Falsification of Patient's Medical InformationReporting medical information such as physical examination findings, lab values, test results, and any other relevant patient information to other students, residents, attending physicians, the patient, the patient's family, or other relevant medical personnel that has been fabricated by the medical student.
2. Responsibility
A medical student must acquire competences with the appropriate concepts, knowledge, and skills which the faculty determine to be essential. These competences shall be utilized to care for the sick and to promote the health and welfare of society. A medical student shall recognize a responsibility to participate in activities contributing to an improved community.
Medical students in the care of patients must not be harmful, dangerous, or negligent to the mental or physical health of a patient or the public. Negligent means the failure to use that degree of skill and learning ordinarily used under the same or similar circumstances by other medical students.
Medical students must pay tuition and other University fees, such as the Quarterly Profile Exam fee, on time. Medical students must complete required forms of evaluation, degree forms, examination applications, etc. on time.
Students must be familiar with and follow the rules and regulations of the School of Medicine, the University, and related professional organizations.
B. Medical Professional Behavior
1. Nondiscrimination
A medical student shall be dedicated to providing supervised competent medical service with compassion, respect for human dignity, and without discrimination. It is against University regulations to discriminate on the basis of race, color, creed, sex, age, national origin, disability, or Vietnam Era Veterans status. The University has an AIDS policy statement consistent with state law that prohibits discrimination against persons with AIDS or who are HIV positive.
2. Representation
A medical student shall accurately represent himself/herself to others including, but not limited to, colleagues, instructors, representatives of the University, patients, attending physicians, and other members of the health care team. Examples of misrepresentation include, but are not limited to, the following:
- A medical student shall never use the title of "Doctor" or M.D., as this clearly misrepresents the student's position, knowledge, and authority.
- Use of fraud, deception, lies, or bribery in securing any certificate of registration or authority, diploma, permit or license issued, or in obtaining permission to take any examinations.
- Impersonation of any person holding a certificate of registration or authority, permit, license or allowing any person to use his/her certificate of registration or authority, permit, license or diploma from any school.
- Forgery, alteration, or misuse of a patient's medical records or knowingly furnishing false information to the medical team and/or professional organizations.
3. Confidentiality
A medical student shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences within the constraints of the law. The patient's right to confidentiality in regard to his/her medical record, which includes confidentiality of personal and social history, is a fundamental tenet to medical care.
The discussion in public of the problems of an identified patient, without the patient's permission, by professional staff (including medical students) violates patient confidentiality and is unethical. Under no circumstances can any medical record be removed from the institution. Photocopying of the entire record is never permitted for presentations or rounds; students are permitted to extract information, but not copy "wholesale" parts of the chart. Names of patients should be omitted from any documents used for these presentations.
4. Disclosure
While the medical student is a member of the medical team and under faculty supervision, a medical student shall continue to study, apply and advance scientific knowledge, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
Sharing of medical information appropriately with a patient and colleagues involved in the care of the patient is a fundamental ethical requirement. The patient must be well informed to make health care decisions and work intelligently in partnership with the medical team. Information that the patient needs for decision making shall be presented in terms the patient can understand. If, for some reason, the patient is unable to comprehend, there shall be disclosure to the patient's authorized representative.
Failure of a medical student to share medical information relevant to a patient with the patient and colleagues involved in the care of the patient is unethical. Providing inaccurate information with these individuals is also unacceptable.
5. Assessment of Personal Competence (Self-Evaluation)
Medical students shall seek consultation and supervision whenever their ability to play their role in the care for a patient is inadequate because of lack of knowledge or experience.
Students are expected to respond to constructive criticism by appropriate modification of behavior.
It is unacceptable for a medical student to attempt procedures or to prescribe therapies without supervision.
6. Professional Demeanor
The medical student is expected to be thoughtful and professional when interacting with patients and their families, attending physicians, supervising residents, and other medical students, and whenever his/her behavior may influence adversely the judgments of others about the professional school or University.
Students shall maintain a neat and clean appearance, and dress in attire that is generally accepted as professional by the patient populations served.
Inappropriate behavior includes, but is not limited to, the use of offensive language, gestures, or remarks. Attempting, directly or indirectly, by way of intimidation, coercion or deception, to obtain or retain a patient or discourage the use of a second opinion or consultation is not appropriate.
7. Informed Consent
Students are to understand the physician's obligation to obtain informed consent from patients, but are not responsible for obtaining it for a physician. Simply, it is the physician's responsibility to ensure that the patient or his/her surrogate be appropriately informed as to the nature of the patient's medical condition, the objectives of proposed treatments, treatment alternatives, and risks involved. The patient's or surrogate's concurrence must be obtained without coercion.
8. Conflict of Interests
If a conflict of interest arises, the moral principle is clear -- the welfare of the patient must be, at all times, paramount. For example, gifts, hospitality, or subsidies offered by manufacturers and distributors of medical and pharmaceutical equipment/goods shall not be accepted if acceptance would influence the objectivity of clinical judgement.
9. Misconduct with Patients
The medical student will not engage in romantic, sexual, or other non-professional behaviors with a patient -- even upon the apparent request of a patient -- while the medical student is involved with the patient's care.
10. Impairment
The medical student will not use alcohol or drugs in ways that impair his/her ability to perform the work of the profession or results in compromised patient care. It is the responsibility of every medical student to strive to protect the public from an impaired colleague and to assist that colleague whose capability is impaired because of alcohol or drug use.
In some instances a medical student's alcohol or drug problem may also be referred to the AIMS Council. However, consideration by the AIMS Council does not remove the medical student's obligation to comply with these Standards of Professional Conduct or the University's Student Conduct Code.
11. Criticism of Colleagues
Professional relations among all members of the medical community shall be marked by civility. Scholarly contributions shall be acknowledged and each person shall recognize and facilitate the contributions of others to this community; slanderous comments and acts are not acceptable. Medical students shall deal with professional, staff, and peer members of the health team in a considerate manner and with a spirit of cooperation.
It is unethical and harmful for a medical student to disparage, without sufficient evidence, the professional competence, knowledge, qualifications, or services of a colleague to anyone. It is also unethical to imply without reliable evidence -- by word, gesture, or deed -- that a patient has been poorly managed or mistreated by a colleague.
12. Teaching
The word "doctor" (for the Latin "docere" -- to teach) implies a responsibility to share knowledge and information with colleagues and patients. It is incumbent upon those entering this profession to teach what they know of the science, art, and ethics of medicine. It includes communicating clearly and teaching patients so that they are properly prepared to participate in their own care and in the maintenance of their health.
III. University of Missouri Student Conduct Code
In addition to the conduct detailed in the preceding sections, a medical student is subject to the University of Missouri Student Conduct Code, as administered by the Office of the Vice Chancellor for Student Affairs, except for provisions dealing with academic dishonesty, Section 200.010 B.1.
Conduct for which students are subject to sanctions falls into the following categories:
A.Forgery, alteration, or misuse of University documents, records or identification, or knowingly furnishing false information to the University.
B. Obstruction or disruption of teaching, research, administration, conduct proceedings, or other University activities, including its public service functions on or off campus.
C. Physical abuse or conduct which threatens or endangers the health or safety of any person.
D. Attempted or actual theft of, damage to, or possession without permission of property of the University or of a member of the University community or of a campus visitor.
E. Unauthorized possession, duplication, or use of keys to any University facilities or unauthorized entry to or use of University facilities.
F. Violation of University policies, rules or regulations or of campus regulations including, but not limited to, those governing residence in University-provided housing, or the use of University facilities, or the time, place and manner of public expression.
G. Manufacture, use, possession, sale, or distribution of alcoholic beverages or any controlled substance without proper prescription or required license or as expressly permitted by law or University regulations.
H. Disruptive or disorderly conduct or lewd, indecent, or obscene conduct or expression.
I. Failure to comply with directions of University officials acting in the performance of their duties.
J. Illegal or unauthorized possession of firearms, explosives, other weapons, or dangerous chemicals.
K. Actual or attempted theft or other abuse of computer time, including but not limited to: a) unauthorized entry into a file to use, read, or change the contents, or for any other purpose; b) unauthorized transfer of a file; c) unauthorized use of another individual's identification and password; d) use of computing facilities to interfere with the work of another student, faculty member, or University official; e) use of computing facilities to interfere with normal operation of the University computing system; and f) knowingly causing a computer virus to become installed in a computer system or file.
HONOR COUNCIL PROCEDURES FOR VIOLATIONS OF THE STANDARDS OF PROFESSIONAL CONDUCT
University of Missouri-Kansas City School of Medicine
Approved by the University of Missouri Board of Curators: December 1994
Honor Council Procedures for Violations of the Standards of Professional Conduct
University of Missouri-Kansas City School of Medicine
I. Jurisdiction of the Honor Council
The Honor Council shall be concerned with incidents of alleged violations by University of Missouri-Kansas City School of Medicine students of the School's Standards of Professional Conduct, Sections II.A and II.B. Violations of Section III will be referred to the Office of the Vice Chancellor for Student Affairs. The standards identify areas of conduct which are judged unacceptable for individuals either who are in or aspire to the profession of medicine. The Standards of Professional Conduct are published in the Council on Evaluation Policy Manual and Guidelines document of the School of Medicine. It is distributed to all newly accepted students during orientation. When a medical student has been charged with one or more acts of misconduct according to these standards, the Honor Council shall adhere to the following procedures detailed herein. The Honor Council shall have the authority to recommend sanctions upon any student appearing before the Council. The disciplinary proceedings described are not to be construed as judicial trials. Care shall be taken, however, to comply as fully as possible with the spirit and intent of these procedural safeguards.
II. Organization of the Honor Council
1. Composition
The Honor Council voting members shall consist of the Chair representing the Dean's Office, five faculty/staff members (1 Docent, 1 Basic Scientist, 2 Clinical Scientists, and 1 Humanities/Social Sciences representative), and one student member (1 Years III-VI). Four members constitute a quorum. Two nonvoting Honor Council staff, the Council Coordinator and the Administrative Assistant, assist the Chair in investigations and generation of reports and are present at the hearings to take minutes.
2. Eligibility and Appointment
Faculty/staff, and student members shall be appointed to the Honor Council by the Dean of the School of Medicine.
3. Chair
The Chair shall count as one member of the Honor Council and shall be entitled to vote on all matters before the Council.
4. Time of Appointment and Term of Office
The Chair and faculty/staff members of the Honor Council shall serve for the duration of their appointments by the Dean. The student member of the Honor Council shall serve for one year.
A student is ineligible to continue as a member of the Honor Council if he/she is placed on academic or disciplinary probation, or if for any other reason his/her continued membership on the Council may not be in the best interest of the School of Medicine as determined by the Dean.
III. Procedures for Report of Violation, Investigation, Informal Disposition, and Notice
A. Report of Violation
An alleged violation of the Standards of Professional Conduct should be reported to the Chair or his/her designee of the Honor Council as soon as possible after discovery of the incident.
B. Preliminary Procedures and Investigation
The Chair of the Honor Council or his/her designee shall investigate any reported student misconduct before initiating formal conduct procedures. The reporter will be requested to meet with the Chair or his/her designee to discuss the alleged violation.
The Chair is responsible for notifying, in writing, the accused student of the charge brought against him/her prior to the commencement of the investigation. In addition, the student charged with misconduct shall receive a copy of these Procedures for Violations of the Standards of Professional Conduct along with the written notice. The Chair shall meet with the accused student to give the student the opportunity to present a personal version of the incident or occurrence.
C. Informal Disposition
After conducting an investigation, the Chair or his/her designee shall provide a written report to the Dean, the accused student, and the Honor Council members.
The Chair shall have the authority to dismiss a charge that is determined unfounded or to impose appropriate sanctions and shall fix a reasonable time within which the student shall accept or reject a proposed informal disposition.
A failure of the student either to accept or reject within the time fixed shall be deemed to be an acceptance and, in such event, the proposed disposition shall become final upon expiration of such time.
If the student rejects informal disposition, it must be in writing and shall be forwarded to the Honor Council.
The Chair may refer cases to the Honor Council for formal investigation and hearing without first offering informal disposition.
The Dean or his/her designee may at any time temporarily suspend or deny readmission to a student from the School of Medicine pending formal procedures when the Dean or his/her designee finds and believes from available information that the presence of a student on campus would seriously disrupt the School of Medicine or constitute a danger to the health, safety, or welfare of members of the School of Medicine community. The appropriate procedure to determine the future status of the student will be initiated within seven calendar days.
D. Notice of Hearing
Upon completion of the investigation, when a student rejects informal disposition or the charge justifies a formal hearing, in the judgment of the Honor Council Chair, the Chair will schedule a formal hearing as soon as possible.
The reporter, witnesses, and accused student will be given written notice of the hearing by certified mail or personal delivery. The notice shall set forth the date, time, and place of the alleged violation, the conduct for inquiry, the date, time, and place of the hearing before the Council, request for attendance of the parties involved, and a reference for the accused student to the Rights of the Accused Student Upon Hearing which are outlined in these Procedures.
Notice by certified mail may be addressed to the last address currently on record with the School of Medicine. Failure by the accused student to have a current correct local address on record with the School of Medicine shall not be construed to invalidate such notice.
The notice shall be given at least seven (7) consecutive calendar days prior to the hearing, unless a shorter time be fixed by the Chair for good cause.
Any request for continuance shall be made in writing to the Chair who shall have the authority at his/her discretion to postpone the hearing if he/she determines the request is timely and made for good cause. The Chair shall notify the Honor Council members, the accused student, the reporter, the witnesses, and any other relevant individuals of the new date for the hearing.
If the accused student fails to appear at the scheduled time, the Honor Council may hear and determine the matter in the student's absence.
IV. Procedure for Honor Council Hearing
Rights of the Honor Council
The Honor Council shall have the right to:
- hear together cases involving more than one student which arise out of the same act of misconduct, but in that event shall make separate findings and determinations for each student;
- permit a stipulation of facts by the Honor Council member who performed the investigation and the student involved;
- permit the incorporation in the record by a reference of any document, affidavit, or other material produced and desired in the record by the School of Medicine or the student charged;
- question witnesses or challenge other evidence introduced by either the School of Medicine or the student at any time;
- hear from the Council Chair about dispositions made in similar cases
- and any dispositions offered to the student appearing before the Council;
- call additional witnesses or require additional investigation;
- dismiss any action at any time or permit informal disposition as otherwise provided;
- permit or require at any time, within a reasonable time as determined by the Council, amendment of the Notice of Hearing to include new or additional matters which may come to the attention of the Council before final determination of the case; provided, however, that in such event the Council shall grant to the student or the School such time as the Council may determine reasonable under the circumstances to answer or explain such additional matters; and,
- dismiss any person from the hearing who interferes with or obstructs the hearing or fails to abide by the rulings of the Council Chair on any procedural question or request of the Chair for order.
A. Rights of the Accused Student Upon Hearing
A student scheduled to appear before the Honor Council pursuant to formal notice of charges and disciplinary hearing shall have the right to:
- submit a written response to the charge outlined in the Notice before the scheduled hearing is to commence;
- request in advance of the scheduled hearing a review of any materials contained in his/her hearing file which will be kept in the Council on Evaluation Office;
- submit a written request for the identities of witnesses to be called to testify before the Council;
- be present at the hearing;
- have an adviser or counselor appear with him/her and to consult with such an adviser or counselor during the hearing; however, the adviser/counselor will not be allowed to question witnesses and/or members of the Council;
- hear or examine evidence presented to the Honor Council against him/her;
- question witnesses present who are testifying against him/her at the hearing;
- present evidence by witness, affidavit, written report, other memoranda, photographs, drawings, and any other relevant evidence of any defense the student desires;
- make any statement to the Honor Council in mitigation or explanation of the conduct in question;
- remain silent to avoid self-incrimination;
- be informed in writing of the findings and any decisions imposed by the Honor Council, Coordinating Committee, and the Dean; and,
- appeal the decision and/or disposition to the Chancellor, as herein provided.
B. Rights of Witnesses
Witnesses shall be notified of the scheduled time, date, and location of the hearing. Witnesses shall bring with them whatever documentation is requested. Failure of a student witness to appear, without good cause, is a violation of the Standards of Professional Conduct.
C. Record of Hearing
All proceedings of the Honor Council are to be held in the strictest confidence by the members and all other persons involved. The hearings shall be audio taped, and written minutes are also recorded. The notice, exhibits, hearing record, verdict, and disposition of the Honor Council shall become the "Record of the Case". This official document shall be filed under strictest security in the permanent records of the Evaluation Council Office. The record shall be accessible at reasonable times and places to both the University and the student for the purpose of review or appeal.
D. Conduct of the Hearing
The Honor Council Chair shall preside at the hearing, call the hearing to order, call the roll of the Honor Council members in attendance, ascertain the presence or absence of the student charged with misconduct, read the Notice of Hearing and charge and verify the receipt of notice of charge by the student, report any continuances requested or granted, establish the presence of any adviser or counselor of the student, call to the attention of the student charged and the adviser any special or extraordinary procedures to be employed during the hearing, and permit the student to make suggestions of or objections to any procedures for the Honor Council to consider.
All requests to address the Council shall be addressed to the Chair. The Chair will rule on all requests and points of order and may consult with Council's legal adviser prior to any ruling. The Chair's ruling shall be final, and all participants shall abide thereby, unless the Chair shall present the question to the Council at the request of a member of the Council, in which event the ruling of the Council by majority vote shall be final.
Rules of common courtesy and decency shall be observed at all times. An adviser or counselor may be permitted to address the Council at the discretion of the Chair. An adviser or counselor may request clarification of a procedural matter or object on the basis of procedure at any time by addressing the Chair after recognition.
Opening Statements:
1) The Honor Council Chair or his/her designee shall make opening remarks outlining the general nature of the case and testify to any facts the investigation has revealed. 2) The accused student may make an opening statement to the Council about the charge at this time or at the conclusion of the School of Medicine's presentation.
School of Medicine Evidence:
1) School of Medicine witnesses are to be called by the Chair of the Honor Council and identified or written reports of evidence are introduced as appropriate. 2) The Council may question witnesses at any time. 3) The student may question witnesses or examine evidence at the conclusion of the School of Medicine's presentation.
Student Evidence:
1) The student shall have the opportunity to make a statement to the Honor Council about the charge. 2) The student may present evidence through witnesses or written memoranda. 3) The Council may question the student or witnesses at any time.
Rebuttal Evidence:
The Honor Council may permit the School of Medicine or the student to offer a rebuttal of the other's presentation.
If it appears that essential testimony is unavailable, or that for other good cause the hearing should be deferred, the Council may continue, recess or discontinue the hearing without prejudice.
V. Determination of the Honor Council
Following the hearing, the Council shall promptly deliberate in closed session out of the presence of the student charged. Determination is to be made regarding both the validity of the misconduct charge and on the discipline, if any, to be imposed.
A. Violation of the Standards of Professional Conduct
The Honor Council shall determine if the evidence presented in the hearing supports the charge of violation of the Standards of Professional Conduct. The Council shall render a decision, by simple majority vote, of whether a violation has been committed by the accused. Each charge of misconduct, if there are more than one, shall be considered individually and/or collectively at the discretion of the Council.
B.Discipline Imposed
The Honor Council shall determine the discipline to be imposed, if any, based upon its deliberations. One of the following forms of discipline is to be recommended by means of simple majority vote of the Council members. Where there are multiple violations, there can be separate sanctions for each violation. The sanctions include, but are not limited to, the following:
- No Disciplinary Action. Given when the student is not found in violation of the Standards of Professional Conduct.
- Warning. A written reprimand to the student that the student has violated the Standards of Professional Conduct. A copy is to be placed in the student's file.
- Probation. A written reprimand to the student for violation of the Standards of Academic Conduct that includes a designated period of time, the probability of more severe sanctions if the student violates any institutional regulation(s) during the probationary period, and subject to any appropriate terms or conditions, such as loss of privileges, restitution, and discretionary assignments.
- Suspension. An involuntary separation of the student from the School of Medicine for a specified period of time or until a special conditions have been met, with a statement whether suspension should relate back to the date of the offense, begin at the time imposed, or begin at a date specified in the future. At the conclusion of the period of suspension, the suspended student is automatically returned to student status. Conditions for readmission may be specified.
- Dismissal. An involuntary separation from the the School of Medicine for an indefinite period of time. The order of dismissal may specify a date before which the faculty will not consider a petition for readmission from the dismissed student.
- Expulsion. Permanent separation of the student from the School of Medicine.
The above sanctions apply to the status of the accused student in the School of Medicine. Any sanction impacting a student's enrollment status and/or privileges will be forwarded to the Vice Chancellor for Student Affairs or designee for information purposes.
An oral presentation of the Council's findings and recommendations is permitted following the hearing, but a written document including findings of fact, verdict, and recommended disposition shall be completed as soon as possible after the hearing. This Final Report of the Council shall be submitted to the Coordinating Committee, the Dean, and the Office of the Vice Chancellor for Student Affairs.
VI. Decision of the Coordinating Committee
The findings and determination of the Honor Council serve as recommendations to the Coordinating Committee and to the Dean of the School of Medicine. The Coordinating Committee, chaired by the Associate Dean for Academic Affairs and composed of members detailed in The Academic Plan for the School of Medicine, reviews the charge of misconduct, the findings of fact, the decision of the Council, and the recommended discipline to be imposed from the Honor Council.
After deliberation and careful consideration, the Coordinating Committee approves, by simple majority vote, one of the following actions: 1) to sustain the recommendations of the Honor Council; 2) to amend the recommendations of the Honor Council to another type of sanction; 3) to remand the Honor Council's recommendations; or, 4) to reverse the Honor Council's recommendations.
The findings and determinations of the Honor Council and the Coordinating Committee shall be transmitted to the Dean in writing within seven (7) consecutive calendar days following the Coordinating Committee meeting. A copy of this recommendation shall also be transmitted to the accused student by certified mail or personal delivery in the indicated time frame.
VII. Decision of the Dean
Upon receipt of the documents from the Honor Council and the Coordinating Committee, the Dean shall review the entire record that includes the following: 1) formal notice of the charges; 2) minutes of the Honor Council hearing; 3) written findings of the Honor Council and its recommendations to the Coordinating Committee; and 4) written decision of the Coordinating Committee concerning the sanction passed.
The Dean will, within a reasonable amount of time, make a decision to either affirm, amend, or reverse the Coordinating Committee's sentence, or remand the Coordinating Committee for further proceedings.
The Dean shall notify the student in writing by certified mail or personal delivery of his/her final decision. Copies of the letter will be sent to the Honor Council Chair, the Coordinating Committee Chair, and the Evaluation Council Office for placement in the student's file and in the official hearing file.
VIII. Right of Appeal
When a recommendation from the Honor Council and the Coordinating Committee is made for some form of disciplinary action other than "none", and this is upheld by the Dean, or if a recommendation of "no disciplinary action" is revised to one of greater severity by the Dean, the student may appeal such decision to the Chancellor or his/her designated representative by filing written notice of appeal with the Chancellor within ten (10) consecutive calendar days after notification of the decision of the Dean. A copy of the Notice of Appeal will also be given by the student to the Dean of the School of Medicine at the time of filing. The student may file a written memorandum for consideration by the Chancellor with the Notice of Appeal.
The Chancellor or his/her designated representative shall review the full record of the case and the appeal documents and may affirm, reverse, or remand the case for further proceedings and shall notify the Dean and the student in writing of the decision on the appeal. The action of the Chancellor shall be final unless it be to remand the matter for further proceedings.
Status during Appeal: In cases of suspension, dismissal or expulsion where a Notice of Appeal is filed within the required time, a student may petition the Chancellor in writing for permission to attend classes pending final determination of appeal. The Chancellor may permit a student to continue in school under such conditions as may be designated pending completion of appellate procedures, provided such continuance will not disrupt the University or constitute a danger to the health, safety or welfare of the University community. In such event, however, any final disciplinary action imposed shall be effective from the date of the action of the Dean.
IX. Status of the Standards of Professional Conduct
Amendments to the Standards of Professional Conduct and/or Honor Council Procedures for Violations may be proposed by petition of any twenty-five members of the student body, the Honor Council on its own motion, or the faculty.
A proposed amendment in the Standards of Professional Conduct and/or Honor Council Procedures for Violations must be approved by the Honor Council, the Coordinating Committee, the Dean, the Chancellor, and the Board of Curators.
The Standards of Professional Conduct and/or Honor Council Procedures for Violations may be terminated at any time by action under the general amending procedure.
All students in the School of Medicine are subject to the jurisdiction of the Standards of Professional Conduct and Honor Council Procedures for Violations upon enrollment.
To insure their knowledge of the Standards of Professional Conduct and Honor Council Procedures for Violations, the presentation of these documents shall be an integral part of the orientation of newly accepted students to the School of Medicine.