POLICY: Clerkship Directors and Clinical Course Directors are responsible for monitoring the progress of medical students in terms of both academic achievement and professional behavior. Upon recognition that a student will be awarded a grade of F (failure), N (failing the first NBME subject examination), or I (incomplete), the clerkship director or clinical course director will send immediate written notification to the student and copies to the Assistant Dean for Clinical Education, the School of Medicine Registrar, and the Associate Dean for Student Affairs. The grade of F will require remediation commence within twelve weeks of receipt of written notification. The grade of I will require all missing essential components be completed within 12 weeks of completion of the academic activity. An extension of this time limit can be granted by the Assistant Dean for Clinical Education. This policy and procedure will apply to all clerkships, required acting internships and required courses taken during the third and fourth year of medical school.

PROCEDURE:

Failure Grades

1. Failure (F) Grades – an F is given when all components of the course have been completed, but the student performance is below the required minimum level of performance.

2. Notification Procedure: When awarding the grade of F, the course or clerkship director will immediately send written notification to the student by certified, return receipt mail. A copy of this correspondence will be sent to the following:

• Assistant Dean for Clinical Education,
• Associate Dean for Students,
• Chair of the appropriate promotion committee,
• School of Medicine Registrar.

3. Academic Standing: Upon receipt of the notification, the School of Medicine Registrar places the student on academic probation.

4. Terms of Remediation:

1. Time limit for Remediation. Remediation of the F grade must be commenced within 12 weeks of written notification. If circumstances prevent remediation within this time, an extension may be requested by the student within ten working days of receipt of the notification. This written request for an extension must be sent to the Assistant Dean for Clinical Education with a copy to the clerkship or course director. The Assistant Dean will notify the student, the clerkship/course director, the Registrar and Associate Dean for Students of the decision within 5 working days of the request receipt. If remediation has not commenced within the 12 weeks, and no extension requested, the student will be referred to the appropriate promotion committee for consideration of academic dismissal.
2. Continuation in the third year. The student will be allowed to continue with third year clerkships, so long as remediation for the failing grade is completed within the stipulated deadline.
3. Advancement to the Senior Year –Senior Academic Work Requiring the Failed Clerkship as a Prerequisite. The student must repeat the entire clerkship prior to beginning any required fourth year courses or any course requiring the failed course as a prerequisite. Occasionally, a failing grade for a clerkship will not be known prior to beginning such a rotation (i.e. the failed clerkship is the last rotation of the third year). The student will be allowed to complete the senior rotation, but academic credit will not be awarded until after successful remediation is completed.
4. Advancement to the Senior Year –Senior Academic Work Not Requiring the Failed Clerkship as a Prerequisite. If the student is informed of a failing grade while taking an elective rotation that does not require the failed clerkship as a prerequisite, then the student may continue the rotation and receive academic credit for the elective. The student may take further elective academic work, but must complete the required remediation by the stipulated deadline.

5. Academic Dismissal. Academic dismissal can be considered for several reasons including, but not limited to the following:

• Remediation is not successful within the deadline stipulated,
• A subsequent clerkship, elective or required clinical rotation is failed.

1. When academic dismissal is considered, the clerkship or course director will send written notification to the student that they are being referred to the appropriate promotion committee for consideration of academic dismissal. This notification will be done by certified, return receipt mail with copies to the appropriate promotion committee, the Assistant Dean for Clinical Education and the Associate Dean for Students.
2. Upon notification of a second failed clerkship grade, the student must stop all academic activities, and await the decision of the promotion committee.
3. If a student is referred to the clinical academic subcommittee for consideration of academic dismissal, this subcommittee will convene within ten working days to recommend an appropriate action. This action may include dismissal or other appropriate remediation as determined by the committee.

Incomplete Grades

1. An Incomplete (I) Grade results when one essential component for the course or clerkship has yet to be completed. When this includes failure of a final examination (NBME) when passing the examination is an essential criterion to pass the course, the N grade will be assigned as a temporary grade.

2. Notification Procedure: Within 5 working days of knowing the student has failed to complete all essential components of the course or clerkship, the course or clerkship director will notify the student by certified, return receipt mail. A copy of this correspondence will be sent to the following:

• Assistant Dean for Clinical Education,
• Associate Dean for Students,
• Chair of the clinical academic subcommittee,
• School of Medicine Registrar.

3. Terms of Remediation of Incomplete and N Grades:

1. Time limit for Remediation. The student has 12 weeks from the date of completion of the course or clerkship to complete remediation of the essential component. If the essential component is not completed within 12 weeks, then the student will automatically receive a failing grade. In the case of a failed NBME subject examination, the student must repeat the examination within 12 weeks with the score pending.
2. Continuation in the third year. The student will be allowed to continue with third year clerkships, so long as remediation for the incomplete grade is completed within the stipulated deadline.
3. Advancement to the Senior Year –Senior Academic Work Requiring the Incomplete Clerkship as a Prerequisite. The student must resolve the incomplete grade, prior to beginning any required fourth year courses or any course requiring the uncompleted course as a prerequisite. Occasionally, the final grade for a clerkship will not be known prior to beginning a required senior rotation (i.e. the failed clerkship is the last rotation of the third year). The student will be allowed to complete the senior rotation, but academic credit will not be awarded until the incomplete grade is resolved.
4. Advancement to the Senior Year –Senior Academic Work Not Requiring the Incomplete Clerkship as a Prerequisite. If the student is informed of the incomplete grade while taking an elective rotation that does not require the uncompleted clerkship as a prerequisite, then the student may continue the rotation and receive academic credit for the elective. The student may take further elective academic work, but must complete the required remediation by the stipulated deadline or the incomplete grade will automatically be converted to a failing grade.
5. Failure of the NBME Subject examination. If the incomplete grade is a result of not passing the NBME Subject Exam, or other essential final exam, the exam will be retaken within the stipulated 12-week deadline. Upon passing the exam, the final grade for the course will be calculated using the first or original exam score. If the repeat exam is not passed on the second attempt, then the student will receive a failing grade, and will be treated as outlined above.
6. Incomplete Grade for Personal Reasons. For an incomplete grade given for "personal" reasons, remediation must be completed within 12 weeks of the end of the clerkship. If remediation has not occurred within 12 weeks, the grade will be converted automatically to a failing grade unless the student withdraws from the course or clerkship.

4. Halt of Academic Progression

1. Additional Grades or Incomplete, Failure or Withdrawal. If a student receives an additional grade of Incomplete, Failure, or Withdrawal prior to remediating an already existing incomplete grade, then the student will be required to remediate all incomplete grades and deficiencies prior to entering any additional coursework. Written notification to the student by certified return receipt mail will include notification of the Assistant Dean for Clinical Education, the Associate Dean for Students, the School of Medicine Registrar and the chair of the appropriate promotion committee. Usually, this second deficiency will place the student on academic probation.
2. Failure to Remediate. If remediation of the incomplete grade produces a failing grade, then the student will receive a failing grade and be treated as outlined above.

This policy and procedure was adopted by the Executive Faculty of the University of Alabama School of Medicine and approved by the Dean on September 21, 1999.