Technical Standards Policy

It is the policy of the University of Arizona College of Medicine – Phoenix (COM – P) that all students possess the capability to complete, with reasonable accommodations when appropriate, the entire curriculum established by the COM-P, which is required to achieve a Doctor of Medicine (MD) degree. The medical curriculum requires demonstrated proficiency in a variety of cognitive, problem-solving, communicative, and interpersonal skills. To achieve these proficiencies, COM – P requires that each student be able to meet the following:

1. Motor skills: A student should have sufficient motor function to execute movements required to provide general care and treatment to patients in all healthcare settings. A student must be able to independently elicit information from patients by palpation, auscultation, percussion, and other diagnostic maneuvers. A student must be able to safely execute motor movements reasonably required to provide general care and emergency treatment to patients.
2. Sensory/observation: A student must be able to acquire the information presented through demonstrations and experiences in the basic and clinical sciences. A student must be able to observe a patient accurately, at a distance and close at hand, and observe and appreciate non-verbal communications when performing clinical assessment and intervention or administering medications. A student must be capable of perceiving the signs of disease and infection as manifested through physical examination. Such information is derived from images of the body surfaces, palpable changes in various organs and tissues, and information communicated by patients and body functions. A student must be able to adhere to the standards of patient assessment and standards of care, including the use of technological equipment.
3. Communication: A student must communicate effectively, sensitively, and rapidly with other students, faculty, staff, patients, family, and other healthcare professionals. A student must demonstrate a willingness and ability to give and receive feedback. A student must be able to: convey or exchange information at a level allowing development of a health history; identify problems presented; explain alternative solutions; and give directions during treatment and post-treatment. A student must be able to process and communicate information on the patient’s status with accuracy in a timely manner to members of the healthcare team. A student must be able to elicit information from patients, describe changes in mood, activity, and posture, and perceive nonverbal communications.
4. Cognitive: A student must be able to problem solve rapidly. This critical skill demanded of physicians requires the ability to learn and reason, and to integrate, analyze, and synthesize data concurrently in a multi-task setting. In addition, a student must be able to comprehend three-dimensional relationships and to understand the spatial relationships of structures. A student must be able to measure, calculate, reason, analyze, integrate, and synthesize in the context of the study of medicine. A student must be able to comprehend extensive written material. A student must also be able to evaluate and apply information and engage in critical thinking in the classroom and clinical setting. A student must be able to consider alternatives and make decisions for managing or intervening in the care of a patient.
5. Behavioral/social: A student must possess the ability to exercise good judgment, and to complete all responsibilities attendant to the diagnosis and care of patients and families. In addition, a student must maintain mature, sensitive, effective, and harmonious relationships with patients, students, faculty, staff, and other professionals under highly stressful situations. A student must have the ability to function effectively under stress and to adapt to an environment that may change rapidly without warning and/or in unpredictable ways. A student must be able to exhibit empathy, integrity, and concern for others.
6. Professional conduct: A student must abide by professional standards of practice. A student must be able to engage in patient care delivery in diverse settings and be able to deliver care to all patient populations.

Technical standards evaluations are used to determine if a student's academic or behavioral performance is/may be affected by impairment that includes but is not limited to: medical, behavioral, or substance use issues. The purpose of the technical standards evaluation is to determine the student's ability to perform their academic and clinical duties responsibly and safely; meaning the student without negative impact to patients, colleagues, self, or anyone in the learning environment or university/clinical properties.

1. The COM-P may require a technical standards evaluation when:
   1. There is a report from any source to the dean, student affairs or respective designee regarding a concern about a student that may negatively affect the health or safety of the student, patients, colleagues, anyone in the learning environment or University/clinical property.
   2. There is a report from any source to the dean, student affairs or respective designee regarding a concern that the student is struggling to meet the technical standards.
2. A student may be immediately removed from the learning environment by the dean, student affairs or respective designee during the course of the technical standards evaluation process. Depending on level of concern, the students may be placed on leave of absence, virtual learning, or another appropriate disposition, pending completion of the evaluation.

Definitions

Technical standards evaluation: An evaluation to determine the student's ability to perform their academic and clinical duties responsibly and safely. The evaluation is completed by a physician or psychologist selected by COM-P, who has no role in the teaching or assessment of medical students, and who has not had mental health contact with students. The technical standards evaluation is not a confidential clinical encounter between the student and evaluator.

Impairment: Conditions that may affect a student's academic or behavioral performance include, but are not limited to: medical, behavioral issues, or substance use disorder.

Technical standards: All accepted candidates to COM-P are required to sign an attestation that the technical standards are met as a contingency of their admission to and continued enrollment at COM-P. Each student endorses an acknowledgement of said requirement, which becomes a part of the student’ permanent record.

Technical standards evaluation report: A written report by the physician or psychologist who conducted the evaluation. The report is addressed to the dean, student affairs or respective designee and includes opinions regarding the student's ability to meet the technical standards with or without accommodation.

Notification: Any and all notifications must be made in writing. Email communication satisfies that requirement.

Process

1. Any individual concerned that a student is experiencing and/or demonstrating serious academic or behavioral deficiencies that interfere with the student’s ability to perform the skills set forth, or who otherwise creates a concern for the health and safety of the student, others, or university/clinical property, must report the concerns to the dean, student affairs, or respective designee.
2. The dean, student affairs, or respective designee will review the reported concerns and will determine if a technical standards evaluation is required.
   1. The dean, student affairs or respective designee will notify the dean, pre-clerkship curriculum and/or dean, clinical curriculum or respective designees, as well as notification to the vice dean, undergraduate medical education or respective designee.
   2. Technical standards evaluations will be conducted by a physician or psychologist who was selected by COM-P and has no role in the teaching or assessment of medical students, who is not a COM-P employee or contractor, and who has not provided medical or behavioral care to the affected student.
   3. The dean, student affairs, or respective designee will provide the pertinent information to the evaluator(s) selected to perform the technical standards evaluation.
   4. The evaluator will generate a written technical standards evaluation report addressed to the dean, student affairs, or respective designee and the registrar, regarding the student's ability to perform the technical standards required for the MD program, with or without accommodations.
3. The evaluation determination report is not required to include specific health information about the student.
4. If accommodations are required for the student to meet the technical standards, the evaluation determination report will note this fact.
5. If a student requires accommodations to meet the technical standards, the dean, student affairs, or respective designee will refer the student to the Disability Resource Center (DRC).
   1. It is the student’s responsibility to initiate contact with the DRC and complete the DRC’s assessment and accommodation process.
   2. If the student fails to contact the DRC within two weeks of the referral, the student will be deemed unable to meet the technical standards of the MD program.
6. A student who cannot meet the technical standards will be offered a medical or personal leave of absence when eligible and such leave meets the conditions of the Leave of Absence Policy and subject to the progression timeline.
   1. An additional evaluation will be required prior to reintegration into the curriculum subject to the process outlined above.
7. If a student has exhausted all leave of absence options, the student may withdraw from the MD program.
8. The technical standards evaluation report and all written records regarding the decisions and determinations will be kept in the student's permanent record secured in Docuware.
   1. A technical standards evaluation report will be considered valid for up to six months after the date of the report if there are no new or continuing concerns. After six months a new evaluation may be required.
   2. Once a technical standards evaluation is received by the Office of the Registrar, it becomes part of a student educational record and is protected by Family Educational Rights and Privacy Act (FERPA).
9. A student who refuses a technical standards evaluation will not be permitted to continue in the MD program and may be dismissed from COM-P in accordance with the following policies:
   1. Dismissal and Removal from Academic Environment Policy
   2. Enrollment, Sequencing, and Grading for Pre-Clerkships Policy
   3. Grading and Progression for Clerkships and Selectives Policy
   4. Grading and Progression for Electives Policy
   5. Student Appeals Committee Procedures and Policy
   6. Student Progress Committee Procedures and Process for Dismissal Policy
10. The cost(s) for the initial and any subsequent required technical standards evaluations will be the responsibility of COM-P. The cost(s) for any treatment will be the sole responsibility of the student.