Learning Environment & Medical Student Mistreatment Policy

Policy ID Number: N/A
Policy Title: Learning Environment & Medical Student Mistreatment Policy
Classification: University
Approval Authority: Undergraduate Curriculum Committee
Responsible Entity: College of Medicine Undergraduate Medical Education
Policy Owner: Clinical Sciences Planning and Evaluation Committee
Preclerkship Planning and Evaluation Committee


I. Policy Statement

The policy defines an appropriate learning environment and provides an overview of examples of student mistreatment, how to report concerns, and the process for follow up of concerns.

II. Scope

This policy applies to students enrolled in the College of Medicine MD Degree program, as well as any faculty, residents, and staff who interact with students.

III. Approval Authority

The final governing committee responsible for approving this policy is the Undergraduate Curriculum Committee. The Preclerkship Planning and Evaluation committee as well as the Clinical Sciences Planning and Evaluation Committee will periodically review the policy for updates.

IV. Purpose of This Policy

The Learning Environment & Medical Student Mistreatment Policy

• Outlines expectations for specific behaviors that establish an appropriate learning environment and mitigate the risk of student mistreatment

• Defines unprofessional behavior and student mistreatment

• Specifies grievance reporting procedures for breaches in the professional learning environment and incidents of student mistreatment

• Outlines the plan to track and address concerns once identified.

V. Who Should Be Knowledgeable about This Policy

College of Medicine Students
College of Medicine Faculty, Residents, and Staff
University Staff and Administration
Hospital Staff

VI. The Policy

Maintaining a safe and healthy learning environment requires that the faculty, administration, residents, fellows, healthcare professionals, staff, and students treat each other with the respect due all colleagues. All educators should realize that students, residents and fellows depend on them for evaluations and references, which can advance or impede their career development. Educators must take care to judiciously exercise this power and to maintain fairness of treatment, avoiding exploitation or the perception of mistreatment and exploitation. The quality of medical education rests not only in the excellence of the content and the skills that are taught, but also in the example provided to students, residents and fellows of humane physicians and educators who respect their professional colleagues at all career levels, their patients, and one another.

An appropriate student learning environment should foster professional growth, support academic achievement, and encourage the attainment of educational goals. Accordingly, MUSC’s learning environment should serve as a model of professionalism and collegiality and be characterized by professional attributes (i.e., altruism, duty, knowledge, and skill). All members of MUSC including faculty, staff and learners annually attest to the MUSC Code of Conduct and should demonstrate the values prescribed therein, which include integrity, trustworthiness, impartiality, respect, stewardship, confidentiality and compliance with laws and policies. Breaches in professional behavior and mistreatment of students threaten the learning environment and the institutional culture of professionalism and will not be tolerated. (MUSC Code of Conduct)

Examples of Student Mistreatment

Student mistreatment is defined as behavior by any faculty or staff member that is discriminatory, unfair, arbitrary, or capricious in nature, including behavior inconsistent with the values presented in the MUSC Discrimination Policy, or behavior that unreasonably interferes with the learning process. When assessing behavior that might represent mistreatment, students are expected to consider the conditions, circumstances, and environment surrounding such behavior.

Examples of student mistreatment include, but are not limited to the following:

· Verbally abusing, belittling, or humiliating a student

· Intentionally singling out a student for arbitrary treatment that could be perceived as punitive

· Excluding students without cause from reasonable learning opportunities

· Assigning duties as punishment rather than education

· Pressuring students to exceed established restrictions on work hours

· Exploiting students in any manner, e.g., performing personal errands

· Directing students to perform an unreasonable number of “routine hospital procedures”, i.e., “scut” on patients not assigned to them or where performing them interferes with a student’s attendance at educational activities, e.g., rounds, classes

· Pressuring a student to perform medical procedures for which the student is insufficiently trained, i.e., putting a student in a role that compromises the care of patients

· Threatening a lower or failing grade/evaluation to a student for inappropriate reasons

· Committing an act of physical abuse or violence of any kind, e.g., throwing objects, aggressive violation of personal space

· Making unwelcome sexual comments, jokes, or taunting remarks about a person’s protected status as defined in the MUSC Nondiscrimination Policy Statement.

· Being treated in an unfair, offensive, or discriminatory manner based on gender, ethnicity, or sexual orientation

*Please Note - the following would not be considered mistreatment:

· Teaching using the Socratic method, i.e., being asked questions to foster critical thinking and further education

· Providing constructive feedback about skills or knowledge areas that need improvement

No Retaliation Policy

The MUSC Code of Conduct strictly forbids discrimination or retaliation against any MUSC members who reports in good faith any instances of conduct that do not comply or appear not to comply with Federal or State laws and regulations or MUSC policies and procedures. At MUSC each member has the right to remain anonymous, as allowed by law, and to use confidential mechanisms provided by MUSC to disclose non-compliant activity without fear of retaliation of such reports. Retaliation can result in employment termination or academic dismissal. Individuals who believe they are experiencing retaliation are strongly encouraged to contact the Senior Associate Dean for Medical Education, the Associate or Assistant Dean for Student Affairs, the Associate Dean for Curriculum in the Basic Sciences, or the Associate Dean for Curriculum in the Clinical Sciences so that the situation can be addressed immediately.

VII. Special situations


VIII. Sanctions for Non-compliance

Failure to comply will result in investigation by student affairs and potentially the Office of Equal Opportunity/Affirmative Action or MUSC Office of Gender Equality. The need for sanctions will be determined based on the results of the investigation. The Learning Environment Review Committee has instituted a process for notifying educators, supervisors, and/or program directors accordingly when a pattern of behavior or a single egregious event is reported.

IX. Related Information

A. References, citations

1. AAMC Statement on the Learning Environment

2. See also University Policy – Treatment of Students Policy

B. Other

Reporting Concerns of Possible Mistreatment

Medical students who experience possible mistreatment or observe other students experiencing possible mistreatment are encouraged to report the incident if the matter cannot be resolved directly with the offending party. Suggested options for reporting are listed below:

Options for Reporting

1. Email or speak directly with any of the following people:

  • theme or course director
  • the Associate Dean for Curriculum in the Basic Sciences or the Associate Dean for Curriculum in the Clinical Sciences
  • the Associate and/or Assistant Deans for Student Affairs
  • the Senior Associate Dean for Medical Education

2. Submit a named or anonymous Learning Environment or Concern Card via the E*Value “Initiate Ad hoc Evaluation” tasks located on the Home Page of E*Value. These evaluations are sent to the Office of Student Affairs.

3. Submit an anonymous report through the MUSC compliance hotline at 1-800-296-0269 (Toll-free, available 24 hours, 7 days a week). MUSC Compliance  

Medical Students requesting complete anonymity should be made aware that doing so may interfere with the College of Medicine’s ability to investigate the concern and the student’s ability to receive information about the follow-up investigation.

Medical Students may also choose to pursue claims of unlawful discrimination or harassment in compliance with the University’s Anti-Harassment Policy: “The Medical University of South Carolina is an equal employment opportunity employer and does not tolerate any form of harassment or intimidation based upon sex, race, color, age, religion, national origin, disability or any other factor. Inquiries or complaints may be addressed to the Director for the Office of Equal Employment Opportunity/Affirmative Action at (843)792-1282.

Further information may be found at Equal Employment 

In the case of possible gender discrimination or sexual harassment, students have the additional option of contacting the MUSC Title IX Coordinators. The Title IX Coordinators address issues that involve students, residents, or faculty as either the complainant or the subject of a complaint. The contact information to make inquiries or file a complaint can be found at MUSC Title IX 

Responding to Concerns of Mistreatment

Every effort is made to respond to concerns of mistreatment in a timely and professional manner to minimize the risk of harm including retaliation. All complaints will be fully investigated and measures will be taken to reach an appropriate resolution. Except in cases of an anonymous complaint, students will be provided with clear and timely feedback concerning the status and resolution of their complaint.

A Learning Environment Review Committee, comprised of the Associate/Assistant Deans for Curriculum and Student Affairs, is charged with reviewing and responding to concerns about the learning environment. In addition to the reporting mechanisms above, the committee also receives and reviews low scores on either educator or course evaluation forms via the Office of Assessment, Evaluation, and Quality Improvement. Committee members initiate an investigation immediately for egregious violations and meet quarterly to review all complaints and identify patterns that need to be addressed. They oversee the process for notifying educators and supervisors about learning environment concerns.
The Office of Student Affairs will provide a de-identified annual written notice of reported concerns of mistreatment towards medical students (with corresponding dates indicated on the report) to the Senior Associate Dean for Medical Education. The Senior Associate Dean will review and present this annual report for discussion and comment with a governing committee of COM Deans (EDAS committee, consisting of Associate and Assistant Deans in the following areas: Education, Diversity, Admissions, and Student Affairs). Aggregate and de-identified data on reports of mistreatment of medical students will be created by the Office of Student Affairs and shared with the Undergraduate Curriculum Committee at least quarterly.

C. Appendices

X. Communication Plan

This policy will be presented annually to:

(1) All medical students in their respective academic orientations held in years 1-4.

(2) All interns in their orientation

(3) All housestaff, nurses, faculty and administration in an annual email from the COM Dean’s Office.

The policy can be found here: COM Policies and Procedures

XI. Definitions


XII. Review Cycle

Reviewed every 2 years.

XIII. Approval History

Approval Authority Date Approved
Undergraduate Curriculum Committee August 15, 2012
Undergraduate Curriculum Committee May 6, 2016
CSPEC December 12, 2018
Undergraduate Curriculum Committee April 12, 2019

XIV. Approval Signature

  April 12, 2019

Donna Kern, MD Date

Title: Senior Associate Dean for Medical Education, College of Medicine