4.08 Policy and Procedures for Consideration of Unprofessional Conduct

 

Conduct inappropriate to the medical profession is behavior that raises serious doubts about the integrity, character, and faithfulness of a student in meeting the obligations of a medical career. Illegal, unethical or other behavior inappropriate to the medical profession that is engaged in by a student outside of the Medical School community may also be considered and addressed under these procedures. It is the expectation of the Medical School that all students, whether or not they are on campus or are currently enrolled as degree candidates, will behave in a mature and responsible manner. This expectation for mature and responsible conduct also encompasses accountability for one’s own well-being, including responsible decision-making regarding physical and mental health. Further, the Medical School expects every student to be familiar with the regulations governing membership in the Harvard community. Because students are expected to show good judgment and use common sense at all times, not all kinds of misconduct or behavioral standards are codified here. See generally Section 4, including Section 4.01: Responsibilities of Teachers and Learners; Section 4.06: Falsification of Admissions Application; Section 4.09: Academic Dishonesty and Plagiarism; Section 4.17: Financial Aid Fraud; Section 4.18: Patient Confidentiality and HIPAA; Section 4.19: Harvard University Sexual and Gender-Based Harassment Policies; and Section 7.21: University-Wide Statement on Rights and Responsibilities.

When information suggesting the possibility that a student has engaged in conduct inappropriate to the medical profession is brought to the attention of the Dean for Medical Education, the Dean for Students, the Academic Society Advisory Dean, or the Promotion and Review Board (PRB), the PRB will take up the matter formally. Where the health, safety, or welfare of students, patients or other members of the Medical School community is deemed to be at risk, the Dean for Medical Education will suspend the student from the Medical School or take any other protective action pending the outcome of these procedures.

When information suggesting the possibility of conduct inappropriate to the medical profession implicates the rules and functions of the PRB the matter will ordinarily be handled by the PRB. When a student’s behavior raises both academic and professional conduct concerns, ordinarily the matter will be handled under the Procedures for Consideration of Unprofessional Conduct.

In all such cases, however, to the extent that the allegations implicate the University’s policies on sexual and gender-based harassment and other sexual misconduct, they shall be handled under the associated University grievance procedures as set forth below; copies of these policies and procedures can be found here on the website of the University’s Title IX Office

When a student is simultaneously a candidate for a degree in another Harvard faculty, administrative leadership from the Medical School, ordinarily the Dean for Medical Education or the Dean for Students, will consult with that faculty to decide which faculty will take primary responsibility for resolving the question of unprofessional conduct and will determine a common action before advising the student. When further action by the Faculty of Medicine is required, the student and his/her/their Advisory Dean will be notified in writing.

 

For allegations of sexual and gender-based harassment or other sexual misconduct

Harvard Medical School has adopted the University-wide Interim Title IX Sexual Harassment Policy and Interim Other Sexual Misconduct Policy. In addition, the University’s Sexual and Gender Based Harassment policy addresses sexual harassment and other sexual misconduct alleged to have occurred between September 2, 2014, and August 14, 2020. Copies of all policies and their associated grievance procedures can be found here. In all such cases, the Harvard University Office for Dispute Resolution (“ODR”) and the Harvard University Title IX Office are responsible for implementing the University’s grievance procedures, which will determine whether a student committed a policy violation. HMS remains responsible for student discipline through the PRB. All members of the PRB will receive appropriate training in the handling and resolution of allegations of sexual or gender-based harassment.

When the PRB learns that a formal complaint has been filed with ODR, a PRB representative will meet with the respondent to explain, among other things, the PRB disciplinary process and how it relates to the grievance procedures implemented by the ODR and the Harvard University Title IX Office, the range of disciplinary sanctions, and the appeals process following the imposition of any discipline. The PRB representative also will be available to meet with the complainant.

Whenever a formal complaint of sexual harassment or other sexual misconduct is investigated and the University’s grievance procedures result in a determination that a student is responsible for a violation of policy, the PRB must accept that determination of responsibility as final and non-reviewable and disciplinary proceedings against the student will proceed with the understanding that it carries the same validity as a determination reached by the PRB itself. The only opportunity to appeal the determination of responsibility for a policy violation is provided within the grievance procedures implemented by the ODR and the Harvard University Title IX Office. The PRB may interview the student and may undertake any other action it deems necessary to arrive at its conclusions, including consulting with senior faculty or administrators at the University when it feels additional expertise or advice would be useful. The complainant will have the option of meeting with the PRB, but is not required to do so. The role of the PRB is solely to determine the appropriate disciplinary response. The PRB may take a number of disciplinary actions, including probation, with or without requirements or restrictions; suspension; and requirement to withdraw, with or without a recommendation to dismiss or expel. Whenever a formal complaint of sexual harassment or other sexual misconduct is investigated and the University’s grievance procedures do not result in a determination that a student is responsible for a violation of policy, the PRB will review the factual findings resulting from the University’s grievance procedures. Should the PRB conclude that the alleged conduct might violate other HMS policies or expectations for conduct, then the PRB will take up the case as set forth below. When a formal complaint of sexual harassment or other sexual misconduct is investigated and the University’s grievance procedures result in a determination that a student is responsible for a violation of policy, an appropriate representative of the Medical School will notify the student and the complainant of the disciplinary decision of the PRB once an outcome has been reached.

Any student who is required to withdraw by the PRB (with or without a recommendation to dismiss or expel) may request in writing that the PRB reconsider its decision to impose discipline. The request for reconsideration must be based on one or both of the following grounds: a procedural error occurred during the PRB’s consideration of the matter that may change the outcome of the decision to impose sanctions; or the student believes the sanctions imposed by the PRB were inappropriate in light of the factual findings and determination of responsibility resulting from the University’s grievance procedures. The request may not challenge the validity of the factual findings or determination of responsibility resulting from the University’s grievance procedures, nor may it introduce facts that could have been presented in the course of the University’s grievance procedures or that conflict with any of those factual findings or the determination of responsibility. The request must be received by the PRB within 10 business days of the student’s receipt of notice of the decision on remedial action or sanction.

If it chooses to reconsider, the PRB may affirm, revise (make more or less severe), or revoke its decision. Written notification of the action on reconsideration will be sent to the student, to his/her/their Society Advisory Dean, and to the HMS Registrar, ordinarily within 10 business days of the meeting at which the request was considered and the decision was rendered. Such notification will constitute the final action of the PRB.

Any student who is required to withdraw (with or without a recommendation to dismiss or expel) and who has requested reconsideration from the PRB may appeal the final action of the PRB to a three-member Appeals Panel designated by the Chair of the Standing Committee on Rights and Responsibilities (SCRR; Section 4.04) in consultation with the Chair of the PRB. All members of the Appeals Panel will receive appropriate training in the handling and resolution of allegations of sexual or gender-based harassment or other sexual misconduct. The student’s appeal must be in writing and must be based on one or both of the following grounds: a procedural error occurred during the PRB’s consideration of the matter that may change the outcome of the decision to impose sanctions; or the student believes the sanctions imposed by the PRB were inappropriate in light of the factual findings and determination of responsibility resulting from the University’s grievance procedures. The appeal may not challenge the validity of the factual findings or determination of responsibility resulting from the University’s grievance procedures, nor may it introduce facts that could have been presented in the course of the University’s grievance procedures or that conflict with any of those factual findings or the determination of responsibility.

The Appeals Panel must receive the appeal within 10 business days of the date of final action by the PRB. The Appeals Panel will hear the student in person and will review the documentary record. The complainant will have the option of meeting with the Appeals Panel, but is not required to do so. The only role of the Appeals Panel is to review the disciplinary actions taken by the PRB; the Appeals Panel will accept as true and non-reviewable the factual findings and determination of responsibility resulting from the University’s grievance procedures. The Appeals Panel will submit a written report of its findings and recommendations to the student and to the Dean for Medical Education, also informing the PRB and the Registrar of the outcome of the appeal. In so doing, the Appeals Panel may affirm, revise (make more or less severe), or revoke the final action of the PRB.

Both the student and the complainant may bring a personal advisor to any interviews with the PRB or the Appeals Panel. A student may be accompanied to any appearance before a reviewing body by a personal advisor who is a member of the student body, faculty, or administrative staff of the Medical School, provided the personal advisor has not had any involvement in the University’s grievance process relating to the complaint. Personal advisors may view a redacted version of any documents provided to the parties and provide general advice. During interviews, personal advisors may not speak for their advisees, although they may ask to suspend the interviews briefly if they feel their advisees would benefit from a short break.

Finally, the student may request review of the decision of the Appeals Panel by the Dean of the Faculty of Medicine. The Dean of the Faculty of Medicine must receive any such request for review within 5 business days of the date of the decision of the Appeals Panel. The Dean of the Faculty of Medicine will review the matter, in consultation with the Dean for Medical Education, the Chair of the PRB, the Chair of the Appeals Panel, or others (e.g., the Faculty Council) at the Dean’s discretion, and will provide a written decision to the student, the student’s Society Advisory Dean, the Dean for Medical Education, the HMS Registrar, and the PRB. The Dean’s decision will be final and binding, except in cases of dismissal or expulsion, in which a two-thirds vote of the Faculty Council is required. The complainant will be notified of the final disciplinary decision.

 

For all other allegations

When, after an initial review of the information suggesting possible inappropriate conduct, further action is deemed necessary by the PRB, the PRB may appoint one or more independent fact-finders. Fact-finders will be Harvard administrators or faculty members drawn from the Medical School or elsewhere. Fact-finders may also be independent contractors engaged by Harvard. The fact-finder(s) will interview the student and may interview other individuals with relevant knowledge, solicit written statements, review the documentary record, and undertake whatever action is required to elucidate the relevant facts. At the conclusion of his/her/their inquiry, the fact-finder(s) will prepare a written report describing the inquiry process and his/her/their findings of fact, identifying any disputed facts. Ordinarily, it is expected that fact-finding will be completed within thirty days, though this timeframe may be extended under extenuating circumstances, including but not limited to complex fact patterns, large numbers of witness interviews, and/or difficulty in scheduling witness interviews. The fact-finder’s report will be submitted to the PRB. The student will also be provided with a copy of the report for the student’s written comments. Any comments must be submitted to the PRB within 10 days of receipt of the fact-finder’s report.
 
The PRB will review the student’s record and current situation in consultation with the student’s Academic Society Advisory Dean and will determine a course of action that may include, but not be limited to, placement in any of the previously indicated structured academic categories (Section 4.03). In matters of consideration of unprofessional conduct, the PRB may also interview the student and may undertake any other action it deems necessary to arrive at its conclusions, including consulting with senior faculty or administrators at the University when it feels additional expertise or advice would be useful. The PRB may take a number of disciplinary actions, including probation, with or without requirements or restrictions; suspension; and requirement to withdraw with or without a recommendation to dismiss or expel.
 
The student will be notified in writing of the decision of the PRB. A copy of such notice will be sent to the student’s Academic Society Advisory Dean, the Dean for Medical Education, the Dean for Students, and the HMS Registrar. The student and/or Society Advisory Dean may be asked to respond to the stated concerns of the PRB.
 
Any student who is required to withdraw by the PRB (with or without a recommendation to dismiss or expel) may request that the PRB reconsider its decision. The request must be in writing and must be based on one or both of the following grounds: a procedural error occurred that may change the outcome of the decision; or the student has substantive and relevant new information that was not available at the time of the PRB’s decision investigation and that may change the outcome of the decision. Disagreement with the PRB’s findings or determination is not, by itself, a ground for appeal. The request must be received by the PRB within 10 business days of the student’s receipt of notice of the decision on remedial action or sanction.
 
If it chooses to reconsider, the PRB may affirm, revise (make more or less severe), or revoke its decision. Written notification of the action on reconsideration will be sent to the student, to his/her/their Society Advisory Dean, and to the HMS Registrar, ordinarily within 10 business days of the meeting at which the request was considered and the decision was rendered. Such notification will constitute the final action of the PRB.
 
Any student who is required to withdraw by the PRB (with or without a recommendation to dismiss or expel) and who has requested reconsideration from the PRB also may appeal the final action of the PRB to a three-member Appeals Panel designated by the Chair of the Standing Committee on Rights and Responsibilities (SCRR; Section 4.04) in consultation with the Chair of the PRB. The student’s appeal must be in writing and must be based on one or both of the following grounds: a procedural error occurred that may change the outcome of the decision; or the student has substantive and relevant new information that was not available at the time of the PRB’s decision investigation and that may change the outcome of the decision. Disagreement with the PRB’s findings or determination is not, by itself, a ground for appeal. The Appeals Panel must receive the appeal within 10 business days of the date of final action by the PRB. The Appeals Panel will hear the student in person and will review the documentary record. The Appeals Panel may adduce and consider any other information it deems useful in reaching a decision. The Appeals Panel will submit a written report of its findings and its decision to the student and to the Dean for Medical Education, also informing the PRB and the Registrar of the outcome of the appeal. In so doing, the Appeals Panel may affirm, revise (make more or less severe), or revoke the final action of the PRB.
 
The student may request review of the decision of the Appeals Panel by the Dean of the Faculty of Medicine. The Dean of the Faculty of Medicine must receive any such request for review within 5 business days of the date of the decision of the Appeals Panel. The Dean of the Faculty of Medicine will review the matter, in consultation with the Dean for Medical Education, Academic Society Advisory Dean, or others (e.g., the Faculty Council) at the Dean’s discretion, and will provide written notice of his/her/their decision to the student, the student’s Society Advisory Dean, the Dean for Medical Education, the HMS Registrar, and the PRB. The Dean’s decision will be final and binding, except in cases of dismissal or expulsion in which a two-thirds vote of the Faculty Council is required.
 

Withdrawal or Leave of Absence during Pendency of a Disciplinary Proceeding

The transcripts of students who are placed on a leave of absence from the MD program pending the outcome of disciplinary proceedings will contain an appropriate notation. Students who have been required to withdraw (with or without a recommendation to dismiss or expel) are not permitted to be enrolled while any request for reconsideration or appeal is pending; the transcripts of such students will contain an appropriate notation.
 

Procedure on Unprofessional Student Comments in Course Surveys

Harvard Medical School regularly solicits student feedback on various aspects of the curriculum in order to improve the educational experience for all students. To that end, we ask that, for all core courses, students provide feedback that is candid, constructive, and critical. This is done via an electronic course survey process that ensures complete confidentiality, and all course surveys and accompanying comments are withheld from course directors until after the course grades have been submitted to the Registrar.
 
In certain rare cases, however, comments from students cross a clear line from critical to offensive, while possessing no redeeming constructive value. Because these comments are made available to the individual faculty member as well as to a number of educational professionals at HMS, including the chair of the instructor’s appointing department, unprofessional comments have the potential to inflict real harm on an individual faculty member, which violates a key tenet of the medical profession.
 
For this reason, the Curriculum Committee (the precursor to the Educational Policy and Curriculum Committee/EPCC) voted to establish a process that will ensure the continued integrity and confidentiality of the course survey process while providing an outlet to address the rare abuses that occur within the system.
 
In order to achieve this goal, a joint ad hoc committee comprised of three students and two academic society advisory deans will be established to review any comment on a course survey deemed to be unprofessional by a course director, instructor, or official in the Office of Educational Quality Improvement (OEQI). To ensure that students on this committee represent the will of the student body, student members of this committee will be either elected student representatives to the EPCC or other curriculum governance committee or other students who hold elective office, e.g., the Student Council Executive Committee. If a majority of the ad hoc committee agrees that the comment does indeed constitute unprofessional conduct, the OEQI will authorize the HMS Information Technology department to override the confidentiality protections and identify the responsible student. This information will be provided exclusively to the student’s Society Advisory Dean, who will determine the appropriate response. The comment will also be redacted from the course survey record.
 

Last updated 5/28/2021