Basic Principles of Medicine

The following changes are in force for the remainder of the term for online distance learning.

Whilst the course is being offered remotely the new requirements for earning course grades are outlined above. Participation is mandatory for all activities and the penalty for participating in less than 80% of activities will be in effect from April 1^st. The table below outlines the number of activities remaining and the minimum number you are expected to participate in. 

Exam breakdown and policies

All exams are pre-calibrated to 79-81% and examinations meeting that performance target will stand, however, we will also reserve the right to scale the examinations to an 80% mean using standard protocol for national board examinations should the class performance be significantly affected by the transition. Therefore, examinations will have an average of 79-81%. 

For all online proctored examinations, the published scores are preliminary at the time of publication; they are retractable if a subsequent investigation demonstrates a failure to comply with examination regulations or proctoring requirements.

Time zone

All course activities and online quizzes are set to the following time zones.
Atlantic Standard Time 
Time zone in Grenada (UCT-4:00) All synchronous classes are delivered in this time zone.

Lectures

The lectures will continue to be offered on MediaSite. These will be scheduled by day so that you can plan content to match online small group sessions, however, the entire lecture catalog will be available for you so that you can watch lectures at any time.

Small Groups

The small group schedule will be published. Zoom will be used as the online platform, and you will be placed in breakout rooms with a facilitator. The full details will be posted on Sakai and Sakai will contain a Zoom utility link in the side bar. These sessions are synchronous and will be at 10 am Grenada time, as per the schedule. All synchronous classes are in Atlantic Standard Time (UCT-4:00). Synchronous classes start at 10:00 am AST.

Assignments

Some assigned readings and resource packets will be made available to you in place of some small groups. All of these resources will be available in the resources tab of Sakai and are directed learning activities to complement the course lectures.

ESoft Quizzes

We will continue to provide weekly quizzes via examsoft. A defined window will be announced via Sakai for the opening and closing times, submission should be made within that window of opportunity. Completing and uploading these quizzes before the deadline will earn you 2 points each to a maximum of 14 points.

IMCQ Quizzes

We will provide MCQ quizzes via ExamSoft that take the place of the IMCQ sessions. A defined window will be announced via Sakai for the opening and closing times, submission should be made within that window of opportunity. Completing and uploading these quizzes and achieving a score of 50% before the deadline will earn you 2 points each to a maximum of 28 points.

Anatomy Lab quizzes

We will provide LAB quizzes via SAKAI. A defined window will be announced via Sakai for the opening and closing times, submission should be made within that window of opportunity. Completing these quizzes before the deadline will earn you 2 points each to a maximum of 6 points.

Faculty Support

Faculty will service the discussion forums in the Sakai sites. In addition some faculty may be available online via Skype or Zoom calls, faculty will indicate their preferences on Sakai and publish times that they are available.

Lesson Plans

The lesson plan tool has been activated on SAKAI and will give you an outline of the order in which the activities for that week should be reviewed. The lesson plan contains links for everything that is available on SAKAI. You will need to refer to the schedule for ESoft quiz and IMCQ timings. 

Professionalism Points

The participation and professionalism points have been redistributed to the online quizzes and activities. The points were reduced in line with the reduction in the denominator due to loss of practical assessments, so the balance between summative examination points and formative assessment points remains the same as before.

To pass the course the student must achieve a grade of 69.50% or higher (472 points) and must write all exams. 

 Reporting of Errors

Errors in participation and in scores for course assessments manually entered into the gradebook must be reported to the Course Director within 48 hours of their publication. Errors reported after will not be considered.

For Online Assessments, where results are immediately accessible upon submission, errors must be reported before the submission deadline. 

COURSE DESCRIPTION

The Course Basic Principles of Medicine 1 (BPM1) is a 17-credit course taught over 17 weeks in Term 1 of the Doctor of Medicine (MD) program of St George’s University School of Medicine, Grenada, and within the Keith B Taylor Global Scholar's Program (KBT GSP), in collaboration with Northumbria University, Newcastle upon Tyne, UK. It is part one of an organ system-based curriculum for the first academic year of the Basic Sciences program and is taught in three consecutive modules:

Foundation to Medicine (FTM) Module

In this first module, students will learn about the biological molecules associated with cells, tissues and organs from biochemical and cellular discussions towards a molecular understanding of human disease and pathology.  Students will learn about normal and abnormal physiological states including homeostasis and how it is controlled via biochemical and genetic means. Cellular control of proliferation, senescence, apoptosis and necrosis will be explored. Histological, biochemical, physiological, and genetic aspects of cancer will be synthesized to develop a comprehensive analysis of the principles of this disease state. Students will increase their knowledge of human patterns of genetic inheritance beyond Mendelian concepts with the objective of seeing patients through a genetic lens. Genetic and genomic tests for diagnosis and characterization will be taught so that students will have a broad understanding of the advantages and limitations of these technologies. An overarching theme of this module is to introduce students to the language embedded in pathology tests and to provide an understanding and interpretation of the results. To this end, biochemical, physiological and genetic aspects of pharmacology will also be introduced.

Musculoskeletal System (MSK) Module

The Musculoskeletal System module is an interdisciplinary study of the anatomical, histological, physiological and pharmacological principles of this organ system. The overall goal of this module is to provide a comprehensive knowledge base for understanding the normal gross anatomical and microscopic structures as well as the development and functioning of the musculoskeletal system. Case studies, practical laboratory sessions and small group discussions are an integral component throughout the entire module. The module also exposes students to cadaveric prosections and ultrasound simulation sessions with standardized patients to aide in their understanding of key anatomical concepts and allows them to apply this knowledge to a clinical setting.

Cardiovascular, Pulmonary and Renal Systems (CPR) Module

The Cardiovascular, Pulmonary, and Renal Systems module is an interdisciplinary study of the anatomical, histological, physiological, biochemical, and pharmacological principles of these organ systems. The overall goal of this module is to provide a sound comprehensive knowledge base for understanding the normal anatomical and microscopic structures, biochemical processes, and functioning of the cardiovascular, pulmonary and renal organs. Case studies and practical laboratory sessions are also presented as an integral component throughout the entire module. An introduction to inflammation, various cardiovascular, pulmonary and renal acid-base disorders will be explored to aid with the application and integration of the normal basic science principles into pathological disease process.

GOALS AND OBJECTIVES

The Basic Principles of Medicine One (BPM1) Course embraces the mission of the Doctor of Medicine Program of St George’s University School of Medicine: the 4-year outcome objectives are listed in Section B: SGU SOM POLICIES AND PROCEDURES

The Basic Principles of Medicine One (BPM1) Course specifically addresses a number of 4-year outcome objectives within the three categories of knowledge (1a, 1b,1c), clinical skills (2a, 2c, 2e, 2f, 2g, 2i, 2l) and professional attitudes (3b, 3c, 3d, 3e, 3g, 3h, 3i) of the Doctor of Medicine Program of St. George’s University School of Medicine.

Basic Principles of Medicine One (BPM1) Course Objectives

A student should be able to:

1. Analyze normal biochemical, genetic, physiological, histological and cellular mechanisms of the human body and their relationship to medicine
2. Understand and describe the development, anatomical, histological and physiological principles of the musculoskeletal system 
3. Identify and describe the macro and micro anatomical structures, developmental, biochemical, physiological processes of the cardiovascular, pulmonary, and renal organ systems. 
4. Discuss, analyze and apply biochemical, genetic, pharmacological, physiological, histological, developmental and anatomical knowledge to normal and pathological processes 
5. Demonstrate professional behaviors and develop effective communication and interpersonal skills during small group practical sessions and interactive clinical settings.

Foundation to Medicine (FTM) Module Objectives

A student should be able to:

1. Compare and contrast the molecular basis of normal and disease states at the molecular, cellular, histological, genetic and physiological level.
2. Analyze a variety of molecular diagnostic tests and provide their interpretations.
3. Discuss biochemical, histological, physiological, anatomical, developmental and genetic aspects of different types of cells, tissues and organs.
4. Discuss the basic principles of pharmacodynamics, pharmacokinetics and pharmacogenetics
5. Develop effective communication of information when discussing and critically analyzing medically related cases

Musculoskeletal System (MSK) Module Objectives

A student should be able to:

1. Identify the gross anatomical and microscopic structures of the musculoskeletal system. 
2. Understand the development and normal physiological functions of the musculoskeletal system. 
3. Demonstrate proficiency in both theoretical knowledge and clinical skills related to functioning and assessment of the musculoskeletal system. 
4. Apply didactic acquired knowledge to clinically based hands-on exercises.
5. Develop professional behaviors and demonstrate effective communication and interpersonal team building skills during small group practical sessions and interactive clinical settings.

Cardiovascular, Pulmonary and Renal Systems (CPR) Module Objectives

A student should be able to:

1. Identify anatomical and microscopic structures of the cardiovascular, pulmonary, and renal organ systems. 
2. Understand the development, biochemical processes and normal physiological functions of the cardiovascular, pulmonary, and renal organ systems. 
3. Demonstrate proficiency in both theoretical knowledge and clinical skills related to functioning and assessment of the cardiovascular, pulmonary, and renal organ systems. 
4. Apply didactic acquired knowledge to clinically based hands-on exercises.
5. Demonstrate professional behaviors and effective communication and interpersonal team building skills during small group practical sessions and interactive clinical settings.

FACULTY, STAFF AND CONTACT INFORMATION

For all administrative questions contact our departmental secretaries, module coordinators and course directors at:

(Please do not send a message to all faculty or to individual faculty members). Faculty and staff will not respond to emails during the weekend. Last email responded to will be Friday at 4:00pm. 

Content Related Questions

For all content-related questions, the most efficient way of interacting with your peers and faculty is by using the Discussion Form in Sakai, the learning management system. Students can find a more detailed description of the Discussion Forum in the student support section below.

Course Leadership Team

The course director oversees the overall organization of the course. Module coordinators organize specific modules within the course and are responsible for Sakai site.                 

Discipline Managers

Discipline Managers are responsible for the content related to their discipline in lectures, small groups and multiple-choice questions.

Courses Secretaries                                        

Teaching Faculty

Standardized Patients 

St. George’s University employs standardized patients in the training and evaluation of medical students. The BPM1 Course uses standardized patients in the physical examination components of the small group practical sessions (SG) and the ultrasound sessions (US). A standardized patient (SP) is a person who has been coached by faculty to accurately and consistently recreate the physical findings, emotional reactions, and response patterns of an actual patient. In addition, the SP’s have agreed to undergo ultrasound and physical examination thereby affording the student an opportunity to learn surface anatomy, physical examination skills and professional communication and conduct in a simulated clinical environment. Students are expected to perform physical examinations (including ultrasound) on both male and female SPs.

COURSE MATERIAL

Copyright 2019 St. George's University.  All rights reserved. 

All course material, whether in print or online, is protected by copyright. Course materials, in part or in their entirety, may not be copied, distributed or published in any form, printed, electronic or otherwise. 

As an exception, students enrolled in the course are permitted to make electronic or print copies of all downloadable files for personal and classroom use only, provided that no alterations to the documents are made and that the copyright statement is maintained in all copies. 

Lecture recordings are explicitly excluded from download and creating copies of these recordings by students and other users is strictly prohibited.

Course Website

The Basic Principles of Medicine One (BPM1) course offers a website through Sakai, our learning management system. This site is used for COMMUNICATION (including Announcements, Calendar and Discussion Forums), COURSE TOOLS (including Syllabus, Resources, Tests & Quizzes, Gradebook, a web link to the student resources of the Required Books, and a link to Lecture Recordings).

To login, go to myCampus Secure Login (Carenage), type in your user ID and password, and click on MyCourses. 

Electronic Resources

Distribution of course material including lecture notes will be in electronic format via the

Learning Management System Sakai. Links to external websites are included, where appropriate. In accordance with Committee for Technology based Teaching and Learning (CTTL) recommendation, students are provided with unlocked PDF files, which may be annotated for personal use. This format facilitates active learning, as it allows highlighting and annotations, using a variety of platforms, operating systems and annotation software. Copyright restrictions regarding the duplication of materials apply (see copyright statement above).

Resources folder contains multiple subfolders in which you will be able to find the course material provided.

Required Textbooks

Biochemistry and Genetics:

• Lippincott’s Illustrated Reviews Biochemistry  Harvey and Ferrier; 7^th edition  
• Human Genetics and Genomics 4^th ed Korf and Irons

Anatomy:  

• Gray’s Anatomy for Students 3^rd ed.  Richard Drake, Wayne Vogl, and Adam Mitchell
• The Developing Human - Clinically Oriented Embryology 10th Edition Keith L. Moore, T. V. N. Persaud and Mark Torchia 
• Gray’s Anatomy Review Book 2^nd ed.  Marios Loukas, Gene Colborn, Peter Abrahams, Stephen Carmichael
• Atlas of Human Anatomy 7^th Ed.  Frank H. Netter 
•  McMinn's Clinical Atlas of Human Anatomy 7^th ed. Peter H. Abrahams, Jonathan D. Spratt, Marios Loukas, Albert Van Schoor
•  Clinical Photographic Dissector of the Human Body  Marios Loukas, Brion Benninger, Shane Tubbs
• Essential Ultrasound Anatomy Marios Loukas and Danny Burns

Physiology:

• Medical Physiology: Principles for Clinical Medicine; 5^th ed Rhoades and Bell  

Histology:

• Histology: A Text and Atlas 7^th Ed Wojciech Pawlina  
• Cell and Molecular Biology Nalini Chandar/Susan Viselli
• Lippincott's Illustrated Q&A Review of Histology 1st Ed Guiyun Zhang & Bruce A. Fenderson

Pharmacology:

• Basic and Clinical Pharmacology BJ Katzung and A J Trevor, 13^th Ed

Optional additional resources:

List of all online medical textbooks available through SGU library:

https://mycampus.sgu.edu/group/library/ebooks

Free online access for SGU students (requires log-in with SGU credentials) AccessMedicine: https://accessmedicine.mhmedical.com.periodicals.sgu.edu/

Searchable medical textbooks

Required Medical Equipment

A Physical Diagnosis (PD) Kit, which is included in the official list of required material for all Terms and was issued to you during the Term 1 registration and orientation process, is essential  for all courses. The PD Kit contents will not all be used from term 1 and it is the responsibility of the student to maintain the kit and its contents throughout their time in Medical School.  The kit includes a combined ophthalmoscope/otoscope set (with reusable otoscope  specula), reflex hammer, set of tuning forks (512 Hz, 256 Hz), penlight (batteries not included), pocket eye chart, tape measure, stethoscope, and sphygmomanometer with two cuffs (1 adult,  1 pediatric). A packet containing disposable items; cotton tipped applicators, tongue depressors and tourniquets are also included. 

Please ensure that you check the contents of the PD Kit on receipt and report any missing items to the course email SOMBPM1@sgu.edu by the end of the 1^st week of term 1 (24 January 2020). Any report of missing items after this date will be treated as lost and will not be issued. 

Faulty items must be reported to Mr Marieo Castle MCastle@sgu.edu within 24hrs of the first small group which require its use. All correspondence regarding faulty equipment must be cc’d to the course email SOMBPM1@sgu.edu. 

Please note that you will need the PD Kit for the Small Group Practical Sessions to perform practical clinical skills in class and for continued practice outside class to prepare you for practical clinical examinations, including Objective Structured Practical Examination (OSPE) in Terms 1 and 2 as well as for exams in Terms 4 and 5. It is your responsibility to ensure that the PD Kit remains fully stocked and that broken and lost items are replaced before the OSPE exam and each new term. Disposable items are issued once only, replacement items may be purchased from the SGU bookstore.

Required Electronic Equipment

Laptop

Students need a personal laptop as specified by SGU Examination Services. It is the responsibility of each student to ensure his/her laptop is in full working condition, as specified by Examination Services, and always keep it up to date and equipped for the SGU wireless network. For those students in ITI an ethernet cable and USB ethernet dongle will be required. In ITI venues no WiFi streaming of content is allowed and all students must be equipped to have wired access to the internet. Ethernet cables and wireless dongles are available for purchase from the University bookstore.

Clicker 

An Audience Response System (clicker) is used to assess student participation and performance in instructional sessions. Its use reflects the participation and performance of the student to whom the device is registered. Misrepresentation of participation and/or performance through the misuse of clickers constitutes academic dishonesty and may result in course penalites and/or referral to the judicial office and dismissal of any student committing such a violation of the Student Code of Conduct. 

Throughout the term, a student may use only a single clicker, which has been registered to their name. Clicker devices are not to be shared with any another student, temporarily re-registered under a different name, or used on behalf of any other student. Each student is responsible for the registration of their individual clicker and responsible for keeping it in full working condition at all times during the course. 

If there is any problem with the clicker report to the course e-mail (SOMBPM1@sgu.edu) on the day the problem occurs and take adequate steps to resolve the issue immediately, e.g. battery replacement, or repair or replacement of device. A new device or batteries can be obtained at the bookstore. Clicker functioning can be checked at the Charter Hall print room.

Students are required to bring their clicker to every scheduled teaching session and it is the students’ responsibility to ensure that their clickers are registered and in working order.

COMPONENTS OF THE COURSE

Lectures

Lectures are an essential component of the BPM1 course. They are designed to provide students  with an outline of what they are expected to know, to prioritize important aspects of course  content, to clarify complex material, and to make relevant connections to clinical contexts. Most  lecturers will focus more on difficult concepts than on self-explanatory facts. 

The posted lecture slides may not be comprehensive and do not replace the need to read  textbooks. It is an important learning exercise for students to read textbooks and glean important  information related to course objectives. Lecture slides are not intended to be used in isolation,  but rather as a complement to the lecturer’s narrative.

Each lecture contains formative assessments (clicker questions), all questions should be answered to earn participation credit for lectures. 

Directed Learning Activities 

DLAs are exercises developed by Faculty to support, complement, and/or supplement the learning of the class and are available through the course management site in different formats, including PDF handouts, Panopto videos, Research papers etc. These DLAs are mandatory and the content of the DLA’s is testable material. The sequence in which the exercises should be completed is important as it coordinates with the lecture(s) they are supporting. The DLAs and the timeline will be available via the course management site and can be viewed at any time.

Small Group (SG) Practical Sessions

Overall Description:

Small Group Practical Sessions (SGs) are an essential component of the course, organized in a dedicated small group facility, and supervised by a Facilitator. The key of these sessions is team work, active professional interaction and critical thinking. The success of these sessions largely depends on all members of the team coming prepared and actively participating in the discussion.  Facilitators shall neither lecture nor provide all the information to be gathered by the students. They monitor, guide, emphasize and correct the facts being discussed. At the end of the session, all students are responsible to have completed all the learning objectives listed for that session. If a group is not able to finish all learning objectives in allotted time, students have the individual responsibility for learning them. If a group finishes all learning objectives before the allotted time has ended, the students must reinforce the learned concepts by inviting interactions with Facilitators, peers and subject experts.   

Overall Objectives:

In addition to the academic objectives which will be outlined in for each small group, students should demonstrate the following qualities:

1. Be present and participat in the small group well prepared 
2. Actively engage in discussion
3. Ability to communicate with a diverse array of peer
4. Ability to express varying views in a professional manner
5. Ability to resolve disagreements in a professional manner

Small Group Formation

The class will be divided into 4 cohorts: A, B, C and D that are assigned based on colleges at the beginning of the term. Each cohort will then be further subdivided into  groups of 7-8 students.  

SG Requirements

• PD kits 
• Textbooks and Atlases for the topic being covered
• Dress Code (see section C)

Small Group Regulations 

1. Arrive on-time for all small groups. Late arrivals are considered unprofessional and subject to disciplinary action.
2. Students must present a cordial and professional attitude during these sessions and make an effort to communicate positively with their peers and clinical facilitator.
3. Students MUST wear their SGU Photo ID at all times. It should be worn in such a way that it is clearly visible to the faculty at the table. 
4. The learning resources, such as monitors, laptops etc., are expensive and limited in number. Any attempts to pilfer or damage these will result in disciplinary action. 
5. The furniture and equipment must not be rearranged at any time. 
6. Food and drinks are not permitted in the small group venues at any time (that includes chewing gum and drinking water).
7. Use of cell phones is forbidden.

Small Group Evaluation

At the end of every small group session, students are expected to evaluate the SG experience. The evaluation will be either paper-based or available on the course management site and should be completed at the end of the small group session. Students will assess the facilitator’s professionalism, knowledge, facilitation and communication skills by scanning the QR code associated with the facilitator’s name card. Similarly, the assigned facilitator will assess each student on the following:

1. Preparation and Participation
2. Task Performance
3. Respect for peers and facilitators
4. Communication skills 
5. Punctuality 

Any deficiencies will be discussed with the student and will be recorded, continual violations will be reported to the course director and the office if the dean of basic sciences.

Categories of Small Groups

• SG (Case Based Discussion)

The goal of case based small groups is to prepare students for clinical practice through the use of authentic clinical cases. They link theory to practice through the application of knowledge to the cases using enquiry-based learning methods. 

• SG (Standardized Patient Encounters)

These are guided team-based sessions on approaching a patient with a system-based complaint. The sessions are intended to be student driven and use clinical vignettes as a means of problem solving as well as aligning knowledge from the basic science with clinical reasoning.  Students may be expected to obtain an adequate focused history, performing a focused physical examination, formulating the differential diagnosis and medical documentation (SOAP Note).  Students may be required to discuss diagnostic modalities, management and complications whenever necessary.

• SG (Presentation)

Presentations are designed to augment the topics covered in lecture. Students should prepare for these using the lecture notes and/or text books. Students may be given unsupervised time to discuss with their peers any concerns with the presentation. Using the presentation-based approach, students will complete a task (PowerPoint presentation, scientific article, image presentation, etc.).  After completing the task, they will present their findings to the rest of the small group. There will be a chance after the presentations to challenge and expand on their understanding of the topic by having others ask questions under the direction of a Facilitator. This will provide an opportunity to practice presentations skills, the newly learned vocabulary, and fortified learned knowledge.

• SG (Models)

These small group sessions employ anatomically-realistic models, anatomical atlases and/or interactive MRI software to familiarize students with key anatomical structures and their 3D relationships. Sessions are guided by a Facilitator and students are expected to localize structures, compare them across the different media and present to group members.  

• SG (Hybrid)

These small group sessions combine the standardized patient (SP) with a human body part (manikins) to simulate clinical scenarios with the purpose of active learning. Students can practice communication and physical examination skills in a safe learning environment while building their self-confidence allowing an easier and more successful transition to clinical clerkships. 

• SG (Health Promotion, Wellness, and Professionalism Sessions (HPWPs)) 

HPWPs are a series of activities held each term that are focused on aspects of health promotion, wellness, and professional identity formation. These sessions are held in a small-group setting and involve a combination of educational approaches including didactic instruction, case discussion, and/or experiential learning. Consistent with other elements of the course, participation in HPWPs is mandatory. 

Cadaver Laboratory (LAB) Sessions

Cadaver laboratory sessions (LAB) are an essential component of the BPM1 course held in the Anatomy Cadaver Lab. During this 2-hour activity, groups of 4-5 students rotate through 5 - 6 stations which may contain prosected specimens, plastinated specimens, bones, anatomical models and imaging (X-Ray, CT Scan, MRI etc.). At each station there may also be discussion of the application of the anatomical knowledge to clinical concepts. The time for each station is approximately 15 minutes. Faculty is available to assist students who may require explanation or who have difficulty identifying structures. 

Preparation: 

To effectively contribute to their lab team, students are expected to come to labs prepared. The material needed for preparation for the lab including the objectives and images will be available in the weekly Resource folder on Sakai. All structures to be identified are listed and described in the Clinical Photographic Dissector of the Human Body. A lab checklist is provided at the end of each chapter and should be used for every lab. Students must be present for the scheduled session to which they are assigned without exception.

LAB Requirements:

• Clinical Photographic Dissector of the Human Body 
• Dress Code (see section B)

LAB Regulations:

• Students must always wear their SGU Photo ID and place it in such a way that it is clearly visible by faculty. 
• The laboratory learning resources such as plastic models, plastinated specimens, and cadaveric materials are expensive and limited in number. Students should take special care when they handle them. 
• Food and drinks are not permitted in the lab at any time (that includes chewing gum and drinking water). 
• Taking pictures is not allowed in the lab at any time. 
• Use of cell phones is restricted. If at all necessary, in the lab, students should use the vibration mode and not answer the phone while in the lab.
• Always Respect the cadaveric material. 
• Students must wear gloves when touching specimens in the wet lab. Students are expected to supply their own gloves. 
• For any lost items in the wet lab please ask the assistance any of the dieners (laboratory technicians).

LAB Open Hours:

The cadaver lab open hours allow for individual or group study with the cadaver specimens. A specific schedule for the open hours will be posted on Sakai. Visiting professors and upper term demonstrators may be present during the open hours depending on availability.

LAB Examination Policies

Lab dress code (full scrubs and closed toed shoes) is required. Students improperly dressed will not be allowed to write the exam. The only items that students can bring to the sequestration and exam venues are: Student ID, Pencil and Eraser, Clicker.  

All other items are strictly prohibited. Students in possession of any prohibited items will be in violation of the examination policies and professional conduct. The items will be confiscated, and students will lose course points beginning with professionalism points. Students should not bring or should arrange to store all personal belongings, e.g. phones, wallets, cigarette cartons etc. in a locker prior to arrival at the venue. 

Simulation Laboratory (SIMLAB) Sessions

Simulation Laboratory (SIMLAB) Sessions are an essential component of the BPM1 course offered in the CPR module. The mannequin-based simulators provide realistic hospital environments to help students practice basic examination skills and integrate the basic sciences with clinical medicine. Students will use mannequin simulators to enhance their skills of cardiovascular and respiratory examination and physical diagnosis. The simulators are programmable human models that demonstrate the apex beat, heart sounds, arrhythmias, murmurs, carotid pulses, vital signs, breath and adventitious sounds. They can also be used to simulate clinical scenarios with the use of laboratory findings and investigations.  

SIMLAB Requirements

• Current Basic Life-Support (BLS) certification
• PD kits - especially stethoscope
• Dress Code (see section C)

SIMLAB Regulations

• Students must always wear their SGU Photo ID and place it in such a way that it is clearly visible by faculty.
• No cell phones allowed in SIMLAB; turn off and place in your carry bag (interferes with electronics in the SIMLAB)
• No cameras of any kind.
• No pens or markers are allowed in the SIMLAB. Pencils will be provided for everyone.

(Pen ink marks manikins FOREVER).

• No liquids allowed in SIMLAB.
• All bags and papers must be left in designated area inside the SIMLAB entrance on the shelves.

Each simulation laboratory contains a formative assessment in the form of an online pretest and/or posttest.

Ultrasound Sessions

These are 1 hours sessions where students are taught the basics of ultrasound techniques.  Clinical facilitators will first demonstrate the techniques on the standardized patient, followed by the students practicing the techniques themselves on the standardized patient. This dynamic imaging modality allows students to review the relevant anatomy of different body systems with focus on the musculoskeletal and cardiovascular systems.

Interactive Multiple-Choice Question (IMCQ) Sessions  

Interactive multiple-choice question (IMCQ) sessions aim to enhance a student’s test-taking skills and increase their exposure to USMLE style multiple choice single best answer questions, which is the standard style for all electronic examinations at St George’s University School of Medicine. These sessions will improve students’ approach to answering MCQs and emphasize the link between questions and course objectives. As a learning tool, IMCQs provide students with valuable formative feedback enabling them to modify their approach to learning course content, and to identify weaknesses that require remediation. 

During the presentation of the question, students are given a discretionary period of 1 to 1.5 minutes to answer the question. Peer discussion is allowed.  The last answer recorded for a question is used in performance calculations. After the single presentation of the question faculty will debrief the question. Active participation is expected and all questions must have a recorded response.  Group discussion with classmates helps to promote improvement in critical clinical thinking and reasoning. Questions used during IMCQ sessions will be posted on the course Sakai after delivery.

To earn the participation point for each IMCQ session, students MUST correctly answer at least 50% of the questions and respond to all questions. Suboptimal participation may result in a loss of session points or a professionalism penalty being applied.

Directed Self Study / Group Study

Apart from studying independently, students are encouraged to form their own study groups of 3 to 5 active members. These groups should meet about 1 to 2 times a week to discuss difficult course concepts. Active participation in these small group discussions is essential to students’ successful understanding, application, and mastery of course material. 

Activities on Course Management Site: 

Weekly ExamSoft (ESoft) Practice Quizzes

Practice quizzes delivered via ExamSoft will be provided every week, the first quiz consist of 20 questions with a limit of 30min. From quiz 2 onward each will be comprised of 25 questions within a 35-minute time window. 20 questions will be on material covered during the week and 5 questions will be from a previous module or material delivered prior to the last exam. Students earn 1 point for each of the practice quizzes up to a maximum of 12 points. A minimum number of correct answers is NOT required. Students will earn the point for uploading a completed quiz irrespective of the number of correct answers. Detailed feedback for each question will be provided at the closing time of each quiz.  ESoft Quizzes are announced on Sakai each week. The quizzes will be open from Sunday morning till Monday evening and are meant as a way for students to check how well they know the material studied previously. 

Practice questions on Sakai 

Additional practice questions will be provided for each week  through Sakai. No points are awarded for these questions. 

Course Assessments

Course assessments may be summative (a high-stakes assessment that counts towards points in the gradebook), formative (a low stakes assessment that provides valuable feedback to students to optimize their learning strategies), or both.  

Summative Assessment Points

The total assessment points that can be earned in the course are listed in the table below:

* These activities must be completed to fulfill requirements for the course. A valid medical excuse is required for students to be given a completion exam.  All completion exams will be offered at the end of the term.

Objective Structured Practical Examination

There will be an Objective Structured Practical Examination which will involve timed stations through which students will rotate. This will assess the professional and physical examination skills that are taught during the BPM 1 course.  

STUDENT SUPPORT

Discussion Forum

The major platform for all content related questions is the Discussion Forum on the course website. Students are encouraged to post their questions on the Discussion Forum and to respond to questions posted by others.

Students are expected to make use of the Discussion Forum rather than emailing questions to individual faculty. Many students have the same questions; therefore, posting on the Discussion Forum allows all students benefit from the posted questions and their timely responses. Course faculty will regularly monitor the Discussion Forum and participate, whenever appropriate.

 When posting questions on the discussion forum, you must tag each post with the lecture number, the small group, IMCQ or ExamSoft quiz that the question is referring to. This will ensure that the relevant faculty members will be available to answer your questions.

Students should only use professional language. Discussions should remain relevant to course material. Use of derogatory remarks or inappropriate language is not allowed. All posts must also be accompanied with the full name of the person posting it. Failure to do so will result in deletion of the post. Anonymous messages are considered unprofessional behavior and a violation of the student honor code. 

Office Hours

Office hours will be provided by all teaching faculty as open office hours (walk in) or by appointment. The available hours (open or appointments) for the different faculty members will be posted weekly on Sakai. Students may also contact individual faculty for appointments at any time during the course.  

ACADEMIC, LEARNING & PSYCHOLOGICAL SUPPORT  

We would like to remind you of the opportunities available at SGU if you experience academic difficulties or wellness and/or mental health concerns. 

Academic Advising, Development and Support (AADS) 

The goal of the Academic Advising, Development and Support Division is to ensure that each student optimizes their path through Basic Sciences by taking full advantage of the resources available at St George’s University. 

Academic advisors are available for all SOM students who wish to receive academic advice during their time in Basic Sciences. Full time academic advisors are available by appointment or during open hours (9 am – 4 pm daily). To schedule an appointment please send an email (academicadvisingSOM@sgu.edu), give us a call (444 4175 ext.3027 or 3494) or visit our office (Lower David Brown Hall, below the Food Court).  

Department of Educational Services (DES) 

DES is your one-stop for improving your academic performance and adapting your learning strategies. You can schedule one-to-one individual appointments with a learning strategist, MCQ approach appointments with a learning strategist (individually and in small groups of 2-3) or strategic online learning strategy support through MyCoach Med. For more information, check out the DES web site: https://www.sgu.edu/student-support-services/departmenteducational-services/ 

Psychological Services Center (PSC) 

PSC provides psychological counseling services through scheduled and walk-in hours from 9 am to 4:30 pm AST, in addition to 24-hour crisis coverage. The PSC also provides group services for dealing with anxiety, grief and chronic conditions, and for learning Mindfulness Skills. Please see the attached PDF for the PSC November Group offers. For more information, please see the PSC web site: https://mycampus.sgu.edu/web/psc

GOALS AND OBJECTIVES OF THE MD PROGRAM

This Course embraces the mission of the Doctor of Medicine Program of St George’s University School of Medicine:

MISSION

St. George's University School of Medicine provides a diverse, multicultural and international environment that empowers students to learn the medical knowledge, clinical skills and professional behaviors to participate in healthcare delivery to people across the world.  

FOUR YEAR OUTCOME OBJECTIVES

1. MEDICAL KNOWLEDGE 

1. Apply the multidisciplinary body of basic sciences to clinical analysis and problem solving using:
2. The knowledge of normal structure, function, physiology and metabolism at the levels of the whole body, organ systems, cells, organelles and specific biomolecules including embryology, aging, growth and development.
3. The principles of normal homeostasis including molecular and cellular mechanisms.
4. The etiology, pathogenesis, structural and molecular alterations as they relate to the signs, symptoms, laboratory results, imaging investigations and causes of common and important diseases.
5. Incorporate the impact of factors including aging, psychological, cultural, environmental, genetic, nutritional, social, economic, religious and developmental on health and disease of patients, as well as their impact on families and caregivers.
6. Utilize the important pharmacological and non-pharmacological therapies available for the prevention and treatment of disease based on cellular and molecular mechanisms of action and clinical effects. Identify and explain factors that govern therapeutic interventions such as clinical and legal risks, benefits, cost assessments, age and gender.
7. Apply the theories and principles that govern ethical decision-making in the management of patients.
8. Evaluate and apply clinical and translational research to the care of patient populations.

 2. CLINICAL SKILLS

1. Communicate effectively with patients, their families and members of the     health care team.
2. Obtain a comprehensive and/or focused medical history on patients of all categories.
3. Perform physical and mental status examinations on patients of all categories appropriate to the patient’s condition.
4. Document pertinent patient health information in a concise, complete and responsible way.
5. Select appropriate investigations and interpret the results for common and important diseases and conditions.
6. Recognize and communicate common and important abnormal clinical findings.
7. Develop a problem list and differential diagnosis based on the history, physical findings and initial investigations.
8. Apply effective problem-solving strategies to patient care.
9. Perform routine and basic medical procedures.
10. Provide patient education for all ages regarding health problems and health maintenance.
11. Identify individuals at risk for disease and select appropriate preventive measures.
12. Recognize life threatening emergencies and initiate appropriate primary intervention.
13. Outline the management plan for patients under the following categories of care: preventive, acute, chronic, emergency, end of life, continuing and rehabilitative.
14. Continually reevaluate management plans based on the progress of the patient’s condition and appraisal of current scientific evidence and medical information.

3. PROFESSIONAL BEHAVIOR

1. Establish rapport and exhibit compassion for patients and families and respect their privacy, dignity and confidentiality.
2. Demonstrate honesty, respect and integrity in interacting with patients and their families, colleagues, faculty and other members of the health care team.
3. Be responsible in tasks dealing with patient care, faculty and colleagues including health-care documentation.
4. Demonstrate sensitivity to issues related to culture, race, age, gender, religion, sexual orientation and disability in the delivery of health care.
5. Demonstrate a commitment to high professional and ethical standards.
6. React appropriately to difficult situations involving conflicts, non-adherence and ethical dilemmas.   
7. Demonstrate a commitment to independent and lifelong learning, including evaluating research in healthcare.
8. Demonstrate the willingness to be an effective team member and team leader in the delivery of health care.
9. Recognize one’s own limitations in knowledge, skills and attitudes and the need for asking for additional consultation.
10. Participate in activities to improve the quality of medical education, including evaluations of courses and clerkships.

EXPECTATIONS

1. Participate in all scheduled classes on time
2. Actively participate appropriately in all class activities and be present for the duration of the entire activity 
3. Bring a fully functional personal “clicker” to all learning activities and respond to all “clicker” polls
4. Complete all assessments and examinations on the course at the scheduled dates and times 
5. Adhere to the dress-code for Laboratory/SimLab, Small Group Discussions, Patient Encounters, and Hospital/Clinic Visits. 
6. Check SGU email daily; this is the only official email account that is used to relay messages between University and students 
7. Check course management site daily for announcements and updates
8. Check posted results of assessments on time
9. Check participation data on the course management site regularly (once a week) and alert the course director immediately to any discrepancies
10. Report illness through the medical self-report system on myCampus Secure Login(Carenage) of the SGU website
11. Voice commendations and concerns through SGA class representatives
12. Use support services available; faculty consultation hours, designated Academic Advisors, Dean of Students Office, Department of Education Services, Psychological Services Center.

13. Participate in the course and instructor evaluations
14. Comply with all requirements outlined in the course syllabus
15. Abide by the University Code of Conduct outlined in the student manual
16. Carry your student ID card at all times on campus

COMMUNICATION REQUIREMENTS

Students are responsible for ensuring that the School of Medicine is able to contact them at all times. They should notify the Registrar of any change in contact information as soon as possible.

Students must monitor and respond to all university communications during their entire matriculation at the University; this includes during the academic terms, clinical rotations, while at affiliated hospitals, while on vacation or a leave of absence, during clinical bridge time, or while awaiting graduation.

Failure to monitor communications, respond to communications, or to act on information contained in communications from the School including failure to participate in mandatory meetings as specified by DOS, DOBS, Academic Advising, Developing and Support Division, or any other administrative body or individual, is considered unprofessional behavior. Such unprofessional behavior may have adverse effects on performance and grades and may lead to a recommendation of dismissal from the University.

STUDENT COMPORTMENT AND PROFESSIONAL COMMITMENT

Professional Commitment

Civil and professional behavior toward all University personnel and fellow students is expected at all times.

When students enter the School of Medicine, they take an academic oath reciting the following professional commitment at the White Coat Ceremony:

“Today is the beginning of my medical education as a physician. I acknowledge my responsibility to continue the pursuit of knowledge and understanding until that day when I will cease to be a practicing physician.

I am entering training for a noble profession in which my interest must always be subservient to those who may seek my assistance. I must be ever conscious of the value   of my fellow health professionals and treat them with respect at all times. My classmates at St. George’s University are now my colleagues, and I owe to them the same support   and encouragement to achieve their goals as I hope to receive from them. I will work alongside my colleagues and professors with tolerance, compassion, and honesty.

I acknowledge my obligation to adhere to the University Honor Code, and to conduct myself with integrity and in an ethical manner at all times henceforth. I shall do all within my power to show in myself an example of all that is honorable and good throughout my medical career. It is a privilege to have been given the opportunity to become a physician. May I be ever conscious of that privilege and never abuse it.”

PROFESSIONALISM

The Four-Year Outcome Objectives emphasize the importance of knowing and developing the professional attitudes and behaviors expected of medical professionals. Professional comportment of students is essential as students develop into medical professionals. Students are expected to adhere to professionalism expectations as specified by the School of Medicine policies and their course Syllabus. Failure to adhere to expectations of professionalism may result in mandatory advising and remediation, loss of professionalism points, failure of course components, or disciplinary action by the Dean.

DRESS CODE (LAB AND SIMLAB)

Full professional scrubs (tops and bottoms) are required for all labs. They must be clean, odorfree, and not overly worn. Tops and bottoms must match in color, style, and fit. Avoid bright, neon, or heavily patterned scrubs. All footwear must be closed-toe and have an enclosed heel or heel strap. Clogs and slides with completely open heels are not permitted (as per safety requirements in clinical settings). Tennis shoes are an appropriate example. This dress code will also apply for any small group practical session (SG) where students will be interacting with Standardized Patients (SP) (see below).

COURSE PARTICIPATION POLICY

Students are expected to participate fully and for the duration of all required activities of the MD program and should be present from the start to the end date of each term. Students should consult the official academic calendar for the published start and end dates for each term prior to making travel arrangements. Travel conflicts are not valid reasons for missing required course activities. (See https://mycampus.sgu.edu/group/oep-registrar/academic-calendars). In case of examination delays travel should not be planned on examination days.

The faculty considers participation to be an essential component of professionalism. Students must participate in all required educational activities as defined by Course and Clerkship directors. Such academic activities include (but are not limited to) lectures, labs, small group discussion, directed learning activities, examinations, and continuous quality improvement. Course Directors take participation into account when determining grades. Non-participation may adversely affect grades and may result in a failing grade. Makeups will not be offered for any missed activities. Students should consult their course Syllabi for additional information related to course participation.

RULES OF CLICKER USAGE

Each student has a registered clicker and is responsible for the activity of that clicker registered through the audience response system. Appropriate use of clickers during class is expected. Students should only use the clicker registered in their name and should be aware of their clicker status (location, functionality) in all learning activities, as its use in class indicates the presence of the student registered to the clicker. To earn participation credit, students must participate in their assigned class activities (assigned by College, cohort or any other means outlined in the syllabus or course management site) and will only earn credit for participation in their assigned activities. Misrepresentation of participation records is a violation of the honor code and students may face academic penalties for attempting to misrepresent their participation record for their assigned learning activities. 

Attempting to earn participation credit for an activity by partial participation, or for which the student has not participated in, will result in referral to the Dean of Basic Sciences Office for disciplinary action and students may be subject to academic penalties and further disciplinary consequences. 

Any student using more than one clicker, or using another person’s assigned clicker, will be referred to the Dean of Basic Sciences office for disciplinary action and may have the academic penalties applied that have been outlined in the course syllabus.

Random clicker checks will be carried out during the term. After the last clicker assessment, a sign-out system will be used to verify student presence and compare it with the participation records from the audience response system. Anyone who is registered as participating through the audience response system, but who is not present for sign-out, will be referred to the Dean of Basic Sciences Office for consideration of the reasons, and possible disciplinary action. 

Any student leaving a learning activity early, e.g. prior to the full debrief after the last clicker assessment of the lecture, will not be considered as fully participating. Although students are expected to make every effort to participate in all required academic activities, they must participate in at least 80% of required course activities to earn participation credit for the course. Any student trying to claim credit for participation, by clicking in on the first and last clicker assessment, but who has left prior to sign-out during checks is in violation and will be flagged during a clicker check. Any student who has clicked in during a clicker check but is not present and signed out, irrespective of the reason for the absence, is in violation and will be flagged during a clicker check.

It is the responsibility of every student to have a registered clicker, to ensure that the student knows where it is and that it is in working order and functional during course activities, and to check the course gradebook weekly to detect any problems with his or her participation records. Failure to do so may result in the loss of participation credit or flagging of the student during clicker checks, for which the student will be held responsible. 

Those students flagged during random clicker checks will receive an e-mail inviting them to explain, in writing and in person, the reasons for the discrepancy between the audience response system and the sign-out data. They will be referred to the Dean of Basic Sciences office for determination of the appropriate academic penalty. They may then be further referred to the Judiciary Office for potential disciplinary action.

DEAN OF BASIC SCIENCES PANEL

The Panel Hearings will be conducted by the Office of the Dean of Basic Sciences. An Associate/Assistant Dean of Basic Sciences, not involved directly in student support, will Chair the meeting, and the membership of the panel will be comprised of at least 2 other faculty of the School of Medicine as appointed by the Dean of Basic Sciences. The faculty serving on the panel will be MD faculty of the SOM that are not involved in student advising and that have experience with the standards for promotion and progression outlined in the student manual. 

A quorum for the committee is 3, decisions are reached by simply majority in which the Chair has a casting vote in the event of a tie. The committee may refer the student to an appropriate support service, or when appropriate,  and as outlined in the course syllabus, recommend application of the appropriate academic penalty published in the course syllabus. The panel may reduce the penalty applied but cannot exceed that published in the syllabus. The recommendation of the Panel is passed to the Dean of Basic Sciences for action and communication to the student by the Dean of Basic Sciences Office.

DEAN OF BASIC SCIENCES EXAMINATION IRREGULARITIES PANEL

The Dean of Basic Sciences Examination Irregularities Panel (DOBS-EIP) is a panel that hears the appeal of students who miss an examination without a validated excuse (e.g., due to arriving too late to be admitted for an examination). 

Based on current School of Medicine policy, the student will be given an Incomplete (I) score for the missed examination, and an academic penalty will be imposed. The DOBS-EIP gives the student the opportunity to explain the extenuating circumstances that resulted in their incomplete grade. The panel recommends to the Dean of Basic Sciences the extent to which the penalty of up to 10% of the total course points is imposed. The student is then expected to take the Completion Examination for the missed exam as scheduled (see Completion Examinations section). Failure to take the Completion Examination as scheduled will result in a failure to complete all course requirements. As a result, the student will earn an F grade for the course.

DOBS-EIP 

The DOBS-EIP comprises at least two Assistant Deans of Basic Sciences, one of whom acts as Chair. Each hearing lasts 30 minutes. Protocol for Arranging a DOBS-EIP Hearing

A student should:

1. Meet with one of the deans in the Dean of Students Office (DOS);
2. Provide sufficient explanation and information to the DOS dean to complete the official request form for a DOBS-EIP hearing. DOS will then forward the form to the Dean of Basic Sciences office for review;
3. Meet with the DOBS-EIP at the scheduled date, time, and venue as arranged by email by the DOBS office;
4. Be prepared to explain the circumstances of the missed examination and provide any supporting documentation, if relevant.

Outcome of DOBS-EIP Hearing

After the hearing, the DOBS-EIP will make a recommendation to the Dean of Basic Sciences regarding the extent to which the up to 10% penalty for a missed exam is applied.

1. Once the penalty has been determined, the student will be allowed to take the scheduled completion examination in order to rectify the “I” score for the exam. The determined penalty of up to 10% (per violation) of the maximum total course points will be applied to the overall course grade. The Completion examination will be held at the date and time as shown in the official Registrar’s schedule. The student has the right to appeal the decision directly with the Dean of Basic Sciences.
2. If the student does not take the Completion Exam as scheduled in order to resolve the “I” grade, an F grade will be recorded as the final course grade. If the student is still eligible to continue his/her studies based on promotion standards, the student would need to repeat the failed course. If the student is recommended for dismissal as a result of the F grade, the student has the opportunity to appeal as per instruction provided.

MEDICAL EXCUSES

Students who have missed a written examination or the physical examination skills assessment with a valid medical excuse will receive an approved Incomplete (“I”) and will be offered a completion exam. Medical excuses must be submitted electronically through the SGU Carenage portal.

COMPLETION EXAMS 

Students who receive an approved Incomplete (“I”) for an exam must take a Completion Examination as per the master SOM schedule (published on the OEP/Registrar site (https://mycampus.sgu.edu/group/oep-registrar/welcome). Regardless of which examination is missed, all completion examinations are held approximately one week after the end of the semester. Failure to take scheduled examinations results in an examination score of zero (“0”).

ABSENCES FROM COURSE ACTIVITIES (NON-EXAM ASSOCIATED POINTS)

Except for examinations, there will be no-excused absences from scheduled course activities and no make-up sessions for missed points associated with missing scheduled course activities. 

UNPROFESSIONAL BEHAVIOUR

Consequences of Unprofessional Behavior

While the School of Medicine realizes that the vast majority of students adhere to the student honor code and understand their obligations as medical students, there are occasional cases of unprofessionalism, necessitating the following rubric for consequences of unprofessional behavior:

 *Additional Notes

1. All cases of unprofessional behavior will be reported to DOBS for tracking and monitoring purposes. 
2. As students progress through the curriculum, SGU expects students to develop their professional identity. Thus, when determining the precise consequence of unprofessional behavior, the semester the student is in and evidence of prior unprofessional behavior may be taken into consideration with an increasing percentage of maximum course point deductions (up to the maximums listed). Course Directors will consult with Dean of Basic Sciences office when determining consequences.
3. Students who engage in unprofessional behavior may be required to meet with a Professionalism Advisor, participate in seminars, and complete stipulated assignments.
4. Unprofessional behavior may be reported by administration on the student's Medical Student Performance Evaluation (MSPE). 
5. The examples of unprofessional behavior listed in the table are not exhaustive.  Other behaviors deemed as unprofessional may be penalized using the rubric most consistent with the unprofessional behavior in question.
6. Point deductions for unprofessional behavior will show in the Sakai Gradebook under the category of “Unprofessional Behavior” with an item titled “Penalty”. A negative sign followed by the number of points deducted will be reflected.
7. Students have the right to request a hearing through the Dean of Basic Sciences office if they believe they have been unjustly penalized.
8. Points deductions are per incident and may be additive per incident.

BASIC SCIENCES EXAMINATIONS

Exams are an integral part of the MD program, and students are expected to comply with examination policies (see Examination Policies) Students are expected to adhere to the master schedule (published on the OEP/Registrar site at https://mycampus.sgu.edu/group/oepregistrar/academic-class-schedules), which provides examination dates and times.

The following are considered mandatory Assessments/Examinations:  

1. Module Examinations
2. Midterm Examinations
3. Final Examinations
4. Lab Practical Examinations
5. Objective Structured Clinical Examinations (OSCEs), 
6. Objective Structured Practical Examinations (OSPEs), 
7. Basic Sciences Comprehensive Examination 1 (BSCE 1)
8. Basic Sciences Comprehensive Examination 2 (BSCE 2)
9. Comprehensive Basic Sciences Examination (CBSE)
10. Completion Examinations for any missed first offering of an examination
11. Physical Examination Assessments
12. SOAP Assessments
13. Other assessments may be detailed in the course specific part of the syllabus

Several of these examinations are comprehensive examinations and are described in further detail in the next section.  

EXAMINATION POLICIES

Students must complete all course examinations in order to meet course requirements and earn a final course grade. If a student completes only part of an examination (e.g., Part 1 but not Part 2 of a two-part examination), then the completed part of the examination is invalidated, no score exists, and the examination as a whole is considered missed.

Students are expected to take all regular and Completion examinations as scheduled (see master School of Medicine schedule published on the OEP/Registrar site (https://mycampus.sgu.edu/group/oep-registrar/welcome).

All students are expected to adhere to the Code of Conduct with respect to all Universityadministered examinations. Examination policies apply to all Examinations (See Appendix Electronic Examination Procedures).

IRREGULARITY REPORTING

Any exam irregularities that significantly affect a student’s examination performance must be reported immediately within the examination venue to the chief proctor at the time of the incidence. For issues that cannot be resolved in the venue students should request an irregularity report be completed by the chief proctor in the venue at that time. Students should mail the Course Director immediately after the exam to alert the Course Director of the irregularity report being filed in the venue. Irregularity reports will not be considered after the examination is completed and the student has left the venue or if the outlined process is not followed.

After grades are published by the Course Director no changes will be made based on irregularity reports that are filed inappropriately or late, therefore students should ensure that all irregularities are dealt with appropriately in venue and that the Course Director is alerted to the presence of a filed report immediately after the examination. In this circumstance, the affected grade is sequestered until the irregularity is investigated. 

In the event that the irregularity report is filed appropriately and it is agreed by the Course Director in consultation with Office of Institutional Advancement (OIA) and the Dean of Basic Sciences Office that it may have affected student performance, the affected grade will remain sequestered. A student may be offered a completion examination after investigation of the events. The completion exam, if offered, is scheduled at the end of term at the regularly scheduled date of the completion exams for the course affected.

In exceptional circumstances it may be necessary to delay the start time of an exam or postpone the examination. Students are advised to not make travel arrangements for immediately after an examination to cover this eventuality. 

Approved Absences from Examinations: Religious Observances

A student who wishes to observe a religious holiday on an examination date may take a completion examination on the scheduled date if appropriate protocol is followed for documenting the religious observance. Specifically, at the beginning of each term, the Dean of Students office will invite students via email to register the dates of their religious holidays that conflict with their examination schedule for that term. Students who register these dates after January 31st (Spring semester), or after August 31st (Fall semester) will not receive an excused absence from examinations. This protocol must be followed each term. The protocol does not cover any dates of travel associated with the religious observance beyond the actual religious holiday. All completion examinations are scheduled after the semester ends, as per the official schedule on the OEP/Registrar site (https://mycampus.sgu.edu/group/oep-registrar/academic-class-schedules). 

MEDICAL EXCUSE

In rare instances, medical reasons may prevent a student taking an examination as scheduled. Students are entitled to one Medical Excuse for examinations per 12-month period. The student receives an “I” for the exam grade and is permitted to take the Completion Examination. Students take the Completion Examination after the semester ends, as per the official schedule on the OEP/Registrar site (https://mycampus. 

sgu.edu/group/oep-registrar/academic-class-schedules). Students should consider this completion examination period when scheduling end of term travel. Travel conflicts are not a valid reason for missing an examination; examinations will not be re-scheduled to accommodate student travel.

Students should use their Medical Excuse wisely as no additional excused absences for examinations will be allowed. If a student does not take an examination as scheduled and has already used his/her Medical Excuse in the prior 12-month period, then the student will receive a “0” grade for the examination.

Students with extenuating circumstances for missing an additional examination should seek guidance from the Dean of Basic Science Office. 

PROCEDURE FOR SUBMITTING MEDICAL EXCUSE (ME)

To submit a Medical Excuse, the student uses the “SOM Examinations” link on the Carenage portal at https://cas.sgu.edu/cas/login). This self-report form should be submitted before the end of the scheduled examination time. The Medical Excuse covers all exams within a 7-day period starting from the date of submission of the Medical Excuse. If a student becomes able to take some or all of the examinations during the timeframe covered by the Medical Excuse, he/she may take any remaining examinations. If a student makes a second Medical Excuse request within 12 months, then the student receives a written notice about his/her ineligibility for a second Medical Excuse and is apprised of the consequences of missing the examination(s).

Note: Students may not request a Medical Excuse once they have started an exam. Once a student has started an exam, a score will be submitted and contribute to the student’s grade, irrespective of how much of the exam is completed.  Therefore, students are strongly discouraged from taking an exam if they are unwell.

 PROCESS FOR RESOLUTION OF MISSED EXAMINATIONS

Any student with an approved absence who misses an examination will temporarily receive a zero “0” score for the missed examination and an Incomplete grade for the course. 

Any student who is not approved to miss an examination must appear before a Dean of Basic Sciences panel, who will determine the academic penalty to the students’ course grade for the absence. The student will then receive a zero 0 score for the missed examination and an Incomplete grade for the course. 

To rectify the zero 0 score, the student must sit the scheduled completion exam. Students must take a Completion Examination as per the master School of Medicine schedule (published on the OEP/Registrar site (https://mycampus.sgu.edu/group/oep-registrar/welcome). Regardless of which examination is missed, all Completion Examinations are held approximately one week after the end of the semester.

Students who do not take the scheduled Completion Examination to rectify their zero 0 score and their Incomplete grade will receive a failing grade for the course.

GENERAL RULES FOR ELECTRONIC EXAMINATIONS

The Office of Institutional Advancement is responsible for the administration of all eletcronic examinations for the SGUSOM. Students must bring a computer with the appropriate specifications to examinations. https://mycampus.sgu.edu/group/office-of-institutionaladvancement/examination-services/training-resources

Examinations are governed by the Examination Policies and Procedures of St George’s University and the Electronic Examination Policies and Procedures (Student Manual and below). All students are responsible for knowing and complying with the University’s Code of Conduct.

According to the Student Manual, “students must be above suspicion in all testing situations. When cheating is suspected, it is not the obligation of the University to prove violation of this Code beyond a shadow of a doubt, but rather by a preponderance of the credible evidence submitted.”

In case of a suspicion indicating that the integrity of an examination might have been compromised, the Course Director, in consultation with the faculty and the administration, may nullify the examination and announce a new date for a replacement examination within a period of seven working days after the original.

An examination announcement will be posted on the course website prior to each examination. It will outline the specific policies and procedures governing this examination and will indicate, when the last student will be allowed into the examination venue. After this time, no late-comers will be admitted.  

Students who fail to appear in time for an examination without a validated and approved reason (medical, catastrophic event or emergency), as stipulated by the Student Manual, will receive a grade of zero (“0”) for the examination. 

All electronic examinations are sequestered and are not available subsequently for individual review. To get feedback on their strengths and weaknesses in the electronic examinations, students will receive an Examination Report, available through their ExamSoft account.

SGU Rules and Guidelines for ExamSoft Online Examinations

The following rules and guidelines supplement the University Examination Policies and Procedures of the Student Manual. Each examinee is responsible for reviewing and adhering to these policies.

For all medical and non-medical excuses, please see the Student Manual.

Prior to Exam Day

Each student is required to provide the necessary environment for online testing, including, but not limited to:

1. Personal computer meeting the required hardware and software specifications, including webcam and microphone, outlined in detail on the Examination Services of  the Office of Institutional Advancement (OIA) website.
2. A quiet, private location, where they can take the examination without disturbance, where they can take the examination alone, at a desk, sitting up-right on their chair for the whole duration of the examination.
3. Examinees are required to take the onboarding/practice (mock) examination prior to exam day, to ensure their computer is working properly.
4. Examinees experiencing technical difficulties must contact the online support team TellExaminationServices@sgu.edu immediately for assistance, and prior to exam day.

Exam Download

You are required to download all blocks of an examination during the 24-hour download window indicated by the Couse Director in the Examination Announcement. We strongly advise to start the download procedure early, to be able to get the necessary help in time, and to avoid unnecessary stress. 

1. If you are unable to download all examination blocks (not just the first block), you have to contact the online support team TellExaminationServices@sgu.edu immediately, but no later than 30 minutes prior to the CHECK IN TIME for the first examination block. 2. If you fail to download all blocks and have not notified the online support team TellExaminationServices@sgu.edu, you will automatically get a score of “zero” for the examination.

Exam Day Preparations

Prior to starting the ExamID personal identification process, a student makes sure all the requirements for Online Proctoring are met, including: 

1. The entire face of the examinee must be visible at all times. Hair long enough to cover the eyes and ears must be pulled back. Hats or other headwear are prohibited. 
2. The eyes of the examinee must be visible at all times. Reading glasses with clear lenses are acceptable, but tinted glasses or sunglasses are prohibited. 
3. The examination room must be consistently well-lit, with a plain background, avoiding dark shadows across the examinee’s face.
4. Personal Student ID issued by SGU, ready for display. A government-issued photo ID is the only permitted alternative.
5. Items banned from regular, on-site examinations, are also banned during online examinations. This includes, but is not limited to:
   • Cell phones
   • Other electronic or communication devices
   • Wrist watches
   • Hoodies
   • Scrap paper
   • Food or beverages
   • Water bottles
6. Additional items banned from online examinations are:
   • Headphones, earphones, headsets
   • Earplugs
   • White boards – you will be able to use the “Notes” function within ExamSoft instead

Password Announcement

Passwords will be announced via the online course management system (Sakai) / email notification approximately 15 minutes prior to CHECK IN TIME of each examination block.

If you are not taking this examination because of a medical or any other valid excuse, please ignore the password notification, and do not proceed to the examination. 

Once you START the first block of an examination, you confirm that you are an active student in the course (not on LOA, not on CR) and that you are medically fit to take the examination.

Students who take the examination are not entitled to take the completion examination.

The Examination

1. Students MUST start the personal identification process through ExamID, as soon as they have received the examination password for the first examination block.
2. After the personal identification process, students MUST start the examination immediately, without any delay.
3. Examinees experiencing technical difficulties at any time during the examination must contact the online support team TellExaminationServices@sgu.edu immediately for assistance. 
4. If you cannot send an email to the online support teamTellExaminationServices@sgu.edu, for example because of an internet outage, you need to call +1 866-429-8889 instead, where your report will be logged.
5. All issues must be reported during the examination to the online support team (see above). Any issues reported to any party after the examination will not be considered. 
6. Students who do not START the examination within 30 minutes from the announced CHECK IN TIME will receive a score of “zero” for the examination, unless there is documented evidence for an approved extension from the online support team TellExaminationServices@sgu.edu. 
7. Once an examination block has been started, the examinee cannot leave the examination desk for the duration of the examination block.
8. The examinee cannot return to a finished examination block.
9. All blocks must be completed and uploaded successfully, for a score to stand. The examination is void if only partially completed or partially uploaded.
10. If an examinee experiences problems that the technical team cannot resolve, a completion examination will be offered (see classification of technical problems below).
11. If an issue is not communicated in a timely manner, then the examinee will not be given the opportunity to complete the examination. 

Technical Issues

Technical issues can arise and will be classified and dealt with as follows:

1. Resolved technical issue: A log will be kept on all technical problems that a student reports to the online support team (TellExaminationServices@sgu.edu). For all resolved technical problems the score of the student earned for the examination will stand.
2. Excused technical issue: If a student contacts the online support team in a timely manner (with enough time to complete the exam), and they cannot solve the technical issue, students will be eligible (without penalty) for a completion examination. This will be solely determined by the online support team (TellExaminationServices@sgu.edu). 
3. Non-excused technical issue: Failure to comply with any of the above regulations, or failure to follow instructions from the online support team

(TellExaminationServices@sgu.edu), will automatically lead to a score of “zero” (0 points) for the examination. A student may file an appeal to the Dean of their School (for SOM: Dean of Basic Sciences).

Appeals Process

A student who receives a “zero” for the examination because of any of the above stipulations may appeal against the “zero” score. A written appeal outlining the sequence of events, and explaining the circumstances that led to the compliance failure, has to be sent to the Dean of their School (studentDOBS@sgu.edu for SOM Basic Sciences). The Dean of Students office may assist the student in the appeals process.

An Examination Irregularities Panel will review the written appeal of a student and make one of the following deliberations:

1. A score of zero will be retained for the examination.
2. The recorded score may be reinstated, if the investigation confirms that the files are intact, can be uploaded, and there is no doubt about the integrity of the files and their logged times or your integrity, in your attempts to ensure the files were uploaded. An academic penalty may be applied for non-compliance with examination procedures. The penalty may be up to 10% of the course grade.
3. The examinee may be required to take a completion examination at the end of term, and an academic penalty may be applied for non-compliance with examination procedures. The penalty may be up to 10% of the course grade.

After Exam Day

1. All examination materials are the intellectual property of St George’s University. Reproduction and/or distribution of examination materials, by any means, including reconstruction through memorization, are strictly prohibited.
2. If you become aware of any suspicious activity related to an SGU examination, please notify the Course Director immediately.
3. Examination irregularities, including falsely reporting technical difficulties, potential violations of the honor code, or other breaches of the examination rules and regulations will be investigated.
4. The Course Director may withhold the examination scores during an ongoing investigation.
5. Once a violation of the examination rules and regulations has been confirmed, the Course Director may impose a score of “zero” (0 points) for the examination.
6. All ID files, monitoring files, and exam result files need to be uploaded for a valid exam score to stand. Absence of any of these files will result in a score of “zero” (0 points) for the examination. 
7. Failure to meet the hardware and software requirements for the examination, including failure to update to the required version of Examplify, will result in a score of “zero” (0 points) for the examination. 
8. In cases of severe violations of the examination rules and regulations, the Dean may initiate disciplinary action, which may ultimately result in dismissal. 

When cheating is suspected, it is not the obligation of the University to prove violation beyond a shadow of a doubt, but rather by a preponderance of the credible evidence submitted. Any suspected violations are reviewed by a university panel.

WRITTEN (ELECTRONIC) EXAMINATIONS

Written electronic examinations are in multiple-choice-single-best-answer format, following the guidelines of the National Board of Medical Examiners (NBME). The NBME provides the United States Medical Licensing Examination (USMLE), a three-step examination for medical licensure in the United States, which is sponsored by the Federation of State Medical Boards (FSMB) and NBME. 

Untested Questions

The use of new, previously untested questions is an essential component of question bank development. Such questions are not graded but may be incorporated into examinations. For each written examination, approximately 20 untested questions will be included for determination of their validity and reliability. These questions do not count toward a student’s grade.

The term “untested question” does not imply a different format or difficulty level. These are standard questions. If these questions generate reliable statistics during the testing process, they will become part of the regular question bank for use in future exams as regular exam items. This process ensures that all assessments are set with well performing items only. 

Pre-Examination Question Review by Faculty

Prior to each examination the Course Director calls a meeting of teaching faculty to review all test items and ensure the validity and high quality of all questions, whether they have been used before or are newly developed. 

Post-Examination Review by Faculty

After each examination, the Course Director calls a meeting of teaching faculty to review the overall examination statistics and item analysis, together with student review feedback, before making final decisions on the validity and reliability of the test and each of the test items. 

ELECTRONIC EXAMINATION PROCEDURES

The following policies and procedures supplement the general guidelines outlined in the University Examination Policies and Procedures in the SGU Student Manual. Each examinee is responsible for reviewing and adhering to these policies. https://mycampus.sgu.edu/group/officeof-institutional-advancement/welcome

Prior to Examination Day:

1. Each student is required to have a laptop for taking computer-based examinations at SGU. Examinees must ensure that their laptops meet the current system requirements, as published by Examination Services at the Office of Institutional Advancement (OIA).
2. NOTE: Some of the latest operating system updates may jeopardize the compatibility with electronic examinations. Examinees are encouraged to seek guidance from Examination Services at OIA, prior to installing updates.
3. Examinees must ensure that they meet the requirements to access the university network at any time, and should confirm access prior to examinations. 
4. Examinees must set the clock on their laptops to the correct local time and time zone (Grenada: Atlantic Standard Time AST = UTC-4; UK: Greenwich Mean Time GMT = UTC, or British Summer Time BST = UTC+1). 
5. For examinations using ExamSoft, examinees are responsible for downloading and registering the required version of Examplify on their laptop prior to examination day. 
6. Examinees are notified via the electronic course management system of all examination related information, including venue assignments, time sequence of examinations (including the download window, time when students enter the assigned venue, and when the doors are closed), and examination specifications (e.g. number of questions, duration etc.). 
7. For examinations using ExamSoft, examinees are required to download the examination during the allocated time window (see time sequence in the examination notification above). 
8. Examinees who are not eligible to take an examination (e.g. students who have withdrawn from course work, or students on an approved leave of absence) are not permitted to download the examination.
9. Examinees experiencing technical difficulties are encouraged to visit Examination Services at OIA for assistance prior to the examination day. An examinee who needs a loaner laptop must adhere to the loaner laptop policy provided by OIA.

On Examination Day:

1. Examinees are expected to assemble outside their assigned venue and ready to enter by the time stated in the examination announcement (see notification prior to examination day above).
2. Examinees must adhere to the instructions given by the Chief Proctor, or the proctors acting under his/her supervision. 
3. Examinees are required to enter their assigned venue only (see notification prior to examination day above) and must take their assigned seat. 
4. All examinees scheduled to sit a computer-based examination are required to bring their laptops and all necessary accessories (mouse, Ethernet cable and power cord/battery charger), for use on examination day.
5. All examinees who present themselves to sit a University examination are required to display a current SGU student identification card to access the examination venue. The SGU ID is the only acceptable form of ID. Any examinee who fails to present this ID will be required to complete a Missing/Lost Identification Form and to present a government-issued photo ID to access the examination venue.
6. Once seated, examinees must place their ID clearly visible on the left side of the desk they are seated at.
7. Permitted items - only the following items are allowed in the examination venue:
   1. Laptop and accessories
   2. SGU ID
   3. Completely clear (see-through) bottle of plain water, which must be placed outside the examination venue for all examinations
   4. Items explicitly permitted for a specific examination (see announcement), or approved by the Disability office
8. Items that are explicitly NOT permitted inside the examination venues include:
   1. Cell phones
   2. iPods/ iPads
   3. Wrist watches
   4. Calculators
   5. Paging devices
   6. Recording/filming devices
   7. Reference materials (book, notes, papers)
   8. Backpacks, briefcases, or luggage
   9. Beverages or food of any type
   10. Coats, outer jackets, headwear 
   11. Jackets/sweaters with pockets
   12. Hooded jackets/sweaters
   13. Note: Sweaters and jackets with hoods are not allowed.
9. Examinees need to be prepared to turn their pockets inside out for inspection.
10. Any prohibited items found inside the examination venue will be confiscated. 
11. Examinees are assigned a seat (either by posting of individual seat assignments outside the venue, on the website, or by the Chief Proctor or an authorized representative at the venue).
12. Examination conditions are in effect at all times inside the examination venue, from the time the first examinee has entered, until the last examinee has left the examination venue. During examination conditions, no communication of any kind is permitted between examinees. Access to any files or programs other than those explicitly specified by the Chief Proctor is not permitted. 
13. No examinee is permitted to enter the examination venue after the doors have been closed (in preparation of the password announcement; see notification prior to examination day above). 
14. White boards, dry erase markers and erasers are provided. Examinees are not allowed to write on the white boards prior to starting the examination.
15. Examinees’ eyes must be visible at all times. Hair long enough to cover the eyes and ears must be pulled back. 
16. An examinee who is experiencing problems should seek immediate attention from a proctor. 
17. Some problems may be solved immediately and on site, but more severe problems may require relocation of an examinee or even termination of the examination.
18. A bathroom break is the only allowed break during an examination. Examinees may not eat, smoke or communicate with anyone other than an assigned proctor during a bathroom break. Examinees must get the attention of a proctor, get permission, sign out and back in and be accompanied by a proctor. 
19. No bathroom breaks are permitted for 30 minutes after the assessment password has been provided and no examinee may leave the examination during this time period.
20. Once an examinee leaves the examination area without signing out and back in as stipulated, he/she is considered to have concluded the examination. He/she will not be allowed back into the examination venue to resume the examination. 
21. To start the examination, the Chief Proctor will provide examinees with the assessment password and give the start signal “START NOW” (or “BEGIN NOW”).
22. Once the start signal has been announced, examinees are required to proceed with their exam without delay. 
23. Examinees are allowed to exit the examination venue when they have completed their examination and displayed the upload confirmation screen (in case of ExamSoft examinations), or whatever procedure has been specified by the Chief Proctor. During the last 10 minutes of an examination, examinees may be instructed to remain seated until dismissed.
24. It is the responsibility of every examinee who downloaded an ExamSoft examination, but is unable to take the examination on examination day, to contact Examination Services at the OIA immediately, to facilitate the process of removal of the examination from their personal computer. 
25. All examination activity is logged and any log file demonstrating irregular activity, such as attempting to disable or tamper with security features, is subject to academic disciplinary action.

After the Examination:

1. An examinee may not attempt to reproduce a test or a test item by any means, including but not limited to reconstruction through memorization and/or dissemination of examination materials by any means.
2. Communications about specific test items, cases, and/or answers with another examinee, potential examinee, or any other person at any time before, during, or after an examination, are strictly prohibited.
3. Every examinee is required to fully cooperate in investigations regarding any examination irregularities, whether committed or observed by themselves or others.
4. Violation of any policy or procedure outlined in this document is reported as an examination irregularity to the Dean of Students and to the Course Director. In the case of NBME examinations, irregularity reports are also sent to the National Board of Medical Examiners, with potential consequences outlined on their website. The Dean of Students decides on subsequent disciplinary action and the Course Director determines the implications for examination scores and course grades.

INTERACTIVE TEAM INSTRUCTION METHOD (ITI)

Students in the MD program are expected to be adaptive, self-directed learners who can capably integrate what they know and apply their knowledge clinically.  This cognitive process may occur independently during and following an academic lecture; likewise, it may occur during and following interactions with others. Teaching and learning in the MD program includes required activities such as academic lectures, formative and summative assessments, small group discussions, laboratory sessions and clinical experiences. Additional optional activities are also available: open lab hours, faculty office hours, peer-to-peer facilitated reviews and academic support seminars. Students are encouraged to take advantage of the many varied opportunities for learning and academic development that are available to them.  Most students matriculate into the traditional, Live Lecture-based Delivery track (LLD) of the MD curriculum. While lectures are the foundation of this delivery format, approximately 50% of contact hours are in small groups and laboratories where students have opportunities for faculty interaction, collaborative learning and academic support. 

The ITI utilizes an instructional pedagogy that provides interaction with faculty and incorporates frequent collaborative active learning based on videos of lectures. The small group discussion and lab components are identical to the traditional LLD delivery track. Students’ progress through ITI in an instructor-guided small-group setting (approximately 8:1 student-to-faculty ratio). Students study the lectures through using the SGU lecture recording platform.   Multiple choice questions, discussions and clinical cases introduced at key points during each lecture serve as catalysts for the clarification of concepts. The instructors of the small groups ensure that all questions raised by students are effectively addressed in the ITI session. The ITI incorporates academic support through Learning Strategies Seminars given by the Department of Educational Services (DES) and individual Learning Strategies Advising meetings. 

ENTRY INTO ITI 

Following every examination period, the Academic Progress Review Committee (APRC) reviews student performance and identifies students with performance trends that indicate students are at risk of not achieving performance standards. Subsequently, during mandatory advising meetings, Academic Advisors meet individually with these students to discuss program requirements and standards, identify obstacles to progress, and consider opportunities for improvement. Performance data indicate that many students who do not meet performance standards in the traditional Live-Lecture delivery track make significant improvement in ITI track; therefore, Academic Advisors may encourage students to choose the ITI track. Students who choose this option by the established deadline transition into the ITI sessions and schedule and must remain there for the remainder of the academic term. 

At the end of the academic term, the APRC makes recommendations about students achieving well above minimum requirements transitioning back into the Live Lecture delivery. The APRC makes all determinations about student progression in the ITI delivery method at the end of each term. 

Technical Requirements for ITI

All students in ITI will require an ethernet cable and a USB ethernet dongle to stream video content. These are available for purchase from the University bookstore if required. Video streaming of the Mediasite lecture content is not allowed via WiFi in the ITI venues.

CREDIT REMEDIATION (CR)

The Four-Year MD program is designed to be continuous without interruption. Any timeline extensions could impact students’ ability to graduate on time. Nonetheless, some students encounter academic setbacks which may be resolved with an opportunity to remediate courses. The APRC identifies students who are not likely to meet academic standards by the end of an academic term and recommends that they be granted a CR option, which is an extension of their timeline by one academic term. Also, a student may choose the CR option.

The CR allows students to repeat the course once if they are not likely to meet academic standards for progress. Deadlines for the CR option are posted prior to the final exam of the last course module. 

Students who opt for the CR do not take the final exam of the last course module; however, they must participate in all remaining scheduled academic activities in the academic term, complete a Final Self-Directed Learning Assignment at the end of the term and present it in person on the scheduled final exam day.  

The Medical Excuse Policy for course examinations applies to the CR Final Self- Directed Learning Assignment. Students with an approved excused absence will be permitted to complete the CR final assignment as per the Completion Examination schedule. Students who receive an approved Incomplete (“I”) for an exam or a CR assignment must complete their CR Assignment in person as per the master School of Medicine schedule (published on the OEP/Registrar site (https://mycampus.sgu.edu/group/oep-registrar/welcome). 

Completion examinations are held approximately one week after the end of the term. Students should consider this completion examination period when scheduling end of term travel.

Students who do not have a Medical Excuse, who fail to complete or submit the CR Final SelfDirected Learning Assignment will receive an Incomplete grade for the course. They must then appear before a Dean of Basic Sciences Office panel to appeal for the opportunity to rectify this and to explain their failure to submit the Assignment. Students must then contact the Course Director to arrange to complete or submit the missed Assignment. Failure to resolve the missing Assignment by the specified deadline will result in the student forfeiting their CR option and receiving a Failing grade for the course.

Students who comply with all CR requirements will receive a grade of CR on their transcript and repeat all term coursework in the ITI delivery. 

They are not charged tuition for their repeat of the course, but administrative fees will apply.

Students who take the CR option are at risk of not meeting the MD program’s satisfactory progress guidelines and will be placed on Monitored Academic Status (MAS) by the Academic Performance Review Committee (APRC). Student should note that although no final grade is issued, during an APRC or CAPPS performance review, a CR is viewed as an academic setback should the student subsequently fail to meet academic or timeline standards. 

An additional CR may be allowed in the second year. Presuming students have no prior academic setbacks or timeline delays (i.e., F or I grades, Leave of Absence/Withdraw, Academic Performance Review Committee/Committee for Satisfactory Academic Progress and Professional Standards and only one previous CR, they may be granted up to two CR terms in accordance with the following rules:

One CR granted during Year 1 (Term 1 or Term 2) and one CR granted during Year 2 (Term 3, 4, or 5); or

Two CRs granted in Year 2 (Term 3, 4, or 5).      

CR COMBINATIONS:

This chart assumes student has no prior grades of “F’ or ‘W’.

Students who use the Credit Remediation (CR) option are at risk of not meeting the minimum academic standards of the MD program and will remain or be placed on Monitored Academic Status (MAS). Students with prior academic setbacks or timeline delays (F or I grade, LOA/W, APRC/CAPPS stipulations) may be ineligible for one or both CR options.

Note: In year 2, Terms 3 and 4 CRs are counted separately— a CR in Term 3 counts as 1 CR, and a CR in Term 4 counts as a separate CR.

ACADEMIC PROGRESS

In addition to meeting academic performance standards for progress, students must also progress through the MD program within the established timeline. Disruptions to a student’s program, whether as a result of personal or academic setbacks (e.g., repeated courses, LOAs), may prevent the student from maintaining timeline requirements.  

Although timeline extensions may be permitted (e.g., CR, LOA), the APRC will consider these extensions when making recommendations for the retention or dismissal of students. Students who have timeline delays or interruptions will be placed on a Monitored Academic Status (MAS) for the duration of the MD program.

At the end of each academic term 1-5, the APRC will review students’ academic performance and identify any students who are not meeting academic performance standards. The APRC will make recommendations to the Dean of Basic Sciences for a student’s progression, promotion or dismissal. Students who fail to meet standards may be allowed to remain in the program if they have had no previous failure to meet standards and no timeline delays. Students with previous failures to meet standards and/or timeline delays may be granted an additional term on MAS or recommended for dismissal in the following situations:

 FAILING GRADES

A failing grade (“F”) is defined as a final course grade of less than the minimum passing grade established for each term. If this is the student’s first attempt at a course, there are two possible consequences of a failing grade: 

1. Continue on Monitored Academic Status (MAS)

Students will be allowed to continue in the MD program, despite failing to meet satisfactory academic performance, if the following conditions are met:

1. No previous F grade in any course in a prior term. 
2. No more than one of the following timeline delays:
   1. Credit Remediation option (CR)
   2. Leave of Absence (LOA)

The student will be given an opportunity to repeat the course in the ITI and will be placed on MAS for the subsequent term. Additional stipulations will be applied.

The student will be permitted to register for the course a second time and to earn a second grade for the course. The grade and credits earned on both the first and the second attempt at a course will be calculated into the cumulative WMPG. The grade earned on the second attempt does not replace the grade earned on the first attempt.

2. Recommended for Dismissal

Students will be recommended for dismissal if any one of the following applies to them:

1. Two of the following in any combination:
   1. Prior Credit Remediation option (CR)
   2. Prior Leave of Absence (LOA)
2. One of the following:
   1. Previous F grade in a course
3. The student will exceed the 3 years maximum allowed to complete Terms 1-5, if permitted to progress.

All students who are recommended for dismissal have the opportunity to appeal to the CAPPS, as per the section on REVIEW, DISMISSAL AND APPEAL PROCESS

  MONITORED ACADEMIC STATUS (MAS)

Monitored Academic Status (MAS) is an internal marker placed in students’ progress files by the Dean of Basic Sciences or the Office of the Dean.  It allows students who are at risk of not making satisfactory academic progress to continue in the program with additional academic advising. Students are placed on MAS throughout the academic program if they meet any of these conditions:

Failing a Term 1-5 course

Requiring an extra term to complete the Basic Sciences program (CR, LOA)

Students on MAS are assessed, supported and monitored by the Academic Advising and Development Support (AADS) division of the Dean of Basic Sciences Office or the Student Support Services in the Office of the Dean in the clinical years. They will be required to meet regularly with their assigned academic advisor who will assess and monitor their progress and make referrals to relevant support services.

RECOMMENDATION FOR DISMISSAL DURING TERMS 1-5 AND BEFORE CLINICALS

 The following criteria will be used by the APRC to determine end of term dismissal recommendations:

1. Failure to complete the basic science curriculum within three years.
2. A second failure to earn a passing grade during basic sciences. Only one F grade is allowed during basic sciences. 
3. Failure to achieve academic progress standards on the second attempt at a course following a Credit Remediation (CR). 
4. Failure to achieve academic progress standards despite 2 timeline extensions, due to an F grade and/or CRs.
5. Failure to meet CAPPS stipulations after the CAPPS retains a student following an appeal of a recommendation for dismissal.
6. Failure to begin clinical rotations within 6 months, after taking the maximum 3 years to complete the Basic Sciences.  
7. Failure to accept the terms of the APRC letter by the deadline specified.

All students who are recommended for dismissal can appeal to the CAPPS, as per REVIEW, DISMISSAL AND APPEAL PROCESS

RECOGNITION OF ACHIEVEMENT

Students who have high cumulative WMPGs are recognized for their achievement as follows:

Cumulative WMPG ≥ 95%: Students are placed on the Chancellor’s List and promoted to the next term.

Cumulative WMPG ≥ 90% - 94.99%: Students are placed on the Dean’s List and promoted to the next term.

STANDARDS FOR PROFESSIONAL BEHAVIOR

The faculty has established professional standards and requires all medical students to meet these standards in order to progress and successfully complete the Four-Year MD Program. The School reserves the right to issue a warning, to place on probation, suspend or to dismiss a student whose behavior renders the student unable to meet the required standards. All term 1-5 courses have professional behavior standards. Failure to meet professional behavior standards may result in up to a 10% penalty of the total available course points and may result in an F grade for the course in which the student is registered. Penalties may be summative if there are multiple penalties. During clinical rotations, professional behavior is worth 20% of the final grade.

Students are expected to abide by the University Code of Conduct and to demonstrate professional behavior at all times. The University Code of Conduct can be found on our website. The Dean of Basic Sciences and/or the Dean of Clinical Years (US and UK) can suspend students at any time for serious breaches of the Code of Conduct. 

PROBATION FOR UNPROFESSIONAL BEHAVIOR

Probation is reflected in students’ progress files for students who violate the standards of professional behavior as defined by the Code of Conduct.  Probation allows students who do not meet these standards to continue in the Doctor of Medicine program for a specified period with a prescribed course of action. Students will be monitored for adherence to stipulations specified in their probation letters.  Although probation does not appear on a student’s transcript, the School of Medicine must supply this information if it is requested by external agencies, such as a state licensing board. While on probation, students’ behavior must improve in accordance with the specific written stipulations given to students.  Students who fail to meet the prescribed course of action risk a recommendation of dismissal.

Information regarding University Disciplinary and Judiciary Policies and Procedures can be found on the Carenage on the University website.

THE COMMITTEE FOR SATISFACTORY ACADEMIC PROGRESS AND

PROFESSIONAL STANDARDS (CAPPS) CAPPS ACADEMIC APPEALS PROCESS

The mission of the CAPPS is to make fair and objective decisions on individual student appeals.

Although the School of Medicine is committed to providing students with remediation  and support needed to facilitate student success, the CAPPS is obligated to consider not only the individual student’s appeal but also key considerations such as  program requirements and standards, as well as student’s performance history, timeline and academic risk factors.

APRC and CAPPS TERMS 1-5

REVIEW, DISMISSAL AND APPEAL PROCESS

Following each major examination, the APRC, comprised of Course/ Module   Directors and Dean of Basic Sciences representatives, will conduct a review and analysis of student performance. At this meeting, the APRC will identify students at risk of failing to meet academic standards.

Following each major examination, Academic Advisors will counsel at-risk students and inform them of the appeals process, should they find themselves recommended for dismissal at the end of the term.

At the conclusion of the final exam period for each term, the APRC will conduct comprehensive review and analysis of student performance. The APRC makes academic progress recommendations to the Dean of Basic Sciences based on students’ achievement of School of Medicine standards as stated in the Student Manual or in additional post-appeal CAPPS stipulations.

Within two working days of the APRC meeting, the Dean of Basic Sciences will email an offer for the student to continue in the program (with stipulations) or a recommendation for dismissal to any student who fails to meet the standards. Students permitted to continue must reply to the email indicating they have accepted the offer to continue with stipulations within the timeframe specified in the email. For those students permitted to continue, a failure to formally accept the terms of the APRC by the deadline specified may result in a recommendation for dismissal. For those recommended for dismissal, the email will describe the reason for the recommendation, detail the student’s options to appeal or to withdraw, and specify the timeframe in which to do this.

The email will provide a link to the electronic Appeal Form which must be completed and submitted, along with official documentation in support of extenuating circumstances described in the appeal by the stipulated deadline (see timeline below). The submission will be automatically directed to the CAPPS office. Once the timeframe to submit the appeal has ended, a comprehensive report providing all appeal information for each student will be generated by the CAPPS office in preparation for the review by the committee. Should a student fail to submit his/her appeal by the stipulated deadline, there is no guarantee that the appeal will be reviewed. While preparing their appeals and considering what supporting documentation to include, students should bear in mind that there is only one opportunity to appeal a recommendation for dismissal. Extensions to the appeal deadline will not be granted, nor will additional appeals.

If a student’s appeal is successful, the CAPPS will determine the conditions a student must meet to progress in the MD program. A letter will be issued to the student detailing the conditions as specified by the CAPPS. The student must respond to this communication to indicate his or her acceptance of the conditions. A student who does not accept the CAPPS conditions has the option to withdraw from the MD program within a specified timeframe. If a student does not accept the CAPPS’ conditions and does not withdraw within the specified timeframe, the student will be dismissed.

Students who are retained after a successful appeal of a recommended dismissal are placed on a Period of Academic Focus (PAF). Students on PAF are assessed, supported and monitored by the Academic Advising and Development Support division of the Dean of Basic Sciences Office. They will be required to meet regularly with their assigned academic advisor who will assess and monitor their progress and make referrals to relevant support services.

The APRC reviews students on a PAF each term. During Terms 1-5, students are removed from a PAF by successfully achieving School of Medicine standards for the duration of Terms 1-5 and satisfying their academic plan as prescribed by the Dean of Basic Sciences or the CAPPS.

If a student’s appeal is unsuccessful, the letter to the student with a rejected appeal will provide the student with the option to withdraw from the MD program within a specified timeframe. If the student does not withdraw within the specified timeframe, the student will be dismissed. The School of Medicine has no further mechanism for appeal.

SCORING AND GRADING POLICIES AND PROCEDURES

Grades are awarded objectively based on the percentage of points earned in the course relative to the maximum number of points available in the course. The total number of points available and a breakdown of how these points can be earned are listed in Section A (Course Specific Information) of this document. No additional points are available. Grades are awarded based on the official grading scale of St George’s University School of Medicine (see below).

Question Review

The Course Director will arrange a meeting of faculty teaching in the course (or course module), to review the summary statistics of the examination, statistical item analysis and student review feedback. 

Please note: Only student question review requests that have been raised during the examination in the appropriate comment box of ExamSoft will be considered. Question review requests reaching the Course Director or individual faculty members after the examination will not be considered. 

If a test item (question) is deleted for any reason, all responses to the question will be accepted as correct. 

The final decisions about question flaws and the appropriate adjustments rest with the Course Director.

GRADING

Before the start of the grading process, all decisions about individual questions, which may have been made during the question review process, will be considered as final.

At the end of term, the overall performance of a student will be determined as a percentage score, made available to the Registrar’s Office and entered into the official St George’s University data base. 

This percentage score is the basis for the determination of individual grades to appear in a student’s transcript, based on the current grading policy of St George’s University School of Medicine.

Completion of the minimum required formative assessments is a requirement for satisfactory completion of a course. Students who do not meet the requirement may receive an overall “F” grade for the course. 

Grading Scale

The current grading scale of St George’s University School of Medicine, for incoming from Fall 2019 is based on percentage scores as follows;

For students matriculated prior to Fall 2019 the grading scales are;

Publication of Results

Results of all assessments will be published in the online course management system. The results of all electronic examinations will usually be posted at the end of an examination period. 

After the results of an examination, an online assessment, or a grade have been published, it is each student’s responsibility to check the published results.

Reporting of Errors

Errors in published scores for electronic examinations (and other course assessments manually entered into the gradebook) must be reported to the Course Director for validation within 48 hours of their publication.

For Online Assessments, where results are immediately accessible upon submission, errors must be reported before the submission deadline. 

Technical errors reported after the deadline will not be considered.

Change of Published Results

A published result can only be changed if the published score or grade is incorrect, and errors have been reported in time.

COURSE AND INSTRUCTOR CRITIQUE PROGRAM

Course and Instructor Critiques: Students are expected to   participate in all classes and other related academic activities as defined for each course by the course director. One such academic activity is participation in the St. George’s University (SGU) Course and Instructor Critique Program.

Student participation in the Evaluation Process is mandatory:   When requested, students in a course are expected to complete all required faculty and course evaluations. The critiques coordinator notifies students when evaluation periods have begun and sends periodic reminders to ensure that critiques are submitted within the allotted time frame.  Failure to complete all required course and instructor critiques means that students did not fulfill all course requirements. The Office of Institutional Advancement, which runs the Course and Instructor Critique Problem, send a letter of non-compliance to the students for non-participation. If the student is non-compliant again, the OIA refers the student to the Dean of Students Office for continued unprofessional behavior.

The Importance of Evaluation

Just as students anticipate a fair and accurate evaluation of their performance and achievement in a course, SGU requires that faculty and course evaluations be completed each term. Continual evaluation and assessment of faculty ensures that the instructional program not only remains consistent, but also improves as students’ needs and expectations are considered.

Feedback

At the beginning of each term, course directors will address the class and summarize the results of the course and instructor critiques from the previous term. In this summary, course directors will report areas that students rated highly and areas that received the lowest ratings. For areas receiving low ratings, the course director details what changes were made to address students’ concerns, thus ensuring that course evaluation influences course design and delivery.

SGU WISDOM

SGU is the first medical school in the world to use a safe digital platform designed to help your Advisors and other SGU leaders understand what matters to you.  It also provides a secure way for students to learn a little bit about each other.  We call it SGU Wisdom, and it’s all about listening. 

Please go to SGU Wisdom, sign up, and do the My Self section by February 1 – it takes less than 10 minutes.  If you signed up in the fall, please be sure that the My Self section is complete and up to date.   Note that we consider completing SGU Wisdom a behavioral sign of professionalism, so please be sure to follow through.   

You will see the Snapshots for Colleagues (a bit about you that students can access) and Snapshots for Leaders (a little more about you that advisors and other leaders can access) in real time.  It’s a great opportunity to make the SGU community even stronger. 

The materials (such as slides, handouts and audio/video recordings) provided to students who are taking courses at St. George’s University (SGU) are the intellectual property of the Faculty and/or Administration of SGU. Students are free to use these materials solely for the purpose of group or individual study. Reproduction in whole or in part is prohibited.