1. Introduction

“Academic difficulty” is a comprehensive term used to refer to all students who are identified as demonstrating less than satisfactory progress in the MD Program. These Guidelines are intended to support and ensure student achievement of course objectives and program competencies, with the ultimate goal being promotion through and graduation from the MD Program. For the purpose of these Guidelines, less than satisfactory progress in a course may be recorded as either “Partial Progress” or “Unsatisfactory Progress”, in accordance with the MD Program’s Standards for grading and promotion.

2. Mechanisms for identifying partial progress and unsatisfactory progress

There are two formal mechanisms for identifying Partial Progress and Unsatisfactory Progress in Years 1 and 2 of the MD Program, as follows:

1. Based on marked assessments and non-marked learning activities: Each Foundations course includes a series of multipoint assessments. Each assessment includes a threshold standard that defines satisfactory progress. In order to receive credit for a course, a student must satisfactorily complete all marked assessments for all of the components and longitudinal themes that constitute the course, and must perform satisfactorily on all non-marked learning activities for that course. The threshold standards for each type of assessment in a course are provided in the course outline. A student who does not achieve the threshold standard for an assessment type or the course as a whole will be identified as being in academic difficulty. Procedures to address partial and unsatisfactory progress based on assessment results (excluding professionalism assessments) are provided in Section 3.
2. Based on professionalism assessments and critical incident reports: Satisfactory professionalism competency is a requirement to achieve credit in every course, and assessment of professionalism competency is included in every course. Satisfactory professionalism competency is required to progress from one year level to the next and to graduate from the program. Assessment of professionalism takes place through competency-based professionalism assessments. Professionalism incidents that require immediate action are addressed through critical incident reports. The MD Program’s professionalism standards of achievement and procedures to address unsatisfactory progress with respect to professionalism are described in the Student professionalism guidelines.

In addition to the formal mechanisms for identifying Partial Progress and Unsatisfactory Progress outlined above, the program is committed to the early, informal identification of students whose progression is not optimal. These informal mechanisms may include assessment-related observations by tutors, including Academy Scholars, as well as conversations between students and tutors, Academy Scholars and/or administrative staff. The purpose of early, informal identification is to ensure that such students have the opportunity to discuss their performance with the appropriate curriculum leader(s) and/or administrative staff in a safe and confidential environment, and that they are aware of the various supports available to them.

3. Procedures to address partial and unsatisfactory progress based on assessment results

(excluding professionalism assessments and critical incident reports)

Note: With respect to the following procedures to address partial and unsatisfactory progress based on assessment results, references to “Foundations Director” and “Director of Student Assessment” should be read to include “or delegate, as determined by the program”. Recommendations to the Board of the Examiners from the Student Progress Committee will be made to the Board on the committee’s behalf by the Foundations Director and/or Director of Student Assessment delegate, as determined by the program.

In the event that the Student Progress Committee decides that a student is not satisfactorily progressing given their performance on a Focused Learning Plan or formal program of remediation:

1. Student Meeting

   Following the initial identification of Partial Progress based on assessment results (excluding professionalism assessments and critical incident reports), a Student Meeting will be held, as follows:

   1. The student will meet with the Foundations Director or delegate, as determined by the program.
   2. The student will be informed orally and/or in writing that they have not been satisfactorily progressing, that the Board of Examiners may be informed of this fact, and that their performance may be discussed at a meeting of the Board of Examiners.
   3. The student may be required to meet with the Associate Dean, Learner Affairs or delegate for the purpose of exploring health-related or personal reasons for their less than satisfactory progress and potential supports needed.
   4. The Foundations Director will consult, as necessary, with other curriculum leaders to determine next steps, including the identification of any additional learning activities, assessments and/or academic supports that are appropriate to the situation, as well as the time period for completion and review of next steps.
   5. The student will be informed of next steps, which will be included in a Focused Learning Plan, as described in 3.b.
2. Focused Learning Plan (“Partial Progress”)

   Following the Student Meeting and determination of next steps:

   1. The student will, with guidance, formulate a Focused Learning Plan to reflect the identified next steps, including the time period for completion and review.
   2. The Foundations Director will review and either approve or not approve the student’s Focused Learning Plan. To facilitate this review, the Foundations Director may consult with other curriculum leaders.
      1. If the student’s updated Focused Learning Plan is approved, the Foundations Director will inform the student and the Focused Learning Plan will be entered in the student’s Learner Chart by the Director of Student Assessment or delegate, as determined by the program.
      2. If the student’s Focused Learning Plan is not approved, the Foundations Director will inform the student, and a meeting with the student will take place to discuss next steps. Based on feedback from the Foundations Director, the student will update their Focused Learning Plan, which will be reviewed and either approved or not approved by the Foundations Director.
   3. After the time period specified in the Focused Learning Plan, the Foundations Director will review the student’s progress, which may include consultation other appropriate curriculum leaders. The outcome of this review will be a progress update submitted by the Foundations Director to the Student Progress Committee.
   4. The Student Progress Committee will review the student’s progress, including consideration of the student’s Focused Learning Plan, and decide whether the student is satisfactorily progressing.
      1. If the Student Progress Committee decides that the student is satisfactorily progressing, the student will be informed by the Foundations Director and/or Director of Student Assessment that their Focused Learning Plan has been successfully completed and that they are satisfactorily progressing.
      2. If the Student Progress Committee decides that the student is not satisfactorily progressing, a formal remediation process will be initiated, as described in 3.c.
   5. In cases where a program of formal remediation is recommended to the Board of Examiners, the student should be provided with timely notice of the recommendation, disclosure of the evidence on which the recommendation is based (i.e. the reasons for the recommendation), and an opportunity to provide a response to the Board of Examiners.
3. Remediation or Probation (“Unsatisfactory Progress”)
   1. The student will be required to meet with the Foundations Director or delegate, as determined by the program.
   2. The student will be informed both orally and in writing by the Foundations Director that they are not satisfactorily progressing according to the terms of their Focused Learning Plan or formal program of remediation, that the Board of Examiners will be informed of this fact, and that their performance will be discussed at a meeting of the Board of Examiners. Students will also be informed of the consequences of not successfully completing the required remediation or probation requirements, as set out in the MD Program’s Standards for grading and promotion. The student must be fully informed of their rights, including their right to provide a written submission to the Board of Examiners in the event that their performance is being reviewed by the Board.
   3. The student may be required to meet with the Associate Dean, Learner Affairs or delegate for the purpose of exploring health-related or personal reasons for their unsatisfactory progress and potential supports needed.
   4. The Foundations Director, in consultation with other curriculum leaders, and subject to the approval of the Board of Examiners, is responsible for the design and content of a formal program of remediation or probation requirements. A program of formal remediation or probation requirements may include the repetition of one or more courses when they are next offered the following year, which may require a delay in promotion to the next year or level of medical training. The Foundations Director will recommend to the Board of Examiners the level of performance expected in supplemental assessments. Specific performance criteria that may differ from those normally used in a course or for a component may be required for successful completion of remedial work or probation requirements. The timing and duration of the remediation or probation will be dependent on the specific course(s)/component(s) in question.
   5. Following the specified time period for completion, the Student Progress Committee will review the student’s progress and decide if the student has successfully completed the formal program of remediation or probation requirements.
      1. If the Student Progress Committee decides that the student has successfully completed the formal program of remediation or probation requirements, the Student Progress Committee will recommend to the Board of Examiners that the student be granted Credit for the course, in accordance with the MD Program’s Standards for grading and promotion.
      2. If the Student Progress Committee decides that the student has not successfully completed the formal program of remediation or probation requirements, the recommendation to the Board of Examiners from the Student Progress Committee will be governed by the MD Program’s Standards for grading and promotion. In such cases, the student should be provided with timely notice of the recommendation, disclosure of the evidence on which the recommendation is based (i.e. the reasons for the recommendation), and an opportunity to provide a response to the Board of Examiners.
   6. The Board of Examiners will make the final determination regarding successful completion of the remediation or probation requirements. Students may appeal to decisions made by the Board of Examiners to the Appeals Committee, which is a standing committee of the Council of the Faculty of Medicine.

Procedures to address unsatisfactory progress based on professionalism assessments and critical incident reports

The MD Program’s professionalism standards of achievement and procedures to address unsatisfactory progress with respect to professionalism are described in the Student professionalism guidelines.