Doctor of Medicine (M.D.)
This catalog is a general information publication only. It is not intended to nor does it contain all policies and procedures relevant to students enrolled in the Joe R. and Teresa Lozano Long School of Medicine (Long SOM). Current Long SOM students are to refer to the M.D. Degree Handbook posted in their CANVAS class cohort site (login required) for full program policies and detailed procedures.
This publication is for informational purposes and does not constitute a contract, either expressed or implied. The Long SOM reserves the right to change any provision or requirement at any time without notice in order to ensure compliance with accreditation standards.
Policy revisions made after publication of the official UT Health San Antonio Catalog will be disseminated to students by email and posted to CANVAS class cohort sites. Students are accountable to policies herein, those in the M.D. Degree Handbook, updates posted in CANVAS, and revisions sent by email.
Notice of Nondiscriminatory Policy
The Long SOM, in compliance with applicable federal laws and regulations, and the Health Science Center Handbook of Operating Procedures, Policy 4.2.1, does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, citizenship, genetic information, sexual orientation or veteran status in any of its policies, practices or procedures.
Admission requirements are detailed online at the Long SOM, Admissions & Outreach website. Applicants must have at least 90 semester hour credits from a United States or Canadian college or university with no grade lower than a C in required course work. While not required at this time, a bachelor’s degree is preferred. Web-based applications are available through the Texas Medical and Dental Schools Application Service (TMDSAS) in Austin. Applicants must take the Medical College Admission Test (MCAT), the CASPer (Computerized Assessment Sample of Personal Characteristics), and submit other required documents to the TMDSAS, such as letters of recommendation and transcripts, in order to have a complete application. Refer to the TMDSAS to obtain the most current specific information about application instructions, and important dates and deadlines. Temporary modifications due to special circumstances (e.g. COVID-19 pandemic) will be found on the Long SOM and TMDSAS websites.
Acceptance & Education Requirements
The Long SOM Admissions Committee uses a holistic review process to assess each and every application. Balanced consideration is given to experiences, attributes, and academic metrics, and consideration is given to how the individual might contribute value as a medical student and physician. The Long SOM Admissions Committee evaluates each candidate’s application to assess these elements of the holistic review and values evidence of academic strength, broad and varied experiences in healthcare, leadership and community service, and the development of an applicant’s personal attributes. Demonstration of integrity, maturity, motivation, judgment, resilience and resourcefulness is also of value. The personal interview is a required component of the application process, invitations for which are issued by the Long SOM Admissions Committee.
Only applicants who are American citizens or possess official status as Permanent Residents of the U.S. can be considered for interview and acceptance at this time.
Applicants are encouraged to review the Factors Considered for Applicant Interview and Acceptance. All candidates must meet the required Technical Standards for Completion of the Medical Curriculum. The Long SOM is committed to nondiscrimination policies for all populations including qualified individuals with disabilities. Please refer to Health Science Center Handbook of Operating Procedures Policy 4.2.1. Nondiscrimination Policy and Complaint Procedure.
The Long SOM may offer early acceptances during the TMDSAS pre-match period from October through December. Other candidates may be accepted through the TMDSAS Match process, results of which are available on the TMDSAS website on February 1. Acceptances may also be offered after the TMDSAS Match, from February through mid July. An applicant receiving an offer of acceptance will be requested to show acknowledgement of the offer of acceptance, usually within two weeks of receipt of acceptance, through the Long SOM admissions software portal. The interview selection process allows for review and re-review throughout the admissions cycle until the TMDSAS Match; applicants who did not receive an interview will be notified of their status in January prior to the Match.
Matriculation is contingent upon satisfactory completion of all requirements, as outlined on the TMDSAS website, on the admissions website, and the Pre-matriculation Checklist for newly accepted students, which includes a background check review (see Medical Student Background Check Policy), submission of final transcripts, completion of the proposed degree plan, satisfactory completion of all prerequisite coursework, and presence at required matriculation events such as White Coat Ceremony and Orientation.
Medical Student Background Check Policy
Applicants who have received an offer of acceptance must satisfactorily complete a background check as a condition of matriculation to the Long SOM. An offer of acceptance will not be final until a review of the background check is performed and satisfactory results are recorded. Admission may be denied or rescinded based on the review of the background check.
Additionally, students who are currently enrolled may have to satisfactorily complete a background check as a condition to enrolling or participating in educational experiences at affiliated clinical sites as required. Students who return from a year of deferred acceptance or leave of absence may also be required to complete a background check, with subsequent review. Students who decline to complete the background check or do not pass the background check review may be dismissed from the medical education program.
Falsification of information, including omission of relevant information, may result in denial of admission or dismissal from the educational program. Refer to the full background check policy for more detail.
Transfer or Advance Standing Applications
The Long SOM does not accept transfer students into the Doctor of Medicine (M.D.) degree program.
Individuals whose graduate work has been in the field of dentistry may apply for advanced standing through the MD/Oral-Maxillofacial Surgery Certificate Program.
Scholarship assistance may be available to students of the Long SOM. Scholarships are awarded based on need, merit, or a combination of both. The Long SOM determines the selection of scholarships based on criteria established by the donor. Scholarships may be renewable depending upon academic performance and/or stated scholarship conditions.
Students can apply for scholarships online through the student portal administered by the Office of Financial Aid and Veterans Affairs. Students must first file the Free Application for Federal Student Aid (FAFSA) in order to be considered for scholarships. The Long SOM Admissions Scholarship Committee makes recommendations for selection of candidates for scholarships to first time matriculants and the Long SOM Scholarship Committee makes recommendations for awards to current students. These recommendations are forwarded to the Office of Financial Aid and Veterans Affairs for processing to student accounts. If the student receives a scholarship, after he/she has been fully awarded, the Office of Financial Aid and Veterans Affairs may need to reduce other aid on the account in order to prevent an over-award of federal funds. Learn more on the Office of Financial Aid and Veterans Affairs Scholarship website.
The degree of Doctor of Medicine (M.D.) is awarded by the Board of Regents upon a student’s successful completion of the degree requirements, recommendation by the Student Progression & Promotion Committee to the Dean of the Long SOM, and certification by the Dean of the Long SOM to the President of UT Health San Antonio.
- be at least 18 years of age at the time the degree is awarded;
- present evidence of good moral character;
- offer evidence of having satisfactorily fulfilled all academic requirements of the four year medical education program;
- comply with all necessary legal and financial requirements.
The acronym CIRCLE (Curricular Integration, Researchers, Clinicians, Leaders, Educators) represents the integrated four-year medical school education program which is described briefly below.
The foundational 19-month curriculum is taught in ten learning modules and three longitudinal modules. Within each module there is progression of knowledge in a systematic fashion as follows: normal structure and function, pathogenesis and pathophysiology of the condition or disorder, clinical manifestations of the condition or disorder, pharamacotherapeutic interventions for the condition or disorder, clinical and translational research and evidence-based medicine approach for the condition or disorder, epidemiology or prevention of the condition or disorder, and interpretation of diagnostic tests. Each module has a weekly thematic content which is synthesized via a small group interactive patient case.
- Molecules to Medicine
- Attack and Defense
- Respiratory Health
- Renal and Male Reproductive
- Mind, Brain, and Behavior
- Endocrine/Female Reproductive
- Digestive Health and Nutrition
- Form and Function: Skin, Muscles, and Bones
- Medicine, Behavior, and Society
- Clinical Skills
- Language of Medicine
Following successful completion of the entire preclinical curriculum students enter the clinical curriculum. This is comprised of 48 weeks of clerkships, 20 weeks of electives, 8 weeks of selectives, and 4 weeks of didactics.
Students must complete 48 weeks of clerkships in eight specialties. Students will complete four-week clerkships for Emergency Medicine and Neurology; six-week clerkships for Family Medicine, Obstetrics & Gynecology, Pediatrics, and Psychiatry; and eight-week clerkships for Medicine and Surgery. Each student will assume increasing patient care responsibility commensurate with achievement of specific milestones and competencies defined by the Curriculum Committee. A longitudinal educational experience will be provided throughout the clerkships to cover topics that are relevant to all disciplines.
Electives and selectives expose students to additional medical specializations and/or allow the student to return to a core specialty with advanced duties and responsibilities. Students may begin electives following the completion of the preclinical curriculum. Selectives can be taken after the completion of the clerkships, and consist of a four-week inpatient selective and a four-week ambulatory selective. Third-year elective experiences allow students to explore other specialties and subspecialties or engage in research before fourth year while still consolidating core knowledge and skills.
MD Degrees with Distinction
The Long SOM offers additional distinction programs that a student can pursue while maintaining satisfactory achievement in the medical education program. Learn more about each by visiting the program’s website.
- M.D. with Distinction in Research
- M.D with Distinction in Medical Education
- M.D with Distinction in Medical Humanities
Alpha Omega Alpha Honor Medical Society
Alpha Omega Alpha (AOA) Honor Medical Society is a national professional organization whose aims are the “promotion of scholarship and research in medical schools, the encouragement of a high standard of character and professionalism among medical students and graduates, and the recognition of high attainment and service in medical science, patient care, and related fields”.
Election is based on academic excellence, and on activities and achievements that promote the values of AOA. The top 25 percent of the graduating medical school class is eligible for nomination to the society. From this top quartile of students, up to one-sixth of the class may be elected to the society based on academic achievement, leadership, character, community service, and professionalism. Students may be chosen in the third or fourth year.
Gold Humanism Honor Society
The Gold Humanism Honor Society, sponsored by the Arnold P. Gold Foundation, recognizes students who best exemplify and manifest humanism in their interactions with patients, peers, faculty, and community. Additionally, elected students demonstrate excellence in clinical care, leadership, compassion and dedication to service. Society membership participates in a community service project that is formulated by the group.
Sample Plans of Study:
The tables below represent courses the students will take in their preclinical and clinical years.
|CIRC 5001||Medicine, Behavior and Society Longitudinal Module||6|
|CIRC 5003||Language of Medicine Longitudinal Module||5.4|
|CIRC 5005||Clinical Skills Longitudinal Module||14.75|
|CIRC 5007||Molecules to Medicine||9|
|CIRC 5009||Attack and Defense||9|
|CIRC 5013||Respiratory Health||4|
|CIRC 5015||Renal and Male Reproductive||5|
|CIRC 6007||Mind, Brain and Behavior||9|
|CIRC 6009||Endocrine and Female Reproductive||7|
|CIRC 6011||Digestive Health and Nutrition||7|
|CIRC 6013||Form and Function: Skin, Muscles & Bones||7.5|
|Total Credit Hours||91.65|
|INTD 3030||Clinical Foundations||3|
|MEDI 3105||Medicine Clerkship||8|
|SURG 3005||Surgery Clerkship||8|
|FMED 3005||Family Medicine Clerkship||6|
|OBGY 3005||Obstetrics/Gynecology Clerkship||6|
|PEDI 3005||Pediatrics Clerkship||6|
|PSYC 3005||Psychiatry Clerkship||6|
|EMED 3005||Emergency Medicine Clerkship||4|
|NEUR 3005||Neurology Clerkship||4|
|1 FOUR-WEEK SELECTIVE (INPATIENT SERVICE)||4|
|1 FOUR-WEEK SELECTIVE (AMBULATORY CARE)||4|
|20 WEEKS OF ELECTIVES||20|
|4 WEEKS OF SENIOR DIDACTICS||4|
|Total Credit Hours||83|
Objectives & Competencies for the Doctor of Medicine (M.D.) Degree
The objectives and competencies for the educational program for the Doctor of Medicine (M.D.) degree program were initially developed and approved by the Curriculum Committee in 2008 and reaffirmed in 2018 with minor revisions. The objectives and competencies are used to guide the curriculum and ensure that students who graduate have achieved competency in three (3) areas basic to being a physician: Altruism, Knowledge, and Skills.
- Altruism: Medical students must be compassionate and empathetic in caring for patients, and must be trustworthy and truthful in their professional dealings. They must act with integrity, honesty, and respect for patients’ privacy and dignity.
Knowledge: Medical students must understand the scientific basis of medicine and be able to apply that understanding to the safe and effective practice of medicine. They must utilize self-assessment and self-knowledge to optimize their learning.
- Skills: Medical students must acquire wide-ranging skills that will enable them to care for patients as a professional.
Under each area of competency there are numerous specific objectives that a medical student will be able to do by the time of graduation. View the full list of objectives and related appendices to learn more.
1.1 List and define the basic principles guiding ethical decision-making.
1.2 Apply ethical concepts to medical ethical dilemmas.
1.3 Demonstrate respect for human dignity.
1.4 Provide compassionate patient care.
1.5 Demonstrate honesty and integrity in educational and professional interactions.
1.6 Demonstrate appropriate patient advocacy.
1.7 Understand the non-medical factors that impact health.
1.8 Understand the issues of access to health care.
1.9 Appropriately address conflicts of interest inherent to the field of medicine.
2.1 Demonstrate knowledge of normal structure and function of the human body.
2.2 Demonstrate knowledge of the pathogenesis and pathophysiology of disease and disorders.
2.3 Demonstrate knowledge of the clinical manifestations of common conditions and disorders.
2.4 Demonstrate knowledge of the pharmacotherapeutic modalities for common conditions and disorders.
2.5 Demonstrate knowledge of the basic principles of clinical and translational research.
2.6 Demonstrate knowledge of the epidemiology of common conditions and disorders.
2.7 Demonstrate knowledge of systems of healthcare delivery.
3.1 Obtain an accurate and complete medical history.
3.2 Perform all components of a complete physical examination.
3.3 Prepare for and perform basic clinical procedures.
3.4 Perform basic interpretation of commonly used diagnostic tests.
3.5 Recognize the typical physical exam manifestations of common medical conditions and disorders
3.6 Demonstrate the skills of clinical reasoning and clinical problem solving for common conditions and disorders.
3.7 Create appropriate management strategies for common conditions and disorders.
3.8 Apply the principles of relieving total pain (physical, psychological, spiritual, social).
3.9 Demonstrate effective and appropriate communication of medical information, both in writing and verbally.
3.10 Demonstrate the ability and commitment to continuously improve medical knowledge and skills.
The Long SOM is committed to creating an environment that promotes academic and professional success in learners and teachers at all levels. The institution strives to create an environment free of behaviors that can adversely affect the Teacher-Learner relationship. An environment where students, residents, fellows, faculty and staff work together, train together and promote the highest level of patient care.
All members of the Long SOM medical education community have a shared responsibility to protect the integrity of the learning environment, a right to work and learn free of unlawful discrimination, harassment and mistreatment, and to report any incident in which that positive learning environment has been compromised.
Standards of Conduct for the Teacher-Learner Relationship
Responsibilities of teachers
Treat all learners with respect, fairness, and equality regardless of age, gender, race, ethnicity, national origin, religion, disability, or sexual orientation
Responsibilities of learners
Treat all fellow learners and teachers with respect, fairness, and equality regardless of age, gender, race, ethnicity, national origin, religion, disability, or sexual orientation
Behaviors Inappropriate to the Teacher-Learner Relationship
Behaviors that demonstrate disrespect for others or lack of professionalism in interpersonal conduct are inappropriate and will not be tolerated by the institution. These include, but are not limited to, the following:
- unwanted physical contact (e.g. hitting, slapping, kicking, pushing) or threat of the same;
- unwanted verbal contact including loss of personal civility such as shouting, personal attacks, insults, or displays of temper (such as throwing objects);
- sexual harassment (including romantic relationships between teachers and learners in which the teacher has authority over the learner’s academic progress) or harassment based on age, gender, race, ethnicity, national origin, religion, disability or sexual orientation;
- discrimination of any form including in teaching and assessment based upon age, gender, race, ethnicity, national origin, religion, disability, or sexual orientation;
- requests for others to perform inappropriate personal errands unrelated to the didactic, investigational, or clinical situation at hand;
- grading/evaluation on factors unrelated to performance, effort, or level of achievement.
- providing health and/or psychiatric or psychological services to any student for which a teacher is involved in the academic assessment or in decisions about the promotion of that student, except in an emergency situation.
Reporting Inappropriate Conduct
General reporting processes and procedures for learners and teachers are outlined in the Standards of Conduct for Teacher-Learner Relationship and the Learning Environment policy (*UTHSA login required). The underlying concern is for the comfort of the individual raising the concern. The Long SOM will not tolerate any form of retaliatory conduct by or toward teachers or learners who report inappropriate conduct in good faith. Individuals who believe that retaliatory action has been taken against them as a result of reporting or raising a concern regarding inappropriate conduct, may report such action through the procedures set forth in the aforementioned policy.
Non-Involvement of Healthcare Providers in Student Assessment
The Non-Involvement of Healthcare Providers in Student Assessment policy (*UTHSA login required) is established to ensure that students are evaluated based on common agreed upon performance measures that are independent of confidential or protected health information. This is essential to ensure that student academic performance is evaluated properly and to ensure that students are not discouraged from seeking medical and/or psychological/psychiatric care that is held in the strictest standards of patient privacy and confidentiality, without concern for consequent adverse actions or repercussions.
Students and health care providers should follow these procedures to make certain that the appropriate care is sought and provided.
Health care professionals who provide medical and/or psychological/psychiatric care to medical students must:
- have no role in the formal academic or professionalism evaluation of medical students at the present or future time.
- have no role in advancement/progression/graduation of medical students at the present or future time.
- recuse himself/herself from the formal academic or professionalism evaluation of medical students and from academic or professionalism decisions of advancement/progression/graduation of medical students, if a dual relationship with medical students is anticipated or is discovered, and, when appropriate and without breaching confidentiality, alert the a dean for student affairs immediately.
- seek medical care through the Student Health & Wellness Center (SHWC). This medical care is usually provided by registered nurses or advanced nurse practitioners under the supervision of the SHWC medical director. The health care providers in the SHWC may refer medical students to other academic or community health care providers for further/follow-up care.
- seek psychological/psychiatric care through the Student Counseling Center (SCC). A multidisciplinary staff, who is not involved in academic or professionalism evaluation and/or decisions of advancement/progression through the curriculum, provides evaluation and short-term treatment including counseling, psychotherapy, and medication management when necessary to medical students with mental health, situational, social, or academic concerns. The health care providers in the SCC may refer medical students to other academic or community health care providers for further/follow-up care.
- Inform staff in the SHWC and SCC that they are students at the Long SOM.
Mistreatment of students will not be tolerated. Mistreatment, intentional or unintentional, occurs when behavior shows disrespect for the dignity of others and interferes with the learning process. Student mistreatment may take many forms all of which impact student performance. Sexual harassment and assault, which are defined by policy through UT Health San Antonio’s Equal Employment Opportunity/Affirmative Action Office, are included in this section as forms of student mistreatment**. Student access to personnel and processes for resolution without retaliation are detailed in the Student Mistreatment Policy (*UTHSA login required). Per policy, a student who has a grievance concerning perceived violation of her/his student rights; discrimination based on age, color, disability*, family status, gender, national origin, race, religion, veteran status, sexual orientation; or sexual harassment/sexual assault** may seek resolution through an informal or formal process. Examples of behavior that are unacceptable to the Long SOM and UT Health San Antonio include:
- Physical or sexual harassment/assault
- Discrimination or harassment based on race, gender, age, ethnicity, religious beliefs, sexual orientation, or disability
- Disparaging or demeaning comments about an individual or group
- Loss of personal civility including shouting, displays of temper, public or private abuse, belittling, or humiliation
- Use of grading or other forms of evaluation in a punitive or retaliatory manner Sending students on inappropriate errands
Medical students who feel they have been mistreated may report such perceptions to any of the following:
- Associate Dean for Student Affairs
- Student Ombudsperson
- Chief Student Affairs Officer/Title IX Director
- Student Counseling Center
- Office of Student Life
- Course/Clerkship Director
These school representatives are empowered to informally discuss a student’s perceptions related to mistreatment, providing guidance. These school representatives should refer the student immediately to the associate dean for student affairs for further instructions.
*see additional related Health Science Center policies/procedures: "Nondiscrimination Policy and Complaint Procedure" at www.uthscsa.edu/eeo/non-discrimination.asp.
**see additional related Health Science Center policies/procedures: "Sexual Harassment and Sexual Misconduct Policy" at www.uthscsa.edu/eeo/harassment.asp.
Code of Professional Conduct
Medical students are expected to maintain the highest standards of professional and ethical conduct. Medical students are expected to conduct themselves in a professional manner in interaction not only with patients, but also with peers, faculty, and staff of the Health Science Center and the broader community. The Long SOM, Health Science Center and UT System have written expectations of professional conduct. The Code of Professional Conduct in the Long SOM governs the expected behavior of medical students. Each module, clerkship or course director may also develop additional written expectations of professional conduct.
A report of professional misconduct is investigated in accordance with applicable Long SOM, Health Science Center and the UT System policy. Any potential violation of professional conduct is reported to the associate dean for student affairs for investigation. The associate dean for student affairs will be responsible for ensuring that no retaliation is made against the complainant. The associate dean for student affairs will interview both the complainant and the accused student, allowing the accused student the opportunity to respond to the charges and to review the available evidence supporting the charges. The associate dean for student affairs will interview others as indicated. All Health Science Center personnel and students must cooperate with the investigation. At the conclusion of the investigation, the associate dean for student affairs will prepare a written report detailing the charges, the investigative process and the results of the investigation. The associate dean for student affairs will present the written report to the Student Progression and Promotion Committee (SPPC) for recommendations. Any disciplinary action/sanction(s) recommended by the SPPC shall be in accordance with the Long SOM Administration of Code of Professional Conduct for Students policy (*UTHSA login required) and applicable Health Science Center policies. The decision of the SPPC is final, pending further appeal to the dean of the Long SOM as outlined in the Appeal Process for an Academic Grievance policy (*UTHSA login required).
The Curriculum Committee (CC) is the faculty body that provides central oversight and makes recommendations to the dean and dean delegates for the overall design, management and evaluation of a coherent and coordinated curriculum. The Student Progression and Promotions Committee (SPPC) is the faculty body charged with review of the academic progress and professional development of each student during all components of the medical education program. The SPPC has primary responsibility for recommending for graduation only those candidates who have satisfactorily completed all graduation requirements and demonstrated the professional conduct appropriate for a physician.
The preclinical phase includes modules taught from the beginning of the first academic year through mid-spring of the second academic year. The clinical phase includes all clerkships and selective/elective courses. The module director determines the academic standards for successful completion of a preclinical module, adhering to a grading rubric approved by the CC. In the clinical years, academic standards for successful completion of a clerkship or selective/elective are determined by the clerkship or course director, remaining within the bounds of applicable CC standardization and approval.
The preclinical and clinical education leaders in accordance with the CC policy and Office for Undergraduate Medical Education (OUME) standards set the grade composition for preclinical modules and clerkships. Per the Timely Reporting of Grades to Students policy (*UTHSA login required), final grades in the preclinical curriculum must be made available to students within 4 weeks of the last day of the module/course. Final clerkship grades must be made available to students within 6 weeks of the last day of the clerkship. Final grades in the curriculum are submitted to the OUME and ratified by the SPPC.
Grades for Preclinical Modules (Class of 2021)
For the class of 2021, all preclincial module grades are based on an A, B, C, F-system. Grades of A, B, and C are considered passing. A=outstanding performance, B=very good performance, C=satisfactory performance and F=indicates failing performance. No grade of D will be issued. The grade of Incomplete (I) is reserved for circumstances in which academic work is not completed due to illness, family emergency, or other non-academic extenuating circumstances. A grade of I is disallowed for substandard academic performance.
For purposes of class rank, each letter grade is assigned a point value as follows:
|Letter Grade||Grade Point Average|
Remediation grades (as described below) will be classified as “Pass” or “Fail”. For purposes of class rank, a course that is remediated to a “Pass” will be given the same grade point value as a “C.”
Class rank will be calculated twice during the four-year medical education program as follows: 1) at the conclusion of the preclinical curriculum 2) at the date that the clerkships must be completed during the clinical years.
Grades for Preclinical Modules (Class of 2022 and beyond)
Beginning in Academic Year 2018-2019, applicable to the graduating class of 2022 and beyond, all preclinical module grades will be based on an Honors, High Pass, Pass, or Fail system.
Assignment of Final Module Grade: All activities that contribute to the final module grade will be entered into a grade calculator maintained and managed by the Office of UME, and the point total will convert to a grade as follows:
- Honors = 90.00-100 and all Components meet “Honors” benchmarks
- High Pass = 85.00-89.99 and all Components meet “High Pass” benchmarks
- Pass = 70.00-84.99 OR >84.99 points but did not meet all benchmarks for “High Pass”
- Fail = 0-69.99 or failure of one or more individual components
Grades for Electives and Selectives
Grades for electives and selectives are based on a pass/fail system. Clinical course student assessment is based on competency and professionalism as per the individual elective or selective grading rubric.
General Academic Progression and Professionalism Requirements
Per the General Academic Progression and Professionalism Requirements for the the Doctor of Medicine (M.D.) Degree Program policy (*UTHSA login required), students who fail to meet minimum passing standards at the conclusion of any Long SOM course are subject to review of their performance in previous coursework. Failure to meet minimum passing standards in more than one course between the time of matriculation and graduation may result in the student being required to repeat a portion of the curriculum or may result in dismissal. Students who fail to complete all degree requirements within six years from matriculation may meet criteria for dismissal. Students who exhibit unprofessional behavior may be subject to dismissal.
The Student Progression and Promotion Committee (SPPC) monitors student progression, promotion, and professional development leading to successful completion of the M.D. degree program. The SPPC ensures uniformity in promotion and graduation by executing established policies related to student advancement and professionalism expectations that are universally applied to all medical students. In this role the SPPC has the authority to:
- mandate a leave of absence (LOA) for a student,
- mandate that a student meet with the associate dean for student affairs and/or the associate dean for curriculum,
- restrict the extracurricular activities of a student, including removal from an office or leadership position the student may hold, and/or
- dismiss a student from the program.
Policy on Academic Progression - by individual year
All students are subject to the Impact of Course Failure on Academic Progression policy (*UTHSA login required). Students should be aware that they are subject to dismissal if they fail to meet satisfactory academic progression requirements. Students should reference the above policy for details regarding the impact of course failures.
Student Progress Based on NBME Comprehensive Basic Science Exam Performance
The National Board of Medical Examiners (NBME) offers the Comprehensive Basic Science Exam (CBSE), an achievement test covering material typically learned during basic science education. The CBSE is designed to reflect the content of USMLE Step 1 exam, and is typically used to gauge readiness for USMLE Step 1 and to identify areas of individual strength and weakness in basic science material. Scores on CBSE can be correlated to scores on USMLE Step 1. The Long SOM has established policies pertaining to successful performance on the CBSE prior to taking the USMLE Step 1 in order to ensure that graduates meet at least minimal licensing requirements and to optimize career outcomes for our students.
All students must take the CBSE at the conclusion of the preclinical phase of the curriculum at a date and time established by the Office for Undergraduate Medical Education (OUME). Students are required to meet score benchmarks established by the OUME in order to progress to the clinical/elective phase of the curriculum, including clerkships. Inability to test on the established testing date may delay planned coursework. Students who miss testing will be placed in a USMLE Step I readiness pathway and will be scheduled to take the CBSE at the next offered opportunity. See Student Progress Based on NBME Comprehensive Basic Science Exam Performance policy (*UTHSA login required).
United States Medical Licensing Examination
The United States Medical Licensing Examination (USMLE) is jointly sponsored by the NBME and the Federation of State Medical Boards. A passing score on each portion of the USMLE is accepted by medical boards in every state as evidence of core competency to practice medicine. The current required exams are USMLE Step 1, USMLE Step 2 CK (Clinical Knowledge), USMLE Step 2 CS (Clinical Skills), and Step 3. The Step 3 exam is taken after medical school graduation.
It is essential that medical students meet required benchmarks that lead to medical licensure. Although designed for the purpose of licensing physicians, scores on USMLE Step 1 and USMLE Step 2 CK are often used by graduate medical education programs in decisions to interview and rank medical students for residency positions. It is therefore incumbent upon the SOM to establish policies pertaining to the timing and passage of the USMLE in order to optimize career outcomes for students and to ensure that graduates meet at least minimal licensing requirements.
Student must pass the USMLE Step 1, Step 2 CK and Step 2 CS in order to graduate from the Long School of Medicine per policies governing the number of attempts on each USMLE step exam. See the relevant policy listed below (*UTHSA login required):
- Requirements for USMLE Step 1 exam
- Requirements for USMLE Step 2 CK exam
- Requirements for USMLE Step 2 CS exam
Appeal Process for an Academic Grievance
An academic grievance is a complaint regarding an academic decision or action that may affect the student’s academic record and or concerns adversely influencing the student's academic status. Examples include, but are not limited to, examination score, module, course or clerkship grades, clinical course narrative comments, remediation, repetition, suspension, probation, professionalism sanctions, and dismissal. A medical student may choose to resolve an academic grievance in the preclinical and clinical phases of the curriculum through either an informal or formal appeal process. An informal appeal process allows a student to pursue resolution of a grievance directly within the administrative structure of a course (i.e. through the associate dean for curriculum in the preclinical curriculum or the clerkship director/course director in the clinical curriculum), while a formal appeal process allows a student to pursue resolution of a grievance through the medical school’s Student Progression and Promotions Committee (SPPC). The Appeal Process for an Academic Grievance policy (*UTHSA login required) defines the procedure and timeline for each option.
Adverse Action Policy
An adverse action is any action taken by the Student Progression and Promotion Committee (SPPC) that affects the status of a student. These actions include dismissal, a mandated leave of absence, repetition of a year of the curriculum, and any action that would affect a student's standard progression through the curriculum. As stated in the Appeal Process for an Academic Grievance policy (*UTHSA login required) and Student Mistreatment Policy (*UTHSA login required) a medical student may choose to resolve an academic or non-academic grievance through either an informal or formal appeal process. However, adverse actions require special attention that include an opportunity to respond to the impending action that relates to advancement, graduation, or dismissal. In those cases, this policy takes precedence over other appeal processes.
A student facing an adverse action that relates to advancement, graduation, or dismissal will have an opportunity to respond to the impending action, including the option to appear before the Student Progression & Promotion committee (SPPC) PRIOR to any SPPC decision. The Adverse Action policy (*UTHSA login required) defines the procedure and timeline for a student wishing to respond to an impending adverse action.
CIRC 5001. Medicine, Behavior and Society Longitudinal Module. 6 Credit Hours.
The Medicine, Behavior, and Society module explores the areas of history, law, ethics, clinical, social and cultural contexts of medicine as well as human behavior & development over the lifespan (cognitive, social and emotional development from infancy to death.) The course will focus on global issues such as the health care system and on local issues such as the physician-patient relationship. Students will be introduced to communication skills, professionalism, research, and cultural competency.
CIRC 5003. Language of Medicine Longitudinal Module. 5.4 Credit Hours.
The Language of Medicine component of the curriculum serves as the common denominator necessary for students to be able to discuss systematic anatomy in the integrated modules to follow. Basic structure, conceptual anatomical principles and development of the human body presented. Knowledge is acquired in didactic sessions emphasizing clinical relevance, reinforced by practical application during laboratory application during laboratory sessions in which supervised cadaver dissection is performed by the students. Imaging techniques, prosections, demonstrations, and presentations by clinical specialists supplement the laboratory work.
CIRC 5005. Clinical Skills Longitudinal Module. 14.75 Credit Hours.
The Clinical Skills Longitudinal module threads throughout the entire first and second year curriculum. Using standardized and real patients, students learn medical history taking and physical examination techniques. In addition, through didactic sessions, simulations, small group sessions and labs, students master the knowledge, communication skills, professional, and interpersonal skills necessary for fostering positive doctor-patient relationships.
CIRC 5007. Molecules to Medicine. 9 Credit Hours.
The Molecules to Medicine module provides the foundation for subsequent courses and clinical practice. Through active, collaborative learning activities which may include, but are not limited to, laboratory, small group, and clinical case sessions the students gain a deeper understanding of the homeostatic structure of molecules, cells, and tissues. Students develop problem-solving skills in a multidisciplinary approach to human health and disease.
CIRC 5009. Attack and Defense. 9 Credit Hours.
The Attack and Defense module is an integrated and innovative look at microbiology, immunology, and infectious disease including public and international health issues. Students are prepared for clinical encounters requiring diagnosis, treatment, and preventive measures for immunological conditions and disorders and infectious diseases by fostering critical thinking skills. The learning environment promotes professional identity formation, effective communication and professionalism. Students acquire a broad understanding of normal and abnormal immune system function through active, collaborative leaning activities which may include, but are not limited to laboratory, small group, and clinical case sessions.
CIRC 5011. Circulation. 5 Credit Hours.
The Circulation module provides an integrated approach to the basic and clinical science concepts related to the cardiovascular and hematopoietic systems. Students acquire a broad understanding of normal structure and function of the cardiovascular and hematopoietic systems including the cardiac cycle, cardiovascular pressures and flows, nutrients and oxygen delivery, hematopoiesis, and the hemostasis system through active, collaborative learning activities which may include, but are not limited to, laboratory, small group, and clinical case sessions. A comprehensive, multidisciplinary overview of the pathophysiology, epidemiology, biostatistics, interpretation of diagnostic tests, and pharmacotherapeutic and other therapeutic principles related to cardiovascular and hematopoietic disorders is included.
CIRC 5013. Respiratory Health. 4 Credit Hours.
The Respiratory Health module integrates basic science and clinical concepts related to respiratory health disease. A comprehensive study is conducted of the normal structure and function, pathophysiology/pathology, clinical manifestations, and interpretation of diagnostic tests for respiratory diseases. The student is immersed in a multidisciplinary study of pharmacotherapeutic approaches to treatment, interventional therapies, the use of evidence-based medicine and research, epidemiology, and prevention in the field of respiratory health. Students acquire a broad understanding of normal and abnormal respiratory system function through active, collaborative learning activities which may include, but are not limited to laboratory, small group, and clinical case sessions.
CIRC 5015. Renal and Male Reproductive. 5 Credit Hours.
The Renal and Male Reproductive module is a comprehensive overview of the structural and urologic components of the renal and the male reproductive system. Students gain a deeper understanding of glomerular and tubular function and pathology, as well as acute and chronic kidney injury and also benefit from a multidisciplinary approach represented by adult and pediatrics, and biochemistry. A broad understanding of normal and abnormal renal and male reproductive system function is achieved through active, collaborative learning activities that may include, but are not limited to laboratory, small group, and clinical case sessions.
CIRC 5017. Hematology. 3 Credit Hours.
The goal of this course is to expose students to the pathogenesis and pathophysiology of disease and disorders as they pertain to the specialty of hematology. During the module, the first year medical students will come to appreciate the basic science foundation for the clinical practice of Hematology. Students will gain an understanding of the medical non-medical factors that effect the hematology system.
CIRC 6007. Mind, Brain and Behavior. 9 Credit Hours.
Mind, Brain, and Behavior module provides a comprehensive introduction to the normal anatomy, development, physiology and radiological features of the human nervous system and its pathologic disorders. Through active learning methods, students will practice clinical assessment of the nervous system while learning the major features of common neurological, neurosurgical, psychiatric and psychological disorders and pharmacological approach for the nature of the experience of the brain. The student will gain an appreciation for the nature of the experience of having an illness affecting the brain and mind, and a deepened compassion for patients with these illnesses.
CIRC 6009. Endocrine and Female Reproductive. 7 Credit Hours.
The Endocrine- Reproductive module provides an integrated, comprehensive study of the normal structure and function of the endocrine and reproductive systems as well as the clinical manifestations of endocrine and reproductive disorders. Innovative, active learning methods which may include, but are not limited to laboratory, small group, and clinical case sessions allow students to develop critical thinking skills and gain a deeper understanding of the role of the endocrine system in regulation of metabolic activity, water and electrolyte balance, the endocrinology of the menstrual cycle, pregnancy, as well as human reproduction. The students benefit from a multidisciplinary approach incorporating the study of pharmacotherapeutic modalities, evidence based medicine, as well as current clinical/translational research applications into the endocrinology/reproductive medicine curriculum.
CIRC 6011. Digestive Health and Nutrition. 7 Credit Hours.
The Digestive Health and Nutrition module provides an integrated overview of the basic science and clinical concepts related to digestive health and nutrition. Through innovative learning methods that may include, but are not limited to laboratory, small group, and clinical case sessions, students gain a deeper understanding of the normal structure and function of the digestive system, as well as pathophysiology/pathology, clinical manifestations and interpretation of diagnostic tests as they relate to digestive health and nutrition. This comprehensive, multidisciplinary study includes pharmacotherapeutic approaches to treatment, interventional therapies, psychosocial aspects of digestive disease, the use of evidence-based medicine and research, epidemiology, and prevention in the field of digestive health and nutrition.
CIRC 6013. Form and Function: Skin, Muscles & Bones. 7.5 Credit Hours.
The Musculoskeletal and Dermatology module provides a comprehensive study of the development, structure, and function of the musculoskeletal and integumentary systems. Students acquire a broad understanding of normal and abnormal musculoskeletal and dermatologic function through active, collaborative learning during laboratory, small group, and clinical case sessions. Diagnostic and therapeutic techniques in the management of musculoskeletal and dermatologic disorders are discussed.
EMED 3005. Emergency Medicine Clerkship. 4 Credit Hours.
This four week core clerkship introduces the 3rd year medical students to the specialty of emergency medicine and reviews principles of emergency care that will benefit a graduate entering any specialty.
FMED 3005. Family Medicine Clerkship. 6 Credit Hours.
The family medicine clerkship introduces students to the principles, philosophy, and practice of family medicine, including fundamental concepts of comprehensive, continuous, cost-effective, family-oriented medical care. Students participate in the care of patients in various outpatient and inpatient settings. Students will have the opportunity to practice clinical problem solving in the undifferentiated patient and to improve their basic clinical skills. Students are expected to gain basic knowledge in the diagnosis and management of common family medicine problems, health promotion/disease prevention, and geriatrics.
Prerequisites: Successful completion of all required preclinical courses is prerequisite to enrollment in any of the clinical clerkships.
INTD 3030. Clinical Foundations. 3 Credit Hours.
The purposes of this completely on-line course are to: 1. Prepare early clinical students to increase knowledge in clinical settings including: a. Exposure to healthcare team members, b. Exposure to roles on clerkship (H&Ps, orders, SOAP notes, prescriptions, etc.), c. Interpretation of EKGs and radiographs, d. Interpretation of normal/abnormal lab values, e. Recognition of fatigue/strategies to combat fatigue in clinical settings, f. Basic understanding of ventilator management/ICU care, g. Patient insurance issues/patient health care financial resources, h. Avoidance of medical legal problems, i. Better success on exams, j. Performance of evidence-based searches in medical literature, k. Understanding fundamentals of translational research; 2. Assist students in developing new skills expected of early clinical students including: a. Intravenous catheter placement, nasogastric catheter placement, urinary catheter placement, and O2 management, b. Sterile gloving and sterile technique, c. Basic suturing/staple placement and removal; and 3. Prepare early clinical students for their roles in clinical settings including: a. Patient care under supervision, b. Patient privacy-HIPAA, c. Professionalism and responsibility to team and patients, d. Patient safety, e. Proper use of social media in patient care, f. Strategies to be best student on the first clerkship, g. OSHA and hand hygiene, h. Proper professional attire, i. Completion of evaluations on residents and faculty. The students will complete credentials for major clinical sites.
MEDI 3105. Medicine Clerkship. 8 Credit Hours.
The objectives of this clinical experience are to provide opportunities for students to develop patient evaluation skills, productive self-learning techniques, a sound pathophysiological approach to medical disease, a concern and awareness for the patient's needs, and personal professional behavior. The student spends eight weeks, divided into two 4-week blocks, assigned to the inpatient General Medicine Service. An additional four weeks are spent in outpatient services. Bedside clinical teaching is emphasized by asking the student to perform patient evaluations, to contribute to the care of selected patients, and to participate in the clinical rounds of the services. During this clerkship the student receives intensive instruction from the Internal Medicine house staff and faculty. In addition, the student is expected to undertake independent patient-oriented reading and to systematically review pertinent information introduced during the preclinical years. Finally, students attend a series of clinical conferences including medical grand rounds, morbidity and mortality conferences, clinical subspecialty conferences, and organized courses in electrocardiography and nutrition. Successful completion of all required preclinical courses is prerequisite to enrollment in any of the clinical clerkships. The student spends eight weeks, divided into two 4-week blocks, assigned to the inpatient General Medicine Service. An additional four weeks are spent in outpatient services. Bedside clinical teaching is emphasized by asking the student to perform patient evaluations, to contribute to the care of selected patients, and to participate in the clinical rounds of the services. During this clerkship the student receives intensive instruction from the Internal Medicine house staff and faculty. In addition, the student is expected to undertake independent patient-oriented reading and to systematically review pertinent information introduced during the preclinical years. Finally, students attend a series of clinical conferences including medical grand rounds, morbidity and mortality conferences, clinical subspecialty conferences, and organized courses in electrocardiography and nutrition.
NEUR 3005. Neurology Clerkship. 4 Credit Hours.
This core clerkship is designed to give the student experience in evaluation of patients with neurologic disorders an opportunity to master the neurological exam in inpatient ward and consultation settings, as well as outpatient settings. The student will be expected to participate in the complete care of assigned General Neurology Ward patients and patients on the Stroke Specialty Wards. Students will also participate in Neurology consult rounds and have an opportunity to see consult patients. They will be assigned to either the University Hospital or VA Neurology wards/consult services for two weeks of the rotation. They will spend one week of the rotation of the Stroke wards service and participate in stroke specialty clinics during that week. One week of the rotation will be devoted to participating in a variety of general neurology and specialty clinics. Students are required to perform appropriately focused history and physical exams, prepare written and verbal presentations, interpret laboratory data and develop a differential diagnosis and management plan on all assigned patients. Students will also attend neurology morning report, the MS3 Neurology Lecture Series, selected Neurology Residency Lecture Series topics and Neurology grand Rounds. Students will receive a clinical performance evaluation by the supervising attending and residents using the SOM 3rd year medical student evaluation form.
OBGY 3005. Obstetrics/Gynecology Clerkship. 6 Credit Hours.
A clerkship consisting of gynecology and obstetrics is provided for medical students who have successfully completed the course in reproductive physiology and pathophysiology. The goal of the clerkship is to provide students with opportunities to prepare to function as a house officer capable of providing preventive care and treatment or competent to identify the patient's need for direction into an appropriate care environment. Supervised direct patient experience occurs in the obstetrical wards, operating room, labor and delivery suite, emergency room, and the obstetrical, gynecologic, family planning, and cancer detection clinics. A guide identifying instructional goals and the mechanisms to reach them is provided. Twenty-five seminars provide the opportunity for integration of clinical experience and didactic learning. In order to enroll, students must have successfully completed all required preclinical courses.
PEDI 3005. Pediatrics Clerkship. 6 Credit Hours.
This third-year pediatric clerkship addresses issues unique to childhood and adolescence by focusing on human developmental biology, and by emphasizing the impact of family, community, and society on child health and well-being. Additionally, the clerkship focuses on the impact of disease and its treatment on the developing human, and emphasizes growth and development, principles of health supervision, and recognition of common health problems. The role of the pediatrician in prevention of disease and injury and the importance of collaboration between the pediatrician and other health professionals in stressed. During this clerkship, students spend time working in outpatient and inpatient settings.
PSYC 3005. Psychiatry Clerkship. 6 Credit Hours.
The psychiatric clinical clerkship is designed to familiarize the student with the personality traits, illnesses, and emotional disturbances that affect health and productivity. It is an opportunity for the student to develop and strengthen clinical skills in interviewing patients, formulating treatment plans, and carrying out treatment with patients who have psychiatric illness. The clerkship is arranged so the student may select the assignment area on the basis of particular interest, i.e., an inpatient/outpatient setting. The student's role in the clerkship is arranged to allow for considerable experience in the working relationship between patient and "physician" in the treatment process. Seminars have been developed to allow the student an in-depth appreciation of the various psychiatric states and emotional problems that affect the general practice of medicine. The student-staff ratio allows for small groups of students to meet with faculty, thereby enhancing learning. The clerkship is an opportunity for the students to look at their personal feelings and values and understand how they influence patient care, to learn how to deal with psychiatric disease, and to become more comfortable in dealing with the personalities of patients with organic disease.
Prerequisites: Successful completion of all required preclinical courses is prerequisite to enrollment in any of the clinical clerkships.
SURG 3005. Surgery Clerkship. 8 Credit Hours.
The eight-week core surgery clerkship is divided into a four-week general surgery rotation and a four-week surgery specialty rotation. The goals of the third-year surgical curriculum are divided into 5 broad categories: 1. Preparation of the medical student for patient care/clinical skills, including a. performance of a focused history and physical examination on a surgical patient, b. interpretation of diagnostic tests and procedures for the surgical patient, c. performance of basic technical skills, d. demonstration of clinical reasoning and problem-solving skills for the surgical patient, e. formulation of a diagnostic and therapeutic plan for a surgical patient; 2. Increase fund of medical knowledge for a surgical patient, 3. Self-directed learning, 4. Application of best evidence-based practices to improve patient care and to prepare for daily activities, and 5. Development of interpersonal and communication skills, including: a. oral presentations to the surgical team, b. written notes in the medical record, c. relationship with patients and their families, d. relationship with the healthcare team, e. practice of professionalism in all settings. In order to achieve these goals, the student should have a sound knowledge of surgical anatomy and the pathophysiology of surgical illness. The student should have strong understanding of the patient's surgical disease process. The student should master simple basic technical skills by the end of the clerkship. The student should master a focused history and physical examination on a surgical patient. The student should propose and interpret diagnostic tests and procedures that are appropriate for the surgical disease. The student should develop a differential diagnosis and demonstrate clinical reasoning and problem-solving skills that integrate clinical data. The student should develop a logical diagnostic and therapeutic plan for surgical problems. The student should develop strong interpersonal relationships and communication skills with patients, their families and the healthcare team. The student should be well read and well prepared for operations and rounds, and begin to develop good habits for self-directed, lifelong learning. The student should demonstrate an understanding of best practices that improve the health of surgical patients. The student should provide competent, compassionate care for patients in all surgical settings.