Student Fair Treatment Policy

Introduction

Boonshoft School of Medicine at Wright State University is strongly committed to a policy of fair and equal treatment for all members of its community. In addition, the School of Medicine has a responsibility to foster in medical students, postgraduate trainees, faculty, and other staff the development of the kind of professional and collegial attitudes needed to provide caring and compassionate health care. In pursuit of these goals, the School of Medicine recognizes that each member of the medical school community should be accepted as an autonomous individual and treated civilly, without regard to his or her race, color, religion, gender, sexual orientation, national or ethnic origin, age, or disability.

Mistreatment

An atmosphere of mutual respect and collegiality among teachers and students is essential to the educational mission of the School of Medicine. However, the diversity of the members of the academic community, the intensity of the interactions that occur in the health care setting, differences in personality, and other factors may lead to incidents of inappropriate behavior or mistreatment. The victims and perpetrators of such behavior might include students, faculty, residents, nurses, or other staff. For purposes of this policy, to mistreat is to treat in a harmful, injurious, or offensive way. The following are examples of mistreatment:

• to speak insultingly or unjustifiably harshly to or about a person
  
• to belittle or humiliate
  
• to threaten with physical harm
  
• to physically attack (e.g., hit, slap, kick)
  
• to require the performance of personal services (e.g., shopping, babysitting)
  
• to threaten with a lower grade for reasons other than course/clinical performance

Such actions are contrary to the spirit of learning and professionalism, violate the trust between teacher and learner, and will not be tolerated by the School of Medicine. Accusations of racial or gender discrimination or harassment are not handled under this policy, but rather under other medical school and university policies.Likewise, disputes over grades are handled not by this policy, but by School of Medicine academic policies as described in the Student Policy Guide (Handbook).

In order to promote an environment respectful of all individuals, the School of Medicine will provide ongoing education to students, residents, faculty, and other staff emphasizing the importance of professional and collegial attitudes and behavior. Also, the School of Medicine will make available a readily-accessible neutral party (called the ombudsperson) whom parties may approach if they believe that have been mistreated. A process has been established to seek reconciliation between the parties in cases of alleged mistreatment. This process seeks to protect the accuser from retaliation and to protect the rights and reputations of all parties involved in a complaint and is set forth below.

Resolution of Claims of Mistreatment

When an allegation of student mistreatment occurs, the parties directly involved should try to resolve the matter themselves, since many such incidents are amenable to resolution in this matter. In some situations, however, this informal approach might be hindered by various factors, including reluctance of the accuser to approach the accused, intransigence of the accused, or differing perceptions of the incident by the parties involved. In such cases, a more formal alternative process is available for resolving the matter. This process is designed to be fair to both the accuser and the accused and to be perceived by the accuser as effective, impartial, and unlikely to result in retaliation.

The position of "ombudsperson" has been established to help resolve such conflicts. The ombudsperson shall be appointed by the Dean for a term of four years. The ombudsperson's role is to maintain a neutral point of availability to initiate the dispute resolution process in the event of a claim of mistreatment. The first communication between the ombudsperson and the person whose action is the subject of the claim will be informal. It is intended to clarify the source of the conflict as well as to identify possible avenues of resolution. The ombudsperson will describe the matters raised by the complainant and request a response from the respondent. The respondent will explain his or her position to the ombudsperson and provide any existing documentation. The ombudsperson will attempt to help each party communicate with the other and understand the other's view of the situation, in order to help the parties resolve the matter in a constructive manner. If it appears to the ombudsperson that there may be areas of flexibility which could lead to a resolution of the matter that is agreeable to both parties, the ombudsperson will help the parties pursue those areas. If, at the conclusion of these efforts, both parties are satisfied with the proposed resolution, the matter is resolved. Otherwise, the ombudsperson shall act to begin formal proceedings by interacting with the Dean's office to schedule a meeting of the Dispute Resolution Council ["DRC"].

The DRC shall be composed of members who are chosen to provide a fair and impartial representation of the various constituencies involved in the medical education process. Each member shall be appointed by the Dean after being recommended by the relevant body. Two first biennium and two second biennium students shall be nominated by the Medical School Student Council; two first biennium faculty and two second biennium faculty members shall be nominated by the faculty; and two residents shall be nominated by the DAGMEC executive committee. In addition, the Dean may appoint additional members if necessary or desirable to provide appropriate racial or gender representation, or to provide appropriate representation for groups involved in the claim (e.g., nurses, staff) that are not otherwise included in the DRC. The Dean shall appoint the chair from the committee membership. Finally, the ombudsperson shall be a member ex officio who votes only to break ties.

When the DRC hears a case, the ombudsperson, accuser, and accused are present. The ombudsperson is responsible for notifying the parties in advance of the date, time, and place of the DRC meeting. The proceedings begin with the ombudsperson presenting the claim. The accuser and accused both have an opportunity to speak and to bring witnesses to speak. The order of speakers is as follows: (1) the accuser; (2) witnesses for the accuser; (3) the accused; and (4) witnesses for the accused. The accused has the right to be present whenever statements are being made by the ombudsperson, the accuser, or any witnesses. Similarly, the accuser has the right to be present during statements by the ombudsperson, the accused, or witnesses. Witnesses will be present only when they are called to give information. After speaking, they will be asked to leave, in order to protect the confidentiality of the parties involved. Both the accused and accuser can be harmed by breaches of confidentiality, and all who are involved in the process of responding to allegations must maintain confidentiality. In some situations the DRC might be justified in communicating ordinarily confidential information to other university officials, provided there is a legitimate "need to know." The accuser and accused are not allowed to bring lawyers to DRC meetings as advocates, advisors, or observers, nor may they bring any other persons, except witnesses. This process is intramural, and its purpose is to resolve the problems without going outside the university.

The process of dispute resolution embodied in the DRC is intended to be as flexible as possible. The "rules of evidence" found in a judicial setting will not apply, and the parties may present any evidence or testimony they wish to the DRC. Any evidence presented will be reviewed by the DRC, who will decide credibility issues. After all parties have presented any evidence they wish to present, all individuals who are not members of the DRC shall leave the room, and the DRC shall discuss the claim and arrive at a conclusion about the facts of the matter. The DRC shall designate one person to prepare a memorandum setting forth the conclusions and recommendations of the DRC. All members of the DRC shall review the memorandum for accuracy and sign it. The completed memorandum shall be forwarded directly to the Dean. Upon receipt, the Dean shall notify both the accuser and the accused of the recommendations of the DRC. The Dean shall advise the parties that either party shall have seven business days to request an appeal, and that if neither party requests an appeal within the time allowed, the DRC's proposed actions shall be implemented.

As set forth above, either party may appeal the recommendations of the DRC. An appeal is initiated by either party notifying the ombudsperson of his or her desire to appeal. Upon the initiation of an appeal, the ombudsperson shall notify the Dean, who shall appoint an appeal panel ["Panel"] for purposes of hearing the appeal. The Panel shall be composed of one member from each constituency represented in the original DRC. Each member shall be selected and appointed by the Dean after consultation with the relevant constituency groups. The Panel shall not hear new evidence, but will only review the testimony presented and the conclusions and recommendations forwarded to the Dean by the original DRC. After reviewing the testimony, conclusions and recommendations, the Panel shall, by majority vote, support or reject each recommendation of the DRC. The Panel's decision and all relevant documentation will be forwarded in writing to the Dean. The Dean will review the relevant documents and notify the student in writing of the Dean's decision.

Every effort will be made to protect alleged victims of mistreatment from retaliation if they seek redress. Although it is impossible to guarantee freedom from retaliation, it is possible to take steps to try to prevent it and to set up a process for responding to it. To help prevent retaliation, those who are accused of mistreatment will be informed that retaliation is regarded as a form of mistreatment. Accusations that retaliation has occurred will be handled in the same manner as accusations concerning other forms of mistreatment; however, accusations of retaliation shall be subject to a higher level of scrutiny.

Drug Impairment

The School's Policy

Success in a medical education environment hinges on maintaining a healthy lifestyle. Substance abuse presents a special concern for the School of Medicine because of its potentially negative impact on patient care and of medical students' potential access to controlled substances.

The school may consider dismissal or other measures to prevent licensure of students whose problems are incompatible with the responsibilities and ethics of medical practice. Students and physicians should follow the American Medical Association's Principles of Medical Ethics to identify colleagues who cannot practice medicine competently.

In accordance with the policy of Wright State University, the School of Medicine does not condone violations of federal, state, or local law. The university reserves the right to inform civil authorities should the law be violated. Illegal use, possession, or distribution of drugs also may be cause for suspension or dismissal.

In addition to the university's policy regarding alcohol use, the school does not condone the use of alcohol while students are on duty or on call in a clinical rotation.

Treating Drug Impairment

The School of Medicine endorses treatment of chemical dependency, addiction, or alcoholism as it does for treating any psychological or physical impairment. Constructive interventions are designed to assure that recovering students can continue their medical education without stigma or penalty.

The student must maintain school standards of performance and behavior. Continuation of medical studies will depend upon successful completion of treatment and an appropriate program of aftercare and monitoring.

How To Report a Possible Drug Problem

Faculty, students, or staff who are concerned about a student's use of drugs or alcohol should contact the Associate Dean for Student Affairs/Admissions. Such reports will be held in confidence unless the information they contain must be used in the course of due process.

The Associate Dean of Student Affairs/Admissions will examine the information and, when necessary, consult with appropriate experts. If further action is warranted, the Associate Dean of Student Affairs/Admissions will recommend to the Dean of the School of Medicine that an ad hoc Committee on Drug Impairment be formed to review the case.

Drug Impairment: Administrative Procedures

Ad hoc Committee on Drug Impairment

In dealing with possible drug abuse, the Dean will appoint four faculty members and one student from each biennium to the Committee on Drug Impairment. The committee will examine the information to determine if reasonable grounds exist to suspect impairment. If so, the committee will obtain clinical and performance evaluations as needed to determine the degree of impairment. If impairment is evident, the committee will:

• Propose an appropriate intervention or rehabilitation strategy;
  
• Propose an appropriate plan to monitor the student's progress in the rehabilitative activities; and
  
• Communicate their decisions to the Associate Dean of Student Affairs.

Student Follow-Through

If a student can manage active enrollment and agrees to the recommended treatment and monitoring plan during unscheduled time, he/she may remain enrolled and fulfill all academic requirements.

If a student cannot manage active enrollment but agrees to a recommended treatment and monitoring program that involves inpatient or outpatient treatment and rehabilitation, he/she may take an official leave of absence. In either case, the student is responsible for all treatment costs.

The ad hoc Committee on Drug Impairment will monitor impaired students. Urine surveillance and consultation with a therapist to determine student compliance may be required by the committee.

Graduating students with a history of impairment may have a statement of their performance records, relative to their difficulties and corrective steps, reported to the director of their residency programs. The Committee on Physician Effectiveness and Well-being of the Medical Society in the state in which they will pursue medical training may also be notified.

Treatment Failure or Non-Compliance

The committee may revise its recommendations if a student fails to:

• Comply with the treatment recommendations of the committee;
  
• Complete the treatment recommended by the committee; or
  
• Regain and maintain fitness.

Normally, in cases of non-compliance with treatment, the committee will recommend dismissal from the School of Medicine. A similar sanction will be expected if the student drops out of the recommended treatment or fails to maintain fitness after being reinstated in the School of Medicine.

Appeal Processes

Students may appeal to the committee for reconsideration of its decisions if new information is available. The final decision for dismissal is made by the Dean of the School of Medicine. A student may appeal the Dean's decision to the President of the university. A written petition must be submitted to the President within seven business days of receiving the Dean's decision. The President's decision is final.

Mental Health

Administrative Procedures

Students experiencing psychological problems will be treated with compassion, support, dignity, and respect for privacy. The school will offer as much support and assistance as possible within the scope of its primary mission of education.

Counseling faculty members in the Office of Student Affairs/Admissions are available for advice and counseling on personal and academic concerns. In addition, students have access to professional counseling through the Department of Psychiatry. Students may contact the director of Student Mental Health Services by calling 223-8840.

Since psychological problems do not necessarily imply unacceptable student performance, the school does not impose administrative actions solely because of a student's psychological condition. However, the school cannot relax those performance and behavior standards that are essential to medical education. Administrative intervention could be required when psychological problems cause unacceptable performance or behavior.

Students or faculty who suspect that a student is psychologically impaired should contact the Associate Dean for Student Affairs/Admissions. If further action appears necessary, the Associate Dean will pursue one of the following alternatives:

• If performance or behavior factors are not involved, the Associate Dean for Student Affairs/Admissions will fully respect the right and responsibility of the student to determine further actions, if any, including leave of absence and professional treatment. The student will be offered all reasonable assistance. Any treatment will be confidential and at the student's expense.
  
  
• If performance or behavior factors are involved, the Associate Dean for Student Affairs/Admissions may intervene. This would include instances such as:
  • threats to life, limb or property of self or others;
    
  • functioning incompetently in a medical education setting;
    
  • inappropriate professional behavior;
    
  • behavior which disrupts academic or clinical activities;
    
  • recurrent need for excessive support which interferes with the responsibilities of faculty, staff, or fellow students;
    
  • violation of local, state, or federal laws;
    
  • violation of policies of the school, the university, or affiliated hospitals; or
    
  • violation of professional ethics.

Under these circumstances, the Associate Dean for Student Affairs/Admissions may take action required to fulfill the responsibilities of the school. This could include:

• continuation with no further action,
  
• continuation after leave of absence for a specified period,
  
• continuation contingent on a supporting clinical opinion,
  
• review by the Student Promotions Committee or Honor Code Council, or
  
• review by an ad hoc committee.

The student may be encouraged to pursue professional help, but the school normally will honor the student's right and responsibility to manage his/her personal issues.

Ad Hoc Student Mental Health Committee

If serious or recurrent behavior problems and/or questions of professional competence exist, the Associate Dean for Student Affairs/Admissions, Student Promotions Committee (SPC), or Honor Code Council may appoint an ad hoc Student Mental Health Committee to review the circumstances and recommend actions. The committee will consist of four faculty members plus one faculty or staff member selected by the student. The committee's recommendations could include, but are not limited to, the following:

• any of the actions described previously;
  
• indefinite leave of absence with specified conditions;
  
• required clinical evaluation;
  
• alteration of the student's academic program; or
  
• dismissal.

Required Clinical Evaluation

A required clinical evaluation will be imposed with discretion and under the following terms, which will be made clear to the student and to the clinician:

• The student may select a clinician from a list provided by the Office of Student Affairs/Admissions.
  
• The clinician is serving as an agent of the school, to assist with education planning, and must be knowledgeable of the medical education process. The school will pay for the evaluation.
  
• The evaluation report will be forwarded to the Associate Dean for Student Affairs/Admissions. Information will be limited to that which is necessary to clarify the student's ability to function as a medical student, including any related treatment requirements.
  
• An ad hoc Student Mental Health Committee convened by the Associate Dean, SPC or ESC and recommending a required evaluation will review the evaluation and make recommendations for action back to the initiating person or committee.

Appeal Processes

Students wishing to appeal a decision requiring a clinical evaluation, treatment, or leave of absence mandated by the SPC or ESC should follow the guidelines for appeal included in the Assessment and Promotions or Ethical Standards policies. Students wishing to appeal a decision by the Associate Dean for Student Affairs requiring a clinical evaluation, treatment, or leave of absence may appeal to the Dean, in writing, within seven business days of receiving the decision regarding their status.

After reviewing the relevant documents, the Dean will notify the student, by letter, of the Dean's decision.