Policy 170(d): Grading, Progression and Academic Standing in the Doctor of Medicine (MD) Program

1.  Purpose 

This policy establishes and communicates a standard for determining acceptable overall academic, professional and clinical performance towards achievement of the curriculum’s learning outcomes in the Doctor of Medicine (MD) program (the “Program”) at Toronto Metropolitan University (the “university”), to provide all students in the Program a measure of academic standing that is transparent and based on uniform definitions and categories while providing consistent rules for progression through the Program.

2.  Application, Scope and Policy Objectives

This policy applies to all MD program students. This policy also applies to all clinical faculty/faculty/teachers/assessors, staff, and administrators in the School of Medicine (the “School”) involved in the progression process. It describes the processes by which final grades, academic standings, and eligibility to graduate are earned and recorded on students’ official academic records. The objectives of this policy are:

• to establish a consistent minimum standard for demonstrating the knowledge, skills, and abilities of course and program outcome.
• to provide a consistent and fair system for determining students' eligibility to graduate.
• to provide all students with a system of academic standing that is based on uniform definitions and categories for their academic progress from first enrolment to graduation.

3.  Definitions

See APPENDIX  A. 

4.  Principles

The values stipulated in the university’s Senate Policy Framework are applicable and fundamental to this policy.

4.1  Integrity 

The university and School respect the importance of accuracy and integrity with respect to students’ official academic records for all stakeholders including students, clinical faculty/faculty/teachers/assessors, and external stakeholders such as patients, prospective employers, government, donors, and other academic institutions. The Office of the Registrar is responsible for ensuring student records and official transcripts are a credible reflection of students’ academic abilities and accomplishments.

4.2  Consistency  

The university and School support and advance the principles of consistency, fairness, and objectivity in the application of all rules and procedures that contribute to the completeness and integrity of students’ official academic records. 

4.3  Clarity

Information regarding the calculation of grades, academic standings, and graduation requirements will be clear and transparent. Students, clinical faculty/faculty/teachers/assessors, and staff should understand the rules and processes used for calculating and assigning grades and academic standings, and the determination of the necessary academic elements required to graduate.

4.4  Timeliness 

Processes used in the determination of academic requirements that will have an impact on students’ academic records should be applied with emphasis on timeliness to allow students the necessary time to address issues and expedite resolutions effectively.

4.5  Equity 

People in different circumstances often require different treatment (equity); this equitable treatment leads to equal access to opportunity and success; and while both equality and equity are related to fairness, equity is about being fair by taking differential circumstances into account (see Senate Policy Framework).   

4.6  Competency-Based Medical Education (CBME):

CBME is an approach to designing health professions’ education that is focused on outcomes, namely graduate abilities, or competencies. CBME uses statements of expected abilities of graduates, to guide teaching, learning, and assessment. Learning activities are deliberately sequenced to provide opportunities to progress from a novice to a competent graduate. With a CBME approach, the curriculum and programmatic assessment support learners’ development of competence. The developmental structure of CBME facilitates every learner’s progress toward the desired level of ability at the time of graduation. Under CBME, course duration does not guarantee a degree of learning.

4.7  Programmatic Assessment 

Programmatic Assessment is founded on a premise that a multitude of low-stakes samples of a learner’s progress on competency achievement is superior to a small number of high stakes tests – using various types of assessment to monitor competencies for a graduating TMU medical student. Assessments have two goals: 

• Assessment for learning – focusing on using assessment as an opportunity for feedback and for students’ ongoing improvement (i.e., for growth); and 
• Assessment of learning – focusing on students’ achievement of their learning outcomes and meeting their targets for each course and Program Learning Outcomes at the end of Year 1 and each of the 3 Phases of the program.

4.8  Social Accountability

The Program has been purposefully developed, community informed, and evidence based to align with the School of Medicine’s social accountability mandate as well as its vision, mission, values, program objectives, and student learning outcomes. It is rooted in principles of community-driven care and cultural respect, humility and safety, with Equity, Diversity and Inclusion (EDI), Reconciliation, and health equity intentionally embedded across all aspects of the Program.

4.9  Accommodation 

All processes and procedures associated with this policy are to be carried out in accordance with relevant law and university policies concerning the accommodation of students (see Policy 159: Academic Accommodation of Students with Disabilities and Policy 150: Accommodation of Student Religious, Aboriginal and Spiritual Observance).

5.   Academic and Clinical Evaluation

5.1   Program Requirements 

5.1.1   All curriculum requirements included in the Program Calendar must be met as published.

5.1.2  Students must complete all courses in accordance with the Program’s curriculum requirements.

5.1.3  All students must achieve the defined milestone of competency for progression within each Phase of the program to be recommended for progression and graduation.

5.1.4  All students must meet the Standards of Professional Conduct for Students in the Doctor of Medicine (MD) Program outlined in Senate Policy 175 and in the Handbook of the Program in each course for progression and for graduation.        Back to top

5.2    Courses and Grades 

5.2.1  The Course Lead assigns final grades for courses as Pass/Incomplete/Fail or other course performance designations as appropriate (see APPENDIX B).

5.2.2  Final grades will be approved by the UGME Competence Committee and verified by the Associate Dean UGME.

5.2.3  Student achievements will be documented in the School of Medicine’s Learning and Assessment Management System (LAMS) in a Portfolio using the relevant assessment data including narrative comments of assessors and supervisors. 

5.2.4  Course grades and academic standings for each student will be shared with the Office of Registrar by the Program each year and will be included on the academic record and official transcript.

6.   Academic Standing and Progression

6.1  Academic Standing 

MD program students are assigned an academic standing at the end of the first year and at the end of each of the three Phases of the Program. The academic standing is an indication of academic and clinical performance in a program of study. A single assessment will not determine a student’s overall standing in the Program. The data accumulated within the student portfolio on LAMS will be the basis of the decision made by the UGME Competence Committee regarding standing. The categories of standing are:

6.1.1  Progressing:

The student has completed all necessary assessments and has met pre-determined learning outcomes. Progression in all courses will require meeting all professionalism standards outlined in Senate Policy 175: Policy on Standards of Professional Conduct for Students in the Doctor of Medicine (MD) Program. 

6.1.2  Progressing with Support:

The student has one or more performance deficits or concerns identified at a level that the Competence Committee is confident can be addressed while the student continues in the next phase or year of the Program. Plans to address the deficit(s) or concern(s) with remediation will be created with a coach and mandatory additional learning support provided. This plan is not anticipated to impact overall achievement of the learning outcomes of the course, academic year, or phase. 

6.1.3   Not Progressing:

The student has been identified by a Course Lead and the UGME Competence Committee as having one or more substantial deficits relating to one or more aspects of the program’s educational outcome(s) and/or experience(s) and/or citation for a Level 3 or 4 Lapse of Professionalism as per Senate Policy 175:Policy on Standards of Professional Conduct for Students in the Doctor of Medicine (MD) Program. In the judgment of the Competence Committee, the educational experience cannot be remediated if the student continues to the next phase or year of study in the Program. The student cannot progress until the identified deficiencies are addressed. The outcome of this Academic Standing notation may include one or more of:

• required repetition of course or Phase,
• leave of absence, remediation and additional support for learning success that is internal or external to TMU, or
• the assignment of the academic standing of Dismissal from Program (DFP).

6.1.4   Dismissal from Program (DFP):

The student repeatedly does not meet the predetermined levels of competencies of the Program. A student may be dismissed solely for a Level 4 Lapse of Professionalism. See Senate Policy 175: Policy on Standards of Professional Conduct for Students in the Doctor of Medicine (MD) Program. Criteria include but are not limited to:

• a grade of fail in a course where a student is undergoing remediation
• inability to complete studies within 6 (six) years of admission to the Program.

A DFP may be appealed (see Policy 168: Grade and Standing Appeals).

6.2   Disciplinary Standings Assigned in Accordance with Policy 60: Academic Integrity

6.2.1   Disciplinary Withdrawal (DW)

An academic standing where a student is permanently withdrawn from a specific program and fully withdrawn from the University as a whole for a period of at least 2 (two) years. After serving the specified period, a student assigned a DW may apply to other programs/certificates at the University. A DW will be placed on both the student’s academic record and official transcript and cannot be removed.

6.2.2  Expulsion

An academic standing involving permanent removal of a student from the University. Students who are expelled from the University shall not be allowed to register or enroll in any class or program of the University. Expulsion shall be permanently noted on a student’s academic record and official transcript. 

7.   Eligibility to Graduate

7.1   Students who have submitted an application to graduate for the relevant graduation cycle will be reviewed by the Competence Committee for graduation-eligibility

7.2  Students will be eligible to graduate if they have;

• met all criteria for each Phase and course
• achieved a grade of Pass in each course
• demonstrated meeting the graduation level of competence for each UGME Learning Outcome of the program
• not have any unremediated Lapses of Professionalism 

7.3.  All graduating students will receive the degree of Doctor of Medicine. There will not be any degree granted with the terms “With Distinction” or other similar terms.

7.4  The student record is closed to changes once an academic credential (e.g., degree) is conferred.

7.5  Students may elect to withdraw their application to graduate for personal, career, or academic reasons and reapply in order to graduate in a subsequent convocation.

7.6  Graduation occurs twice per year, in June and in October.

8.  Timespan 

8.1  The MD Program at TMU is designed as a 3-Phase, 4-Year program. The maximum time line for completion is 6 (six) years from admission to the program to graduation.

8.2  Under extenuating circumstances, such as unexpected health conditions, students may be granted permission by the Dean to extend the timespan to graduate with only one extension granted. In order to graduate, a student will be required to meet the academic requirements in effect when the extension is granted or such alternative requirements as may be stipulated by the School in keeping with the University’s academic policies.

8.3  The Dean’s decision not to extend the timespan to graduate can be appealed directly to the Senate Appeals Committee see Policy 168: Grade and Standing Appeals) 

9.   Interpretation and Application

The interpretation and application of this policy is the responsibility of the Dean, School of Medicine, who also makes final decisions when required, under this policy. 

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Related Policies/Procedures

Senate Policy 60: Academic Integrity

Policy Policy 61: Student Code of Non-academic Conduct 

Senate Policy 135: Final Examinations

Senate Policy 150: Accommodation of Student Religious, Aboriginal and Spiritual Observance

Senate Policy 157: Establishment of Student Email Accounts for Official University Communication

Senate Policy 159: Academic Accommodation of Students with Disabilities

Senate Policy 168: Grade and Standing Appeals

Senate Policy 175: Standards of Professional Conduct for Students in the Doctor of Medicine (MD) Program Senate 

 

Appendix A

Definitions 

Academic Record

A student’s internal record retained by the University and used as the basis for the official transcript. It is also used for advising purposes.

Academic Standing

A determination based on the final course grades at the end of Year 1 and at the end of each of the 3 Phases of the program. It is used to determine a student's eligibility for progression and graduation. 

Alternatives Assessments

Assessments that are replacement academic evaluations of student achievement, that are prepared and/or approved by a clinical faculty or faculty member in response to a student with demonstrated extenuating circumstances which resulted in missing or non-completion of an assessment.

Assessments

In line with Programmatic Assessment (PA), multiple different assessment approaches and tools to sample student progress over time are utilized in the UGME curriculum, including: Progress Testing (PRT), Formative written assessments; Small group assessment; Laboratory assessments; Workplace-based assessments (WBAs); Project-based assessments; Standardized Clinical Assessments – which incorporates Objective Structured Clinical Examinations (OSCEs) and Simulated Performances (Sim).

Assessors 

Those assessing students’ learning and skills development in the TMU MD Program, including clinical faculty, faculty or peers. This also applies to other healthcare providers, community-based individuals, and patients in an organization affiliated with the School. All assessors are oriented to their role and the tools used as part of the program of assessment through appropriate training.

Competencies 

The graduating program outcomes (also termed TULOs) grouped thematically under 8 (eight) roles, with the expectation that a competent graduating future physician seamlessly integrates the competencies of: Health Advocate; Collaborator; Professional; Leader; Scholar; Communicator; Medical Expert (the integrating role); Self.

Course Lead

The person responsible for overall leadership of a course in UGME.

Clinical faculty

Anyone with a clinical faculty appointment.

faculty (lower case f)

Anyone represented by the Toronto Metropolitan Faculty Association (TFA).

Final Course Grade 

A measure of a student’s final academic performance in a course. Students receive their official final course grade only from the Registrar’s Office. Refer to Appendix B for Course Performance Designations.

Learning and Assessment Management Systems (LAMS)

A software platform for organizing and mapping curriculum and assessment elements for medical students across multiple years and learning assignments. This is used to deploy, display, gather, curate, and collate assessments for use by the Program Council, coaches, students, relevant clinical faculty, faculty and staff in the MD program, and the Competence Committee using secure databases with permission layers. Students will be able to add artefacts which are part of the expected assessment (e.g., reflections). 

Official Transcript 

An official transcript is the complete record of a TMU MD Program student’s academic history. The official transcript also displays admission to and withdrawal from the program of study and other credits granted towards a program. All official transcripts are complete and unabridged. Partial transcripts are not issued. An official transcript is issued and certified by the Office of the Registrar and has security features that verify its authenticity. 

Phase

A distinct time period in the four-year UGME curriculum: Phase 1 means Foundations Phase, September Year 1 through March Year 2; Phase 2 means Clinical and Community Immersion Phase, April Year 2 through August Year 3; and Phase 3 means Professionalization Phase, September Year 4 through April Year 4.

Learning Plan

A formalized plan of study developed and agreed to by the relevant clinical faculty/faculty member(s) in consultation with the student which outlines what must be achieved and may also allow the student to continue in their program of study. It defines the maximum and/or minimum number of courses that can be taken, assigns specific courses and required outcomes, and recommends academic support and seminars.

Registrar’s Office (Office of the Registrar)

The office at TMU is responsible for ensuring the accuracy and integrity of student records and that official transcripts are a credible reflection of students’ academic abilities and accomplishments. 

Remediation

A process of addressing and correcting deficiencies in a student’s knowledge, skills or understanding of the course material, professional achievements and/or performance. This process, overseen by a designated faculty member, contains a learning plan that attempts to understand root causes (to prevent recurrence); has a defined timeline and milestones; and offers additional support as needed.

Suspension Period

A period during which a student may not register in any Toronto Metropolitan University courses or programs. A suspension period may result from a Disciplinary Suspension academic standing assigned in accordance with Policy 60.

Timespan

The maximum period of time to complete a program's curriculum and graduation requirements, calculated starting from admission to the program to graduation.

UGME

Undergraduate medical education.

Year

The MD Program is a four-year program that is split across three phases. Phase 1 includes Year 1 and part of Year 2. Phase 2 includes the remainder of Year 2 and all of Year 3. Phase 3 incorporates all of Year 4. Each year commences in September but has a different end point. Year 1 runs from September to June; Year 2 runs from September to June; Year 3 runs from September to August; and Year 4 runs from September to April.

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Appendix B

Course Performance Designations 

DEF (Deferred) - an interim grade assigned during the investigation of academic misconduct (as described in Senate Policy 60: Academic Integrity). The DEF grade will be replaced by an official course grade upon resolution of the matter.

FLD (Failure in a Pass-Fail course) - failure to meet the minimum satisfactory standards for a course with a pass/fail designation (as predefined in the course outline). 

INC (Incomplete) - the identified course or section of a course assessment component is not completed to the level of competency identified by the program.

PSD (Passed) - satisfactory performance in a course (as pre-defined in the course outline).

Other Abbreviations 

CBME – Competency-Based Medical Education: an outcomes-based approach to the design, implementation and evaluation of education programs and to the assessment of learners across the continuum that uses competencies or observable abilities. 

EDI – Equity, Diversity, and Inclusion

EPA – Entrustable Professional Activity: units of professional practice that capture essential competencies in which learners must become proficient before undertaking them independently. 

LAMS – Learning and Assessment Management System

LAU - Learner Affairs Unit of the School of Medicine

MD – Doctor of Medicine

MSPR – Medical School Performance Record

OSCE – Objective Structured Clinical Examination

PA – Programmatic Assessment

PRT – Progress Testing

WBA – Work-Based Assessment

TULO – TMU UGME Learning Outcome

 

Procedures: Policy 170(d) Undergraduate Medical Education, Grading, Progression, Academic Standing 

1.  Programmatic Assessment                      

1.1  Programmatic Assessment (PA)            

The Grading, Progression, and Academic Standing Procedures (the “Procedures”) outline the processes to be followed in carrying out the UGME Grading, Progression, and Academic Standing policy and the roles and responsibilities of students, faculty, teachers, and other assessors, Dean or designate, and Senate

• Outcomes of a curriculum described as a series of statements on the expected abilities of graduates, called a competency framework. 
• Many samples of students’ progress in achieving the outcomes competencies over the course of the curriculum. Each sample is but a data point of relatively low stakes with students provided with feedback for improvement to support learning.
• Multiple different assessment approaches and tools to sample student progress over time. 
• Multiple assessors provide a variety of inputs into student progress.

1.2  Student Portfolios

These learning portfolios, housed in the LAMS software platform, are a collection of evidence of the student learning and achievements supporting progressive competency. The student portfolio contains the various assessments, data, and other evidence of learning. The LAMS will be used by the UGME Program Council, coaches, students, relevant clinical faculty, faculty and staff in the MD program, and the Competence Committee. This will serve as a tool for the Competence Committee to review data to provide feedback, unofficial final course grades, progression, and graduation-eligible decisions and record Progression Plans. The portfolio will also be necessary to provide transparency for students and to enable them to reflect on their learning to date, to have self-awareness, and to establish learning plans. It will also help academic coaches guide students in their learning. Students are able to add artifacts which are part of their expected assessment (e.g., reflections). The records retention schedule will follow TMU’s Records Retention Policy.

2.  Final Course Grades 

2.1  The Course Lead is responsible for viewing, in a holistic fashion, all assessments in the student portfolio for a course and indicating whether the student has met the predefined standard for the course. 

2.2  The Course Lead will assign a final course grade of Pass/Incomplete/Fail. 

2.3   Final Course Grades can be appealed (see Policy 168: Grade and Standing Appeals). 

2.4   Where the work is incomplete (INC), the Course Lead will stipulate what is required to complete the course. The INC is an interim grade that will display on the student record and student transcript until a grade change is submitted. 

2.5   Where there is an investigation of academic misconduct (as described in Senate Policy 60: Academic Integrity), an interim DEF grade will be applied. The DEF grade will be replaced by an official course grade upon resolution of the matter.

2.6  Numerical scores for assessments within a course, where applicable (e.g., in Monthly Knowledge Assessments), shall be used only to track progress of individual learners, and shall not appear on transcripts. Similarly, a given domain of competency can be designated as achieved or not-yet achieved. The various assessments within a course are not appealable.

2.7   Student achievement will be documented on the student record and the official transcript. Relevant narrative comments of assessors and supervisors will be housed in the student record on the LAMS and will support progression decisions and appeals (where relevant) by the UGME Competence Committee.

2.8   For each course in a given year, students must complete the prerequisite course to progress to the next year level of that course.

2.9   All final UGME courses shall be Pass/Fail.

2.10  The final course grades will be approved by the Competence Committee and validated by the Associate Dean, UGME. If approved as valid, the Associate Dean, UGME will request the Program Registrar to forward final grades to the Office of the Registrar(TMU).

2.11   All final course grades must be submitted by the designated individual from the UGME Office to the Office of the Registrar (TMU) by the date determined as communicated by the Registrar’s Office.

2.12   Final course grades are considered official as per the date outlined in the “significant dates” section of the Undergraduate Medical School Calendar each year.

2.13   Official final course grades may not be posted or disclosed to students by any faculty/teacher/assessor. Final course grades cannot be displayed to students in the learning management system course shell. Students will receive their official final course grades only from the Registrar’s Office, available for viewing in MyServiceHub.

2.14   Final course grades will display on the student’s academic record and official transcript.

3.  Academic Standing 

3.1   At the end of Year 1 and at the end of each of the 3 (three) Phases of the MD program, the academic standing of students will be determined by the UGME Competence Committee. Following a review of students’ portfolios by each Course Lead and a determination of the grade within each course, the Competence Committee will undertake a holistic review of each student file. 

3.2   The data accumulated within the student file will be utilized to determine the standing of a student and make student progression decisions (along with accommodation, professionalism, and remediation plans - if needed).

3.3   This Year/Phase achievement review will include all the assessments from all the courses along with the Progress testing (PRT) and the objective structured clinical examinations (OSCE) results (if any).

3.4   Academic standing at the end of Year 1 and in end of each of the three phases will be determined by meeting all of the following progression requirements (where applicable): 

• achieving a grade of pass in all phase-specific courses; 
• meeting professionalism standards of the Program and School;
• achieving the defined level of performance in the phase’s progress testing assessments; 
• completing to a level of pass, all phase-specific work-based assessments; 
• achieving pass for all phase-specific Entrustable Professional Activities (EPA) assessments; 
• successful completion of the assigned stage of completion for projects assigned to the phase
• completion of all formative quizzes with a grade of pass; 
• completion of the Phase’s documentation of the professional portfolio as per program guidelines;
• achieving a level of pass in all phase-specific OSCEs; 
• completion to a level of pass of all phase-specific laboratory assessments; 
• submission of required peer-related and community/patient based feedback with reflections in the individual portfolio;
• attendance at and completion of assignments for any community immersion experiences as outlined in the phase or phase-specific course terms; and
• submission of any required assessments for individual learning.

3.5   Based on these criteria, standing will be classified into one of the following 3 stages of progress:

Progressing: The student has completed all necessary assessments and has met pre-defined learning outcomes. They have thus completed a year or a phase satisfactorily

3.5.1  Phase 1: There are two progression decision points in Phase 1. At the end of Year 1, the student has completed all the Year 1 courses and met all the educational outcomes for these courses. At the end of Year 2 (Phase 1), the student has completed all the Year 2 courses and met all the educational outcomes for these courses. All formative assessments are completed. The student has met the expected standard for all defined assessments including the Progress tests (PRT) and will have met the standard for the OSCE. The student has no unremediated Lapses of Professionalism in their file.

3.5.2  Phase 2: At the end of Phase 2, the student has completed all Clerkship required learning experiences and will have met the progression standard with completion of the Phase 2 stage of program learning outcomes. The student has met all the learning outcomes for Phase 2. The student has met the expected standard for all defined assessments including the Progress tests (PRT) and will have met the standard for the OSCE. The student has no unremediated Lapses of Professionalism in their file.

3.5.3  Phase 3: At the end of Phase 3, the student has completed all the requisite electives, the self-selected focused learning activity, and the modules to support transition to PGME. The student has met all the Phase 3 learning outcomes for the longitudinal courses. The student has met all the learning outcomes for Phase 3. The student has met the expected standard for all defined assessments including the Progress tests (PRT) and will have met the standard for the OSCE. The student has met a graduating level of competency in all TULOs. The student has no unremediated Lapses of Professionalism in their file.

Progressing with support: The student has a performance challenge identified at a level that the assessors are confident the deficit(s) or concern(s) can be addressed while the student continues in the program. Plans to address the deficit(s) or concern(s) will be created by the UGME Office in consultation with the Course Lead and involving the LAU. Students who have received a Fail grade in a course cannot progress. Students who have achieved an incomplete in a course or courses, may be able to progress with support, and will be assessed on a case-by-case basis, as per the decision by the UGME Competence Committee.

Not progressing: The student has demonstrated an inability to meet the graduating competencies and/or has achieved a Fail in a course or courses and the educational experience(s) cannot be made up while the student continues in the program. The student cannot progress until the deficits are addressed. This will require significant assistance from the UGME Office and the LAU which will extend curricular time. They may be required to repeat with remediation and/or learning plan or be subject to Dismissal From Program (DFP).

3.6   The decisions of the UGME Competence Committee will be shared with the Associate Dean UGME for validation and recorded in the program database and on the student’s official transcript.

3.7   Communication to the student will be electronic through the program learning and assessment management software. Communication timelines will follow UGME processes for progression decision making as outlined in 4.1 below. This will be no later than three weeks following the UGME Competence Committee meeting. A progression decision is not official until it is recorded and communicated to the student by the Registrar’s Office.

3.8   Standing decision of Progressing with Support and Not Progressing can be appealed (see Policy 168: Grading and Standing Appeals). 

4.   Competence Committee                                                              

4.1   The Competence Committee will monitor student progress and validate student progression four times per academic year, at the end of the first year and at the end of each of the 3 (three) phases. 

4.2   This committee will comprise School of Medicine faculty who are not Phase Leads or Course Leads or in any leadership role in UGME (i.e., Accreditation Lead, Accommodation Lead, etc.). Committee members will be trained in the global assessment of students’ portfolios at the standard expected. Members will be required to declare and monitor for all conflicts of interest. All members will sign confidentiality attestations.

4.3   This committee will identify students who are not progressing as expected or are at risk of non-progression. Students with cited professionalism issues will also be reviewed and next steps recommended. Should the student fail to progress because of failure in one or more course(s), there will be a plan created for academic remediation for the student, with support from the UGME office and LAU, that is approved by the Competence Committee, to support the student meeting the phase milestones. Options would include continuing in the Program studies while repeating the course/year/phase; requesting a non-academic leave of absence or if applicable, Dismissal From Program (DFP). 

4.4   The Competence Committee may make recommendations that are appropriate in the circumstances, including, without limitation, for a student to request a leave of absence to allow for addressing health, academic or personal issues impacting their learning and progression. If a student declines the recommendations, the Competence Committee will assess next steps on a case-by-case basis.                                                                                                                                    Back to top    

5.  Program and Graduation Requirements

5.1   Using predetermined standards, the Competence Committee will recommend students for the MD degree designation upon satisfactory demonstration of graduation competence in all TULOs.

5.2   Students must be registered with a full course load during the academic year except under exceptional circumstances and with prior approval of the Competence Committee.

5.3   Students will be reviewed in May of Phase 3 of the MD program by the Competence Committee for graduation-eligibility. 

5.4   Students who are not progressing and hence unable to graduate may appeal this decision (see Policy 168: Grade and Standing Appeal).

5.5   Students may elect to defer graduation for personal, career, or academic reasons and elect to convocate at a later date.

5.6   Graduation occurs twice per year, after the end of Winter Term and after the end of Spring/Summer term. Students must submit an application to graduate within TMU’s applicable deadline dates for each term.

5.7   Criteria for Obtaining the MD: In order for students to be recommended for graduation by the Competence Committee and the Associate Dean UGME, there must be:

• clear documentation of progression across phases; 
• completion of all program requirements which includes achieving a grade of Pass in all program courses and subsequent standing of ‘Progressing’ in each of the three Phases; completion of all assigned remediations, where applicable; 
• not having exceeded 6 (six) years of study in the program since matriculation unless sanctioned by decisions from the program’s appeals process; and,
• no unremediated Lapses of Professionalism.

6.  Course Repeats

6.1    All course attempts including repeated courses are recorded on the official transcript and academic record and cannot be removed.

6.2   Only failed courses can be repeated. No course can be repeated more than once (two attempts in total). If students fail a course for a second time, they will be assigned an academic standing of Dismissal From Program (DFP)

7.  Voluntary Withdrawal 

7.1    A student who chooses not to continue in a program must officially withdraw from the program. Withdrawn students will not be entitled to use the services of the University or the program.

7.2   A student who voluntarily withdraws from the UGME may re-apply through the UGME Admissions Office. Students in this situation will be treated as new applicants to the MD program. Readmission is not guaranteed and may be subject to conditions.

8.  Grade Revisions

8.1   Course Leads are responsible for submitting grade revisions. Grade revisions are submitted to the UGME Competence Committee. 

8.2   Once the revision has been authorized, the UGME Competence Committee must submit the form to the Registrar’s Office for updating.

8.3   Student Records will update the grade revision to the student’s academic record in MyServiceHub. 

8.4   All final course grades will be displayed on the student’s transcript.

9.  Incomplete Grades  

9.1   The designation of “Incomplete” (INC) indicates the identified course or section of a course assessment component is not completed to the required level of competency identified by the program.

9.2   The designation INC is an interim grade and is not counted as credit to fulfill prerequisite requirements and program requirements.

9.3   Course Leads assigning a grade of INC must complete the MD Program Incomplete Grade Request Form within 7 (seven) working days of assigning the grade of INC, clearly defining the outstanding work to be completed and a final deadline by which the outstanding work is to be completed.

9.4   The student may be assigned a standing of Progressing with Support with an INC grade in a course, based on assessment of the student's profile and determination by the UGME Competence Committee. Students who have more than one INC grade will be assigned a standing of Not Progressing. The Course Lead will determine the date by which the incomplete work must be finalized. This will be forwarded to the UGME Competence Committee for confirmation. Following this, the date and plan will be communicated to the student and recorded in the academic record. The MD Program will retain a copy of the Incomplete Grade Request Form for the School’s student file.

9.5   If the identified course or section of a course assessment component is not completed to the required level of competency identified by the MD program within this time frame, the INC designation will be converted to a grade of Fail (FLD).An outstanding INC may impact the ability to meet requirements to enroll in subsequent courses. 

9.6   INC designations appear on the official transcript and academic record until it is or is not successfully remediated. 

9.7   If a student has 2 or more INCs outstanding by the end of the timeline established by the Competence Committee, they will be required to repeat the year/phase.

9.8   Students with extenuating circumstances that impact completion of an assessment(s) may request a final grade of INC by petitioning the Course Lead or the Competence Committee within 1 week of the circumstances cited as driving the INC request.

9.9   Once the outstanding course work is completed and (where applicable) submitted by the student for grading, the Associate Dean UGME in discussion with the Course Lead will arrange for the work to be graded and submit a revised final course grade to the Registrar’s Office using the Automated Grade Revision Process or other established procedures. The INC will be replaced by an official final course grade when the work is completed and a final course grade is submitted by the Course Lead.

9.10  Students assigned a Standing of Not Progressing at a time when they have an outstanding INC grade must resolve the INC prior to appealing the standing decision.

9.11  In extenuating circumstances, such as an unexpected health condition, the student may request approval from the UGME Competence Committee for a one-time extension to the original INC completion date agreed to on the Incomplete Grade Request Form. When granting an extension, the Competence Committee will consider the student’s academic progress in their program of study. All extensions must be reported to Student Records using the Incomplete Grade Request Form. The form must include the final extension date. 

9.12  INC grades that have not been resolved in compliance with the student’s learning plan will be converted to a grade of Fail.

9.13  Students will be required to resolve outstanding INCs within published deadlines to clear outstanding academic graduation requirements in order to be considered for graduation-eligibility.

10.  Timespan to Complete Degree 

10.1  Once per academic year, after the enrollment period, any student who has exceeded their time for completion of the program will have a “hold” applied to the academic record. The hold will restrict the student from enrolling in future courses.

10.2  Under extenuating circumstances, students may petition the Dean or designate for an extension to these time limits.

10.3  An extension will only be granted to students whose progress is fully satisfactory. No registration will be permitted beyond the extension deadline. 

10.4  Students must request the extension prior to the last day of classes for the term in which the time limit will expire. 

10.5  Students requesting a timespan extension must submit electronically the following information to the Dean:

• an explanation for the reason for the request including any extenuating circumstances
• a detailed and realistic academic plan of study and timeline for completion during the extension period including length of the extension being requested
• supporting documentation to demonstrate the extenuating circumstances 

10.6  If a timespan extension is approved by the Dean or designate, the hold on the record will be updated to reflect the extension end date.

10.7  All documentation including the Dean or designate’s approval, the study plan and the extension date must be forwarded by the UGME Office to Student Records to retain permanently in the student’s record.

10.8  Once the extension date expires, the student will no longer be able to enroll in further courses. 

10.9  If the request for a timespan extension is denied or if a further extension is being requested, students may appeal directly to the Senate Appeals Committee (SAC) for a final consideration of their request. This is a SAC Timespan Extension Appeal.                                       Back to top

11.  Appealing the Denial of a Timespan Extension to the Senate Appeals Committee (SAC)  

11.1  If the student chooses to appeal the Dean or designate’s decision regarding a timespan extension request, or if a further extension is being requested, the appeal will be considered by the Senate Appeals Committee (SAC). 

11.2  In the case of an appeal of a denial, the student must request the appeal within 10 (ten) business days of the denial. 

11.3  Students must provide the following information by email to senate@torontomu.ca

• Senate Appeals Committee Timespan Appeal Form 
• a letter to the Senate Appeals Committee expressing why the request should be considered 
• any new evidence not previously submitted (if applicable) 
• all previously submitted documentation to the Dean or designate including their decision 
• explanation of the reason for the request including any extenuating circumstances
• a detailed and realistic academic plan of study and timeline for completion during the extension period 
• supporting documentation 
• in the case where a further extension is being requested, a student must also provide a letter explaining the reason why the plan of study from the first timespan extension was not completed

11.4   A Notice of Review will be sent to the student within 10 (ten) business days of their SAC Timespan Appeal being received and will include when the review of their appeal will occur together with the names of the panel members conducting the review. 

11.5  The student will not attend the SAC review. The review will be based on the official transcript and documentation provided by: 

• the student 
• the School

11.6  The SAC will consider the extension as applicable in the MD program of study.

11.7  The SAC decision will be issued by email within 10 (ten) business days of the review.

11.8  SAC decisions are final and not appealable.

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Related Policies/Procedures 

Senate Policy 60: Academic Integrity

Policy Policy 61: Student Code of Non-academic Conduct 

Senate Policy 135: Final Examinations

Senate Policy 150: Accommodation of Student Religious, Aboriginal and Spiritual Observance

Senate Policy 157: Establishment of Student Email Accounts for Official University Communication

Senate Policy 159: Academic Accommodation of Students with Disabilities

Senate Policy 168: Grade and Standing Appeals

Senate Policy 175: Standards of Professional Conduct for Students in the Doctor of Medicine (MD) Program Senate