VP&S Policies, Procedures and Student Professional Expectations for Major Clinical Year (MCY)
Student Occupational Exposure Policies/Procedures
Please see this website for information about Body Fluid Exposures and Occupational Injuries: https://www.studenthealth.cuimc.columbia.edu/our-services/occupational-exposures
Medical Services is available to treat all body fluid exposures and occupational injuries. Remember, body fluid exposures are a medical emergency.
· If you sustain an occupational exposure, contact Student Health on Haven immediately. If we are closed, contact the Student Health clinician on call at 212-305-3400 and go to the nearest emergency room.
· If prophylaxis is indicated, the goal is to start within 1-2 hours of the exposure.
· You must also file an incident report at your clinical site for any body fluid exposure or injury.
A blood-borne pathogen exposure is not JUST a needle stick, but the exposure of non-intact skin or any mucosal surface to blood or other potentially infectious body fluids (e.g., semen, vaginal secretions, breast milk, cerebrospinal fluid (CSF), peritoneal or pericardial fluid, saliva in dental procedures, or any fluid contaminated by blood).
Follow these steps immediately for a blood-borne pathogen exposure:
· Cleanse the injury (soap and water).
· Notify your resident, preceptor or attending to arrange for prompt counseling and testing of the source patient for HIV, Hepatitis C and Hepatitis B. Getting the source patient tested can potentially save you a month of prophylaxis, drug side effects, and many months of anxiety.
· Seek medical attention immediately.
· Notify Student Health.
Attendance and Absence Logging Policy
The VP&S attendance and absence policy is located on the VP&S website:
Requesting an approved absence from a mandatory curricular activity
Students should not schedule personal events that would result in an absence from a mandatory curricular activity or assessment. We recognize that students may experience planned or unplanned life events that may impact learning, however, and have designated the following circumstances as acceptable reasons for being absent from a mandatory curricular activity:
a) Acute illness
b) Urgent health care needs
c) Personal crisis (for example, death in the family)
d) Religious holiday observances (as described in the Columbia University Regulation on Religious Holidays)
e) Participation in a scientific conference where the student is the lead author/presenter and directly participating in the conference presentation
f) Residency interview
g) Significant life event not otherwise specified
If a student anticipates missing a mandatory session or assessment during MCY or D&I phase for any of the above reasons, they must request an anticipated approved absence as soon as possible but at least 4 weeks in advance of the start of the clerkship/rotation via this Qualtrics form. The student will be notified that the absence is approved within 1-2 weeks of the request.
Clerkship/electives directors will be notified of approved anticipated absences. Once approved, students should contact their clerkship directors, preceptors, attendings, and house staff of the dates of approved absences well in advance so that appropriate arrangements for on-call scheduling, patient care, and makeups can be made.
In cases of unanticipated absences involving illness and unexpected emergencies, students must notify the Office of Medical Education of an unanticipated absence through a Qualtrics form as soon as is feasible and must also notify their clerkship directors and preceptors and/or team senior residents and attendings by email of their absence.
Students wishing to discuss additional reasons for absences may contact the Associate Dean for Student Affairs, Support and Services.
Absences: If students miss 20% or more of a clerkship (e.g., five or more days for five-week clerkships, one or more days for one-week clerkships), they will receive a grade of incomplete for the clerkship and be required to make up the missed time and possibly the entire clerkship.
Accommodations policy: While working in clinical settings, it can be challenging to balance self-care with professional duties. To help maintain their self-care, students who need accommodations to attend medical appointments should notify the Office of Education at psmcy@cumc.columbia.edu. Students do not need to disclose their specific medical needs. The Office of Education will provide a list of students needing accommodations to clerkship and elective directors without reference to students’ specific medical need. Students are also asked to alert clerkship and elective directors of their accommodation at least four weeks prior to the start of the clerkship or elective.
Shelf exam study time: Students are given ½ day off from clerkship duties* during the week of the clerkship shelf examination to study. This day/time will be determined by the clerkship director.
*Please note that in the Neurology clerkship, the ½ day shelf exam study time will be during the afternoon of the OSCE.
Wellness day: Students are given ½ day for wellness activities during each core clerkship. This wellness day may not be taken during the last four days of clerkship, nor may it be combined with any approved absences. The student's wellness day must be approved in advance by the clerkship director.
Respectful and inclusive learning environment statement
The Columbia University Vagelos College of Physicians and Surgeons (VP&S) bears special responsibility to assure that its students learn in an environment that fosters mutual respect, civil behavior, and the values of professionalism, ethics, and humanism. The standards and procedures for the VP&S Learning Environment and how to report any concerns can be reviewed here. https://www.vagelos.columbia.edu/education/student-resources/honor-code-and-policies/learning-environment-standards-procedures-and-policy
Inclusion is a value of Columbia University Vagelos College of Physicians and Surgeons (VP&S). These guidelines for educators are intended to combat bias which decrease our ability to provide equitable medical care, and to increase inclusion within our medical school. Through these guidelines, co-created by VP&S students, faculty, and administrators, we aim to foster dialogue and encourage community learning around issues of bias in medicine. https://www.vagelos.columbia.edu/education/academic-programs/md-program/curriculum/about-curriculum/promoting-bias-free-curriculum
All instructors are informed of our anti-bias and inclusive curriculum guidelines. We welcome your feedback to improve the course materials and learning environment. https://cumc.co1.qualtrics.com/jfe/form/SV_38Zh0vdTRzM3ZJz
Reporting Mistreatment or Hostile Learning Environment
VP&S encourages students to report mistreatment or hostile learning environment in end of course evaluations or at any other time using this Qualtrics online survey form(link is external and opens in a new window). The Center for Education Research and Evaluation (CERE) tracks reports of mistreatment and hostile learning environment, maintaining the anonymity of the student. The deans for student affairs and curriculum, and the vice dean for education, regularly review these reports and monitor follow-up actions within the departments where the events occurred. To fully preserve anonymity, reports are ‘quarantined’ until after course directors have submitted clerkship grades.
Professional Behavior:
Professionalism is a key determinant of a physician’s ability to provide safe, high-quality care to patients, and protecting the safety of patients is the overriding concern of the faculty of medicine at VP&S. Medical students who fail to maintain appropriate professional behavior and/or adequate academic performance will be subject to review, potential disciplinary action where relevant, and possible dismissal from the Columbia University Vagelos College of Physicians and Surgeons (VP&S). Standards for Professionalism.
Generative AI Policy for students/ Plagiarism:
Absent a clear statement from a course instructor granting permission, the use of Generative AI tools to complete an assignment or exam is prohibited. The unauthorized use of AI shall be treated similarly to unauthorized assistance and/or plagiarism (page 11 of Standards and Discipline).
Generative AI Policy | Office of the Provost (columbia.edu)
Students are encouraged to speak with their instructors regarding their expectations.
Student Honor Code
Dress Code
Students should adhere to the dress code policy while on clinical rotations.
Clinical Supervision Policy
Medical students must be supervised in the clinical environment in accordance with the VP&S Clinical Supervision Policy.
Students may report any concerns about inadequate supervision directly to the course/clerkship director; at the end of course/clerkship evaluation; or through a qualtrics reporting link: https://cumc.co1.qualtrics.com/jfe/form/SV_38Zh0vdTRzM3ZJz(link is external and opens in a new window)
Medical Student Duty Hours
Student duty hours during MCY clerkship will follow the VP&S Work Hours Policy.
If a student is concerned about a violation of the work hours policy at a site, the student is encouraged to immediately report this to the clerkship director. The student can also report this on the end-of-clerkship evaluation form, and/or use this Learning Environment/Duty Hours Qualtrics online survey form https://cumc.co1.qualtrics.com/jfe/form/SV_38Zh0vdTRzM3ZJz(link is external and opens in a new window) to confidentially or not confidentially report work hours violations.
Conflict of Interest Policy
Health professionals who provide or receive any health services, including psychiatric/psychological counseling, to/from a medical student may not be involved in the academic assessment or promotion of the student receiving those services, in accordance with the VP&S conflicts of interest policy. Similarly, they may not access the student's records in accordance with legal requirements for security, privacy, confidentiality, and accessibility of patient information.
A student may request reassignment if a perceived conflict of interest exists with a faculty member by contacting the course/clerkship director and, if appropriate, the Curricular Affairs Dean before the beginning of the course or clerkship. They also may request reassignment from the course/clerkship/elective director on the first day of the course.
Completion of Clerkship Evaluation and Provision of Clerkship Feedback
Thoughtful completion of the end of clerkship evaluation is required in accordance with the VP&S Student Completion of Course and Curricular Evaluations Policy and appreciated to help with continuous quality improvement of the course. Students complete clerkship evaluations at the end of each clerkship, and evaluations are due within 14 days. Clerkship directors can only review the confidential evaluations after they have submitted final clerkship grades. This is referred to as the evaluation quarantine.
Grade Clarification/Grade Appeals
Students who wish to discuss or appeal their clerkship grade must follow the VP&S Grade Appeals Policy.
Academic Progress and Promotion Policy
Academic promotion through the MCY year is detailed in the Academic Progression and Promotion Policy.
Longitudinal Competency-Based Progression Monitoring / Medical Education Program Objectives (MEPOs)
In addition to each clerkship's grade, you will be evaluated on a competency scale in several additional clinical skills and attitudes (medical education program objectives - MEPOs) specific for the course. These will appear on your SPE (student performance evaluation). These are skills/attitudes that are core to becoming a physician. The school will track your progress in attaining competency in these MEPOS through the curriculum until graduation to ensure you can meet the expectations of intern year. Watching your progress ensures readiness for each phase of the curriculum and provides support when needed.
The scale measures your expected progress through the curriculum.
· Level 1: Expected level of an Early Pre-clinical student; indicates an ability to do this with assistance, prompting and/or direct support
· Level 2: Expected level of a Late Pre-clinical student; indicates an ability to do this more independently while in a standardized or supervised setting, Students should reach this level before transitioning to MCY
· Level 3: Expected level of a MCY student; indicates an ability to do this independently in a true clinical setting where patient care is directly affected
· Level 4: Expected level of a student upon graduation; indicates an ability to meet the expectations of intern year
After each semester you will be given a dashboard that displays how you are achieving progression in the MEPOs to allow you to compare your progress across courses. You will have the chance to meet with your coach to review your progress and reflect on strength and improvement areas. When needed, the progress committee may suggest additional support to ensure you meet the expectations for the next stage in the curriculum (MCY). One of the VP&S graduation requirements is the completion of the Completion of the Reflection on Learning Growth: Coaching and Portfolio Review process, so participation in this coaching program, portfolio reflections, and related activities is required.
Student Assignment of Clerkship Sites
Student assignment to clerkship sites has been done in accordance with the MCY Clerkship Assignment Policy.
Once schedules are finalized prior to the start of the Major Clinical Year, students are not permitted to request a site reassignment apart from one-for-one swaps where students can request a direct swap of a clerkship site assignment with another medical student. To facilitate a one-for-one swap request, medical students must provide written notice to the clerkship director and Curricular Affairs by emailing: psmcy@cumc.columbia.edu(link sends e-mail) no later than six weeks prior to the start of the rotation. The request must include the names of both students interested in swapping their site assignments, their contact information, and their rationale for switching. The decision to approve or deny swap requests is made by the Senior Associate Dean for Curricular Affairs in concert with clerkship directors based on the potential impact the change may have.
On occasion, the school may have to reassign student clerkship locations during the Major Clinical Year due to sudden changes in teaching capacity at clerkship sites or extenuating student personal circumstances. Such changes, though rare, are made with the final approval of the Senior Associate Dean for Curricular Affairs.
General Information for MCY including Transportation Reimbursements for Clerkships
For general questions related to MCY, please send an email inquiry through UserVoice: https://psofficeofed.uservoice.com/
Your inquiry will be directed to the appropriate person in the office of medical education (curricular affairs, student affairs) who can best answer your question.
UserVoice has a page containing information for FAQs regarding MCY year. This includes information on transportation, Lyft reimbursement, and housing.