policies and procedures.  As determined by COSEP, unexcused absences may be characterized as a professionalism deficiency; in which case COSEP may require a student to engage in professionalism remediation.
6. Emergencies and events outside the control of the student (illness, death in the family, etc.) must be documented, but will be considered as an excused absence. It is the responsibility of the student to contact the appropriate course director and curriculum coordinator as soon as it is reasonable to do so to notify them of their unexpected absence. Documentation should be submitted to this link within 2 weeks of the unexpected absence for the absence to be counted as excused. Failure to submit appropriate documentation in a timely manner may result in the absence being classified as unexcused.
7. For all simulation events, appointment times are distributed 4-6 weeks prior to the event. Students who wish to change their appointment time for any reason are encouraged to first find a classmate willing to swap appointments, and then request confirmation of the swap by jointly emailing the Simulation Coordinator. These requests to swap appointment times with another student must be made at least less 7 days prior to the event. To respect the appointment times of subsequent groups, learners who are not present at the beginning of the event orientation may be rescheduled to an alternate date. 

How will habitual tardiness and absenteeism be monitored?

Markers of attendance for mandatory sessions include, but may not be limited to, visual confirmation of attendance by faculty facilitators, the completion of session-level assessments, and attempts to complete session-level evaluations as tracked through ExamSoft.

Students are expected to submit all assigned session-level evaluations during the evaluation window and must complete session-level assessments to receive a performance score. Student attendance throughout the duration of an entire session will be monitored by faculty facilitators. Any student who arrives after roll call, will be counted as tardy. As outlined above (in #5), habitual tardiness may warrant the submission of an Early Concern Note.

Consequences of Unprofessional Behavior

Any episode of unprofessional or disrespectful behavior may result in a failing grade and/or presentation to the COSEP (Committee on Student Evaluation and Promotion) or the Special Committee on the RMC Environment (SCORE). The result may include disciplinary action up to and including dismissal.

RMC Vendor Policy for Students

Some vendors of products or services for medical school students (e.g., board preparation programs) employ aggressive marketing tactics. These tactics are designed to bypass standard business practices of the University as they relate to commercial interests. For example, a vendor may offer individual or group incentives to arrange for the vendor to host an information session on campus for other medical students. Although students are encouraged to seek additional resources to supplement their learning in the RMC curriculum, this policy is designed to avoid conflicts of interest that may unduly influence access to or acquisition of such resources.

Definitions

• A “vendor” is an employee or independent contractor who represents an entity that provides information regarding a particular good or service, or seeks to influence decisions about the selection of goods or services to RU or its students.
• A “benefit” is a gift, good, gratuity, courtesy, compensation, loan, service, scholarship, reimbursement of travel expenses or other favor given to oneself and/or one’s family. Examples of benefits include but are not limited to: cash, checks, gift certificates, product credits, meals, property, favors, prizes, and admission to entertainment, sporting, or any other hospitality events.
• A “University resource” includes any facility, technology, property, or expertise that is controlled, supported, employed, or owned by RU. Examples of University resources include but are not limited to: classrooms, laboratories, meeting facilities, study spaces, dining facilities, computers, Rush email addresses, faculty/staff time or expertise, intellectual property such as teaching materials, and a variety of software (e.g., Blackboard, Examsoft, WebEx).

Prohibited Conduct

The following conduct on the part of RMC students is considered to be a conflict of interest:

1. Accepting benefits from vendors.
2. Disseminating information or giving a presentation, lecture or talk that is controlled by a vendor or otherwise lacks proper professional independence (e.g., the vendor creates the slides or presentation materials, has final approval of the presentation content, or if the student is expected to disseminate information on behalf of the vendor).
3. Arranging, on behalf of a vendor, informational or promotional events that utilize University resources without written permission* from the OMSP (e.g., WebEx conference, RMC email address lists).
4. Using University resources to disseminate, on behalf of a vendor, information about vendor products and services without written permission* from the OMSP.
5. Sharing University resources with a vendor (e.g., RMC email address lists) without written permission* from the OMSP.
6. Accepting promotional items from a vendor for the express use or display on the RU campus that incorporate or display a vendor’s product name and/or logo. This includes wearing any article of clothing, badge, pin, sign or other item that displays the name or logo of a vendor.

Responsibility and Violations

All RMC students are responsible for the enforcement of this policy and for the reporting of violations* to the OMSP. Violations of this policy will be referred to the Honor Code Council, SCORE, and/or COSEP, as appropriate.

* Requests for vendor activity as well as violations of the vendor policy should be submitted on the following page: http://www.surveygizmo.com/s3/2262654/Educational-Vendor-Forms