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Section 2: Standards, Conducts, and Professionalism
 
Section 2: Standards, Conduct, and Professionalism

Medical education requires that the accumulation of scientific knowledge be accompanied by the simultaneous development of specific skills and other competencies. Our College of Medicine (CMED) has a responsibility to society to graduate the best possible physicians.

             Cheating on Examinations
             Fabrication, Forgery and Obstruction
             Multiple Submission
             Complicity
             Computer Misuse
             Misuse of Intellectual Property
             Process of Review
Academic Standards
Academic standards refer to acceptable demonstrations of mastery in various disciplines, before matriculation and after, as judged by faculty members, examinations, and other measurements of performance. Acceptable levels of mastery are required in six broad areas of competency once a student matriculates at CMED:
        Medical/scientific knowledge
        Clinical Skills
        Professionalism
        Communication/interpersonal skills
        Practice-based learning (engaging in self-assessment and making improvements in one's learning and performance)
        Systems-based practice (effectively carrying out responsibilities in a complex system of medical and associated professionals)
Technical Standards or Standards of Capacity
Students at CMED must have capacity/ability in five broad areas:
        Perception/Observation
        Communication
        Motor/Tactile function
        Cognition
        Professionalism (Mature and Ethical Conduct)
Perception/Observation
Students must be able to accurately perceive, by the use of senses and mental abilities, the presentation of information through:
        Small group discussions and presentations
        Large-group, team-based learning sessions
        One-on-one interactions
        Demonstrations
        Laboratory experiments
        Patient encounters (at a distance and close-at-hand)
        Diagnostic findings
        Procedures
        Written material
        Audiovisual material
 
Representative examples of materials/occasions requiring perceptual abilities beginning in years 1 and 2 include, but are not limited to:
        Books;
        Diagrams;
        Discussions;
        Physiologic and pharmacological demonstrations in animals, microbiologic cultures, gross and microscopic studies of organisms and tissues;
        Chemical reactions and representations;
        Photographs;
        X-rays;
        Cadaver dissections;
        Live human case presentations; and
        Patient interviews and physical exams.
 
Additional examples from year 3 and 4 include, but are not limited to:
        Physical exams;
        Rectal and pelvic exams;
        Examinations with stethoscopes, otoscopes, fundoscopes, sphygmomanometers, and reflex hammers;
        Verbal communication and non-verbal cues (as in taking a patient's history or working with a medical team);
        Live and televised surgical procedures;
        Childbirth;
        X-rays, MRIs, CAT scans, and other diagnostic findings; and
        Online computer searches.
 
Communication
Students must be able to communicate skillfully (in English) with faculty members, other members of the healthcare team, patients, families, and other students, in order to:
        Elicit information
        Convey information
        Clarify information
        Create rapport
        Develop therapeutic relationships
        Demonstrate these competencies
 
Examples of areas in which skillful communication is required beginning in years 1 and 2 include, but are not limited to:
        Answering oral and written exam questions;
        Eliciting a complete history from a patient;
        Presenting information in oral and written form to preceptors;
        Participating in sometimes fast-paced, small-group discussions/interactions;
        Participating in group dissections; and
        Participating in pathology labs.
 
Additional examples of areas in which skillful communication is required in years 3 and 4 include, but are not limited to:
        Participating in clinical rounds and conferences;
        Writing patient histories and physicals;
        Making presentations (formal and informal) to physicians and other professionals;
        Communicating daily with all members of the healthcare team;
        Talking with patients and families about medical issues;
        Interacting in a therapeutic manner with psychiatric patients;
        Providing educational presentations to patients and families;
        Participating in videotaped exercises;
        Interacting with clerkship administrators; and
        Writing notes and papers.
 
Motor/Tactile Function
Students must have sufficient motor function and tactile ability to:
        Attend (and participate in) all classes, groups, and activities which are part of the curriculum;
        Read and write proficiently;
        Examine patients;
        Do basic laboratory procedures and tests;
        Perform diagnostic procedures;
        Provide general and emergency patient care;
        Function in outpatient, inpatient, and surgical venues;
        Perform in a reasonably independent and competent way in sometimes chaotic clinical environments; and
        Demonstrate these competencies.
 
Examples of activities/situations requiring students' motor/tactile function beginning in years 1 and 2 include, but are not limited to:
        Transporting themselves from location to location;
        Participating in classes, small groups, patient presentations, review sessions, dissections, laboratory work, and microscopic investigations;
        Using a computer;
        Performing a complete physical exam including observation, auscultation, palpation, percussion, and other diagnostic maneuvers;
        Performing simple lab tests;
        Using light microscopes; and
        Performing cardiopulmonary resuscitation.
 
Additional examples of experiences requiring motor/tactile function in years 3 and 4 include, but are not limited to:
        Accompanying staff on rounds and conferences;
        Performing venipunctures, thoracenteses, paracenteses, endotracheal intubations, arterial punctures, Foley catheter insertions, and nasogastric tube insertions;
        Taking overnight call in the hospital;
        Performing physical, neurological, gynecological, pediatric, and obstetric examinations (with the appropriate instruments);
        Dealing with agitated patients in emergency situations;
        Maintaining appropriate medical records; and
        Acting as second assistant in the OR (retracting, suturing, etc.).
 
Cognition
Students must be able to demonstrate higher-level cognitive abilities, which include:
        Rational thought
        Measurement
        Calculation
        Visual-spatial comprehension
        Conceptualization
        Analysis
        Synthesis
        Organization
        Representation (oral, written, diagrammatic, 3-dimensional)
        Memory
        Application
        Clinical reasoning
        Ethical reasoning
        Sound judgment
 
Examples of applied cognitive abilities beginning in years 1 and 2 include, but are not limited to:
        Understanding, synthesizing, and recalling material presented in classes, labs, small groups, patient interactions, and meetings with preceptors;
        Understanding 3-dimensional relationships, such as those demonstrated in the anatomy lab;
        Successfully passing oral, written, and laboratory exams;
        Understanding ethical issues related to the practice of medicine;
        Engaging in problem solving, alone and in small groups;
        Interpreting the results of patient examinations and diagnostic tests;
        Analyzing complicated situations, such as cardiac arrest, and determining the appropriate sequence of events to effect successful treatment; and
        Working through genetic problems.
 
Additional examples of required cognitive abilities in years 3 and 4 include, but are not limited to:
        Integrating historical, physical, social, and ancillary test data into differential diagnoses and treatment plans;
        Understanding indications for various diagnostic tests and treatment modalities - from medication to surgery;
        Understanding methods for various procedures, such as lumbar punctures and inserting intravenous catheters;
        Being able to think through medical issues and exhibit sound judgment in a variety of clinical settings, including emergency situations;
        Identifying and understanding classes of psychopathology and treatment options
        Making concise, cogent, and thorough presentations based on various kinds of data collection, including web-based research;
        Knowing how to organize information, materials, and tasks in order to perform efficiently on service;
        Understanding how to work and learn independently; and
        Understanding how to function effectively as part of a healthcare team.
 
Professionalism (Mature and Ethical Conduct)
Students must be able to:
        Consistently display integrity, honesty, empathy, caring, fairness, respect for self and others, diligence, and dedication;
        Promptly complete all assignments and responsibilities attendant to the diagnosis and care of patients (beginning with study in the first year);
        Communicate with, examine, and provide care for all patients—including those whose gender, culture, sexual orientation, or spiritual beliefs are different from students' own;
        Develop mature, sensitive, and effective relationships, not only with patients but with all members of the medical school community and healthcare teams;
        Maintain sobriety in all academic and clinical environments, refrain from illegal substances at all times, and refrain from inappropriate, illegal or excessive use of legal substances;
        Abide by all state, federal, and local laws, as well as all CMU and CMED codes of conduct;
        Tolerate physically, emotionally, and mentally demanding workloads;
        Function effectively under stress, and proactively make use of available resources to help maintain both physical and mental health;
        Adapt to changing environments, display flexibility, and be able to learn in the face of uncertainty
        Take responsibility for themselves and their behaviors
        Recognize that involvement in patient care is a privilege and must be treated this way at all times; and
        Embrace a service orientation toward patient care.
 
Examples of professional behavior beginning in years 1 and 2 include, but are not limited to:
        Attending required experiences on time and with an appropriate level of preparation;
        Handing in assignments on time;
        Zero tolerance for plagiarizing or cheating;
        Treating faculty, staff, patients, their families, and other students with respect;
        Accepting constructive feedback from faculty with open-mindedness and the intention to improve;
        Making an effort to understand prejudices and preconceptions that might affect patient interactions or collegial relationships (especially in the areas of race and ethnicity, sexual orientation, gender, disability, age, socioeconomic status, and religious differences); and
        Developing successful working relationships with preceptors, staff, and peers by accepting constructive feedback.
 
Additional examples of professional behavior in years 3 and 4 include, but are not limited to:
        Maintaining a professional demeanor on service (e.g. white coat, name tag, appropriate attire, neat appearance, respectful speech, sobriety);
        Representing one's self accurately;
        Appreciating and preserving patient confidentiality;
        Responding sensitively to patients' social and psychological issues;
        Developing empathic listening skills;
        Understanding social biases and stigmas, and not reinforcing them;
        Advocating for patients when appropriate;
        Using hospital/clinic resources responsibly;
        Being present, prepared, and on time for rounds, lectures, conferences, and procedures;
        Obtaining advice when handling ethical dilemmas;
        Accepting constructive feedback from attending physicians and residents with open-mindedness and the intention to improve; and
        Contributing to the effectiveness, efficiency, and collegiality of healthcare teams.
 
Learning Environment
The following is a list of the professional attributes that CMED expects medical students to develop as part of their educational experience and contributes to the learning environment:
Personal Attributes
        Intellectual curiosity
        Demonstration of strong skills in critical thinking
        A dedication to lifelong learning and self-improvement
        Ethical values, such as honesty, integrity, fairness, and truthfulness
        Demonstration of maturity and emotional stability
 
Interpersonal Attributes
        Strong interpersonal and communications skills
        An appreciation and/or commitment to diversity 
        Collegiality and a spirit of teamwork
        Respect for self and others
 
Attributes Relating to Medicine and Patient Care
        Motivation and interest in medicine
        Dedication to duty and a sense of calling and commitment to serve others as a first priority
        Sensitivity, compassion, and interest in patients and others
 
The leadership team at CMED, including the dean and the associate deans developed the list of professional attributes, which were then endorsed by the Curriculum Committee and the Medical Student Self-Study Committee.
 
The medical student professional attributes described above, and the CMED technical standards relating to professionalism will be presented to students during year 1 orientation, and reviewed again during the year 3 orientation. Professionalism is a competency that is formally taught in the Art of Medicine course, and students will receive instruction in professionalism that includes the professional attributes named above. These attributes are included in the CMED Student Handbook and are given to all residents and faculty at the time of their initial appointment. Resident and faculty development sessions will include a discussion of the professional attributes expected of students, and instruction on how to evaluate students. They will be also available on the CMED Student Affairs website.
 
An important goal for CMED is to graduate well-educated physicians who strive to attain the highest standards of academic and personal honesty, compassion, integrity, dependability and self-awareness. CMED intends that its students follow in the altruistic tradition of medicine, placing the welfare of their patients and society above self-interest. Plans for student professional development will reinforce the importance of character and ethical principles in the practice of medicine. CMED will support professional development through integrated curricular, mentoring, advising, and co-curricular activities. CMED students are also required to comply with the CMED technical standards for professionalism (mature and ethical conduct).
Assessment of students' attainment of appropriate professional attributes
Observation of student professional behavior is an ongoing process at CMED. There will be formal assessments of professional behavior at a variety of times throughout the curriculum. Professionalism is one of the competencies that students will be required to master, and both students and residents in training will be expected to display the elements of professional behavior at all times. Professionalism will be covered in depth in the longitudinal year 1 and year 2 course, The Art of Medicine. Students will be asked to demonstrate their knowledge and understanding of professionalism and professional behavior as part of the course assessment. CMED will use Praise/Concern Cards to praise the display of positive professionalism attributes and identify concerns about an individual's professionalism. A copy of the Praise/Concern Card is found under "Policy on Standards of Conduct for the Teacher-Learner Relationship" in this section of the handbook.
Teaching students to identify and address unprofessional behavior
Professionalism will be taught in the formal curriculum as previously described. Several learning modules will be developed that describe scenarios where unprofessional behavior occurs. In small group settings, students will discuss how to respond when they witness unprofessional behavior.
Mechanisms for faculty and/or students to report unprofessional behavior
Refer to the Policy on Standards of Conduct for the Teacher-Learner Relationship section of the handbook.
Maintaining appropriate canons of professional behavior in education and clinical settings
The CMED Executive Committee established the canons of professional behavior, which are included in the faculty bylaws and endorsed by all faculty and students at CMED. Faculty will agree to abide by them as one of the conditions of the CMED faculty appointment. The faculty bylaws regarding professionalism include a requirement that all faculty abide by the policies set forth in the AAMC's Teacher-Learner compact. Discipline chairs will be responsible for ensuring the maintenance of professional behavior by all faculty members in their discipline. All educational settings that are affiliated with CMED will endorse the canons of professionalism set forth by the dean. All CMED physician affiliation agreements and the affiliation agreements with clinical partner organizations include the requirement that physicians (who are appointed as CMU faculty and are engaged in the instruction of CMU medical students) will be expected to comply with the CMED bylaws, which includes the Teacher-Learner Compact.  Every faculty member will receive a copy of the faculty bylaws. These bylaws will be reviewed in faculty orientation sessions, and in annual faculty development sessions.
CMU Code of Academic and Professional Integrity
CMU Code Policy of Academic and Professional Integrity is for the entire University and all colleges and programs in its domain. For conduct relating to health care activities, please refer to Standards of Capacity with attention to Professionalism, Learning Environment, and Standards of Conduct for the Teacher-Learner Relationship, all of which are in this section.
 
All students are expected to conduct themselves in an exemplary fashion, according to the standards of conduct outlined in the CMED technical standards Section E: Professionalism, the CMU Academic Integrity Policy, all codes of conduct at affiliated hospitals, relevant laws and regulations, and usual societal standards of responsible adult behavior.
 
A description of academic integrity and dishonesty as outlined by the CMU Code of Academic and Professional Integrity is described below. This description applies to any and all student experiences in which academic credit is involved (e.g., courses, internships, practica, theses).
 
Academic Integrity
Because academic integrity is a cornerstone of the University's commitment to the principles of free inquiry, students are responsible for learning and upholding professional standards of research, writing, assessment, and ethics in their areas of study. In the academic community, the high value placed on truth implies a corresponding intolerance of scholastic dishonesty. Written or other work which students submit must be the product of their own efforts and must be consistent with appropriate standards of professional ethics. Academic dishonesty, which includes cheating, plagiarism and other forms of dishonest or unethical behavior, is prohibited. A breakdown of behaviors that constitute academic dishonesty is presented below. The definitions and clarifications are meant to provide additional information and examples of these behaviors. They are not intended to be all-inclusive. Questions regarding this policy or requests for additional clarification can be directed to the Office of Student Life (989-774-3016) or the College of Graduate Studies (989-774-4723).
 
Academic Dishonesty Includes:
Cheating on Examinations
Definition: Cheating is using or attempting to use materials, information, notes, study aids, or other assistance in any type of examination or evaluation which have not been authorized by the instructor.
 
Clarification:
1.      Every direct quotation must be identified by quotation marks or appropriate indentation and must be properly acknowledged by parenthetical citation in the text or in a footnote or endnote.
2.      When material from another source is paraphrased or summarized in whole or in part in one's own words, that source must be acknowledged in a footnote or endnote, or by parenthetical citation in the text.
3.      Information gained in reading or research that is not common professional knowledge must be acknowledged in a parenthetical citation in the text or in a footnote or endnote.
4.      This prohibition includes, but is not limited to, the use of papers, reports, projects, and other such materials prepared by someone else.
Fabrication, Forgery and Obstruction
Definition: Fabrication is the use of invented, counterfeited, altered or forged information in assignments of any type including those activities done in conjunction with academic courses that require students to be involved in out-of-classroom experiences. Forgery is the imitating or counterfeiting of images, documents, signatures, and the like. Obstruction is any behavior that limits the academic opportunities of other students by improperly impeding their work or their access to educational resources.
 
Clarification:
1.      Fabricated or forged information may not be used in any laboratory experiment, report of research, or academic exercise. Invention for artistic purposes is legitimate under circumstances explicitly authorized by an instructor.
2.      Students may not furnish to instructors fabricated or forged explanations of absences or of other aspects of their performance and behavior.
3.      Students may not furnish, or attempt to furnish, fabricated, forged or misleading information to university officials on university records, or on records of agencies in which students are fulfilling academic assignments.
4.      Students may not steal, change, or destroy another student's work. Students may not impede the work of others by the theft, defacement, or mutilation of resources so as to deprive others of their use.
Multiple Submission
Definition: Multiple submission is the submission of the same or substantially the same work for credit in two or more courses. Multiple submissions shall include the use of any prior academic effort previously submitted for academic credit at this or a different institution. Multiple submissions shall not include those situations where the prior written approval by the instructor in the current course is given to the student to use a prior academic work or endeavor.
 
Clarification:
1.      Students may not normally submit any academic assignment, work, or endeavor in more than one course for academic credit of any sort. This will apply to submissions of the same or substantially the same work in the same semester or in different semesters.
2.      Students may not normally submit the same or substantially the same work in two different classes for academic credit even if the work is being graded on different bases in the separate courses (e.g., graded for research effort and content versus grammar and spelling).
3.      Students may resubmit a prior academic endeavor if there is substantial new work, research, or other appropriate additional effort. The student shall disclose the use of the prior work to the instructor and receive the instructor's permission to use it PRIOR to the submission of the current endeavor.
4.      Students may submit the same or substantially the same work in two or more courses with the prior written permission of all faculty involved. Instructors will specify the expected academic effort applicable to their courses and the overall endeavor shall reflect the same or additional academic effort as if separate assignments were submitted in each course. Failure by the student to obtain the written permission of each instructor shall be considered a multiple submission.
Complicity
Definition: Complicity is assisting or attempting to assist another person in any act of academic dishonesty.
 
Clarification:
1.      Students may not allow other students to copy from their papers during any type of examination.
2.      Students may not assist other students in acts of academic dishonesty by providing material of any kind that one may have reason to believe will be misrepresented to an instructor or other university official.
3.      Students may not provide substantive information about test questions or the material to be tested before a scheduled examination unless they have been specifically authorized to do so by the course instructor. This does not apply to examinations that have been administered and returned to students in previous semesters.
Misconduct in Research and Creative Endeavors
Definition: Misconduct in research is serious deviation from the accepted professional practices within a discipline or from the policies of the university in carrying out, reporting, or exhibiting the results of research or in publishing, exhibiting, or performing creative endeavors. It includes the fabrication or falsification of data, plagiarism, and scientific or creative misrepresentation. It does not include honest error or honest disagreement about the interpretation of data.
 
Clarification:
1.      Students may not invent or counterfeit information.
2.      Students may not report results dishonestly, whether by altering data, by improperly revising data, by selective reporting or analysis of data, or by being grossly negligent in the collecting or analysis of data.
3.      Students may not represent another person's ideas, writing or data as their own.
4.      Students may not appropriate or release the ideas or data of others when such data have been shared in the expectation of confidentiality.
5.      Students may not publish, exhibit, or perform work in circumstances that will mislead others. They may not misrepresent the nature of the material or its originality, and they may not add or delete the names of authors without permission.
6.      Students must adhere to all federal, state, municipal, and university regulations for the protection of human and other animal subjects.
7.      Students may not conceal or otherwise fail to report any misconduct involving research, professional conduct, or artistic performance of which they have knowledge.
8.      Students must abide by the university's Policy on Research Integrity where applicable, which can be found under Policies at the following web address: www.orsp.cmich.edu.
Computer Misuse
Definition*: Misuse of computers that is disruptive, unethical, or illegal use of the university's computer resources, including any actions which violate the university's Rules for Computing and Networking Resources. Misuse of computers also includes disruptive, unethical, or illegal use of the computers of another institution or agency in which students are performing part of their academic program.
 
Clarification:
1.      Students may not use the university computer system in support of any act of plagiarism.
2.      Students may not monitor or tamper with another person's electronic communications.
3.      Students may not use university computer resources to engage in illegal activity, including but not limited to the following: illegally accessing other computer systems, exchanging stolen information, and violating copyright agreements which involve software or any other protected material.
 
*For the CMED program, the Computer Misuse definition also refers to all social media use, including, but not limited to Facebook and Twitter. CMED follows the AMA policy, "Opinion9.124 - Professionalism in the Use of Social Media", based on the report," Professionalism in the Use of Social Media," adopted November 2010. Please refer to the following link: http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9124.page.
Misuse of Intellectual Property
Definition: Misuse of intellectual property is the illegal use of copyright materials, trademarks, trade secrets or intellectual properties.
 
Clarification:
1.      Students may not violate the university policy concerning the fair use of copies. This can be found under Policies at the following web address: www.orsp.cmich.edu.
 
Ethical and Professional Behavior
Students are expected to adhere to the ethical and professional standards associated with their programs and academic courses. Such standards are generally communicated to students by instructors and are available through publications produced by professional organizations. Unethical or unprofessional behavior will be treated in the same manner as academic dishonesty.
Policy on Standards of Conduct for the Teacher-Learner Relationship/ Mistreatment of Students

Statement of Philosophy
CMED is committed to creating an environment that promotes academic and professional success in students and teachers at all levels. This success is dependent on an environment free of behaviors that can undermine the important missions of our institution. An atmosphere of mutual respect, collegiality, fairness, and trust is essential. Although both teachers and students bear significant responsibility in creating and maintaining this atmosphere, teachers bear particular responsibility for modeling appropriate professional behaviors. Teachers must be mindful of this responsibility in their interactions with their colleagues, their patients, and those whose education has been entrusted to them. The expectations of the conduct of students and faculty regarding the teacher-learner relationship fall under the responsibilities regarding professionalism that are outlined in the faculty bylaws and the student handbook.  Expectations of faculty and students conduct are included in the faculty bylaws and the CMED Student Handbook, and include a requirement that all students and faculty abide by the policies set forth in the AAMC's Teacher-Learner Compact.
 
Responsibilities in the Teacher/Learner Relationship
CMED will follow the guidelines of the AAMC Teacher-Learners Compact, see https://www.aamc.org/initiatives/residentcompact/. The language has been adapted for use with both medical students and residents, who are designated as 'learners' and 'physicians-in-training.' Features of the program include the following:
Commitments of Faculty – CMED Faculty will:
2.1      Maintain the highest standards of care, respect the needs and expectations of patients, and embrace the contributions of all members of the health care team as role models for learners;
2.2      Use the utmost effort to ensure that all components of the educational program for physicians-in-training are of high quality, including individual faculty contributions as teachers;
2.3      Fulfill the responsibility to nurture both the intellectual and the personal development of learners, committing to foster academic excellence, exemplary professionalism, cultural sensitivity, and demonstrate a commitment to maintaining competence through life-long learning;
2.4      Demonstrate respect for all learners as individuals, without regard to gender, race, national origin, religion, disability or sexual orientation; and will cultivate a culture of tolerance among the entire staff;
2.5      Ensure physicians-in-training have opportunities to participate in patient-care activities of sufficient variety and with sufficient frequency to achieve the competencies required by their chosen discipline. CMED faculty will ensure that learners are not assigned excessive clinical responsibilities and are not overburdened with services of little or no educational value;
2.6      Provide physicians-in-training with opportunities to exercise graded, progressive responsibility for the care of patients, so students learn how to practice their specialty and recognize when, and under what circumstances, to seek assistance from colleagues and prepare physicians-in-training to function effectively as members of health care teams;
2.7      Ensure learners receive appropriate supervision for all of the care they provide during their training;
2.8      Evaluate each learner's performance on a regular basis, provide appropriate verbal and written feedback, and document achievement of the competencies required to meet all educational objectives;
2.9      Ensure learners have opportunities to partake in required conferences, seminars and other non-patient care learning experiences and that they have sufficient time to pursue the independent, self-directed learning essential for acquiring the knowledge, skills, attitudes, and behaviors required for practice; and
2.10    Nurture and support residents in their role as teachers of residents and medical students.
Commitments of Learners – CMED Learners will:
2.11    Acknowledge our fundamental obligation as physicians—to place our patients' welfare uppermost; quality health care and patient safety will always be our prime objectives;
2.12    Pledge our utmost effort to acquire the knowledge, clinical skills, attitudes and behaviors required to fulfill all objectives of the educational program and to achieve the competencies deemed appropriate for our chosen discipline;
2.13    Embrace the professional values of honesty, compassion, integrity, and dependability;
2.14    Adhere to the highest standards of the medical profession and pledge to conduct ourselves accordingly in all interactions. We will demonstrate respect for all patients and members of the health care team without regard to gender, race, national origin, religion, economic status, disability or sexual orientation;
2.15    Understand the need for faculty to supervise all our interactions with patients and, as physicians- in-training, learn most from being involved in the direct care of patients and from the guidance of faculty and other members of the health care team;
2.16    Accept our obligation to secure direct assistance from faculty or appropriately experienced residents whenever we are confronted with high-risk situations or with clinical decisions that exceed our confidence or skill to handle alone;
2.17    Welcome candid and constructive feedback from faculty and all others who observe our performance, recognizing that objective assessments are indispensable guides to improving our skills as physicians;
2.18    Provide candid and constructive feedback on the performance of our fellow residents, of students, and of faculty, recognizing our life-long obligation as physicians to participate in peer evaluation and quality improvement;
2.19    Recognize the rapid pace of change in medical knowledge and the consequent need to prepare ourselves to maintain our expertise and competency throughout our professional lifetimes; and
2.20    Fulfill our own obligations as professionals. We pledge to assist both medical students and fellow residents in meeting their professional obligations by serving as their teachers and role models.
 
Compact
This compact serves both as a pledge and as a reminder to resident physicians and their teachers that their conduct in fulfilling their obligations to one another is the medium through which the profession perpetuates its standards and inculcates its ethical values.
 
Mistreatment of Students
Process of Review
The faculty handbook provides the review process which is included here: Any learner who feels he/she has witnessed or has been the subject to conduct outside of a respectful teacher/staff – learner relationship including discrimination, harassment, or abuse should submit their concern. To submit a concern anonymously, click here. To submit a concern without remaining anonymous, email CMEDsecure@cmich.edu or discuss the report or alleged violation with one of the following individuals:
    Associate Dean of Student Affairs
    Associate Dean of Medical Education
    Dean of CMED
    small group facilitators (faculty)
    Course directors
    Clerkship directors
    Preceptors
    CMU Human Resources
    Research Advisor
 
These individuals may intervene in an informal fashion to provide feedback to faculty members with the goal of improving the teacher-learner interaction and the learning environment. If the course director or either of the Associate Deans identifies, through an initial investigation, the possibility of faculty misconduct that may represent a violation of the Standards of Conduct for the Teacher-Learner Compact or CMU policies have been violated, a formal review will be immediately initiated following the procedures outlined in the CMED Bylaws and Faculty Handbook.   If the severity of the conduct clearly violates the expectations for the performance of faculty as outlined in the faculty bylaws, the chair of the faculty member's discipline will be asked to review information related to the incidents. Possible outcomes include warnings, formal sanctions (resulting in a letter that will remain in the faculty member's file for the purposes of monitoring and documentation), or faculty dismissal and/or non-renewal of the faculty contract.
 
In any event, if the conduct is of a criminal nature the CMU Police or other appropriate law enforcement officials will be contacted immediately: https://www.cmich.edu/about/emergency_safety/police/Pages/default.aspx   
 
In addition, students are encouraged to report possible sexual, racial, or ethnic discrimination, including harassment to the CMU Office of Civil Rights and Institutional Equity: https://www.cmich.edu/office_president/OCRIE/Pages/default.aspx
Student Misconduct
Personal conduct and professional behavior are among the competencies assessed for all CMED courses and are among the benchmarks for recommendation of the SPCC for student promotion.
5.1       CMU's General Regulations Concerning Student Conduct are published annually in Section 3.1, Appendix II of the CMU Graduate Bulletin.
5.2       At CMED, misconduct may be in the area of academic misconduct (e.g., plagiarism, cheating, etc.), professional misconduct (e.g., failure to respect patient confidentiality, misuse of a computer information system, misuse of an on-call room, etc.), or personal misconduct (e.g., assault, harassment, other potentially criminal activity, etc.).  The Student Performance and Conduct Committee (SPCC) has the responsibility for dealing with all categories of Student Performance. Specific definitions for misconduct are published annually in the CMU Graduate Bulletin, Policy on Academic Integrity.
 
           
CMED allegations are subject to SPCC review procedures
 
5.3       Alleged Student Misconduct
 
5.3.1 Anonymous complaints will be considered to the extent possible but may not result in any formal action. Complaints can be made by clicking here.
                    
         Complaints may be made to the Course Director or Clerkship Director in writing, orally, or by email. When a complaint is received by someone other than these, it shall be referred to the Course Director or Clerkship Director for review. Each complaint will be addressed on a case by case basis.
        
         Praise and Concern cards may be filed as hard copy or electronically via CMEDsecure@cmich.edu.  Hard copies of the praise and concern cards will also be available in the student lounge in the CMED building, in the Office of Student Affairs, and on East Campus in the medical education office. They can be returned in a drop box in the CMED student lounge and medical education office on East campus.
 
         The person alleging misconduct may contact either the SPCC or the Office of Student Affairs, who will advise the individual in bringing the issue to the SPCC.  Conduct issues will be addressed by the SPCC, please refer to Part 1.3 under Student Promotion, Review, and Remediation Policy in Section Two: Academic Programs (Note: Potential criminal misconduct should be reported to the proper legal authorities).
        
         Once complaints are made via online cards, orally, or verbally, the person (first point of contact) receiving the complaint information will fill out a complaint form and submit it to the Office of Student Affairs for tracking purposes; ie date of initiation, complaint itself, persons involved, next steps/resolution, if any.
5.3.2 The process for review/reconsideration of allegations will follow the procedures outlined in Section 4.0 of the Student Promotion, Review, and Remediation Policy found in section three of this handbook.
 
PRAISE CARD
Faculty/Preceptor/Student/Staff Name:___________________________________________ Date:_____________________
I am documenting the following excellent behavior displayed by the above named CMED faculty member/ student/staff. I believe they should be recognized as an excellent role model.
 
__________________________________________________________
 
CONCERN CARD
Faculty/Preceptor/Student/Staff Name:___________________________________________ Date:_____________________
I am documenting the following unprofessional behavior displayed by the above named CMED faculty member/student/staff. I believe they displayed behavior unacceptable for a professional role model.
 
__________________________________________________________
Chemical Impairment
As the CMED Technical Standard of Professionalism describes in the Student Handbook Section Two: Standards, Conduct, and Professionalism, sobriety is expected in all academic and clinical environments.
Chemical impairment is considered an inability to perform the duties fully expected of medical students due to the acute or chronic use/abuse of alcohol or drugs, including inappropriate use/abuse of prescription drugs.
 
CMED staff and faculty believe healthy medical students learn and prosper in their profession and life. We want to assist our students in creating a life balance that carry them through and beyond medical school. Challenges to this may surface on occasion, including issues dealing with illicit substances. CMED and the Office of Student Affairs want students to be aware they are not alone in dealing with these issues and referral resources are available to them both on and off campus.
 
Educational programs and resource information will be posted and made available through the Office of Student Affairs. CMU and community resources include, but are not limited to, University Health Services, CMU Counseling office, and Addiction Solutions. Students with any specific concerns are encouraged to meet with the Assistant Dean of Student Affairs.  Discussions will be confidential and, depending on the circumstances, efforts will be made to assist the student with continuation of their schooling. 
 
Chemically impaired students who have not sought or are receiving assistance currently will be immediately referred to the SPCC for violation of professional conduct.
Diversity
CMU
A diverse campus community is inclusive of different backgrounds, religions and cultures, as well as a diversity of opinions. Central Michigan University welcomes and promotes the rich tapestry of humanity - taking the collective talent and knowledge of a diverse body of students from all walks of life to make the world a better place in which to live, work, play and prosper with dignity and respect for the world in which we live. Diversity prepares CMU students to compete and live in a global economy and a global village. It reflects the university's mission of providing student-centered education and fostering personal and intellectual growth to prepare students for productive careers, meaningful lives, and responsible citizenship in a global society.
 
This mission and commitment to a welcoming and inclusive environment is achieved through the Office for Institutional Diversity and the Office of Civil Rights and Institutional Equity. The Office for Institutional Diversity (OID) periodically assesses the institution's long-term diversity goals. Through its offices and services, OID offers campus-wide programs and activities for students, faculty, and staff that foster better understanding across diverse groups. Programs and activities include:
        4S Pathways to Academic Student Success program;
        MI GEAR UP;
        Native American Programs Office;
        Office of Lesbian Gay Bisexual Transgender Queer Services;
        Office of Diversity Education;
        Office of Multicultural Academic Student Services;
        Student Transition Enrichment Program; and
        Upward Bound.
 
The Office of Civil Rights and Institutional Equity coordinates and monitors CMU's affirmative action/equal opportunity efforts and programs to assure compliance with the Americans with Disabilities Act, Title VII of the 1964 Civil Rights Act, Executive Order 11246, and other relevant state and federal statutes. The office supervises the maintenance of related reports and records, and provides and develops related educational programs and materials. The office also offers guidance and advice to all community members on the university's nondiscrimination and affirmative action policies and procedures, assists departments with recruitment and retention activities, and receives and resolves complaints of discrimination from students, employees, and others.
 
In particular, five goals or actions articulated in the mission statement directly address the importance of diversity at Central Michigan University:
1.      Encourage the practice of values pertaining to professionalism, character and citizenship, including concern for the welfare of humanity, dedication to public service and awareness of the social issues confronting a diverse global society.
2.      Provide support services and a physical environment that foster student success.
3.      Offer co-curricular activities that enhance intellectual, cultural, social, ethical, physical and emotional development and participation of students in Division I-A athletics.
4.      Create and nurture an environment that attracts and retains students, faculty and staff who embody and promote cultural, racial and global diversity.
5.      Provide educational experiences and programs to enhance mutual trust, respect, understanding and sense of community with people from all backgrounds and cultures and to ensure an international and global perspective.
 
 
CMED
CMED believes in the importance of diversity. It has contributed to the strength of our state and country and the we seek a diverse student body, faculty, and staff. CMED embraces the AAMC definition of diversity, which includes racial and ethnic diversity, socioeconomic diversity, gender diversity, diversity in sexual orientation, and geographic diversity: https://www.aamc.org/initiatives/diversity
 
These diversities are key to CMED's success in creating a strong learning environment. Our program will train students to practice and provide culturally competent and responsive care for all patients.
CMU Board of Trustees' Nondiscrimination Policy
Central Michigan University is an affirmative action/equal opportunity institution. It encourages diversity and provides equal opportunity in education, employment, all of its programs, and the use of its facilities. It is committed to protecting the constitutional and statutory civil rights of persons connected with the university.
 
Unlawful acts of discrimination or harassment by members of the campus community are prohibited.
 
In addition, even if not illegal, acts are prohibited if they discriminate against any university community member(s) through inappropriate limitation of access to, or participation in, educational, employment, athletic, social, cultural, or other university activities on the basis of age, color, disability, gender, gender identity/gender expression, genetic information, height, marital status, national origin, political persuasion, race, religion, sex, sexual orientation, veteran status, or weight. Limitations are appropriate if they are directly related to a legitimate university purpose, are required by law or rules of associations to which the Board of Trustees has determined the university will belong, are lawfully required by a grant or contract between the university and the state or federal government. Limitations of current facilities related to gender identity/gender expression are excluded from this policy.
 
The president is directed to promulgate practices and procedures to realize this policy. The procedures shall include the identification of an office to which persons are encouraged to report instances of discrimination and a process for the investigation and resolution of these reports/complaints.
 
CMED Honor Code
 
This section will be written by the inaugural class of CMED.