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In the teaching and learning of Medicine, professionalism is a core academic competency. The primary intention of this policy is to provide an effective mechanism for the early identification of students who need assistance with their professional development so that appropriate remediation can be implemented in support of their successful completion of the program. The secondary intention of this policy is to assist with crucial academic decisions when remediation is unsuccessful or inappropriate.

This policy is not intended for application to incidents of formative feedback that are normative to the education and enculturation of a medical student. It is intended for those circumstances in which a student comes to attention because of conduct that is outside the recognized norms within that student’s cohort. Professionalism issues may also be addressed in the objectives and evaluation mechanisms of specific courses.

The policy covers most allegations of unprofessional conduct behaviours that occur in academic or clinical settings or other work placements, or that are related to the student's area of professional study, including all allegations of academic misconduct as delineated in the University of Saskatchewan Regulations on Student Academic Misconduct. See 2.d. below for possible exceptions. The Dean of the College of Medicine delegates administrative responsibility for this policy to the Associate Dean, Education.

Note that when students are away from the program (school breaks, vacation, leave, etc.) the policy nevertheless applies to them pursuant to their ongoing recognition as members and representatives of the college and the profession (i.e., participation in college-related activities, use of college communications, self-identification as medical students, etc.) Because medical students are on the educational registry of the College of Physicians and Surgeons of Saskatchewan, they are subject to the Saskatchewan Medical Professions Act (1981) and thus are expected to eschew “unbecoming, improper, unprofessional or discreditable conduct.”

1. Informal Procedures

Many cases of alleged unprofessional conduct on the part of students result from misunderstanding or lack of familiarity with the expected standards. (See both Appendix One for College of Medicine specifications of professional conduct and Appendix Two for University of Saskatchewan specifications of academic misconduct.) A case of this kind can often be addressed through an informal meeting with the student by a teacher/supervisor who first identifies the issue. Generally, a conversation and cautionary explanation may be sufficient, although it may also be reasonable to expect that the student will address the issue in a manner mutually agreed upon. A brief account of the circumstances and response, signed by both the teacher/supervisor and the student, should be submitted to the “formative file” of the Professionalism Panel (see Section 3 below) for documentation purposes. (See the Appendix Three for a copy of the informal report form and more detailed instructions.) Should two or more such accounts be received, the Panel may, at its own discretion, arrange to meet with the student through the Associate Dean, Education, as delineated below.

Clinical courses include Professionalism as a component to be taught and assessed. This policy is not intended to override course-related assessment processes or documentation. However, if unprofessional conduct is identified that is outside the developmental norms for a student’s cohort, in addition to the documentation required for the course itself, an informal report form should be submitted for consideration by the Professionalism Panel. This will ensure that repeated incidents are recognized and addressed as such, rather than being addressed in isolation.

When the student and the teacher/supervisor cannot agree on an informal resolution, when the nature of the conduct is such that it should be addressed through a more formal approach, and/or when the outcome might/should affect the student's final grade, academic record (including the Medical Student Performance Record, or MSPR), or academic progress in the program, the formal procedures should be followed, as delineated below.

2. Formal Allegations of Unprofessional Conduct

The formal procedures are designed so that the allegation can be investigated, the student can speak to the issues, and the response can be both commensurate and effective.

Note: Questions concerning procedural matters relating to the following rules should be directed to the Director of Student Affairs of the College of Medicine.

  1. A formal report of unprofessional conduct may be made by a member of the General Academic Assembly, an instructor, a student, an administrative official of the University, a staff member in an affiliated facility, or a member of the public. The Associate Dean, Education will make a written copy of this policy and associated forms available on request.
  2. A formal allegation of unprofessional conduct shall be in writing and shall be signed by the person making it. (See Appendix Three for a copy of the formal report form.)
  3. A formal allegation shall be delivered to the Associate Dean, Education for the College of Medicine.
  4. Should allegations pertain to circumstances that are solely personal and/or unrelated to the study of medicine (for example, student-student social interactions), the Associate Dean will refer the matter to the University Secretary, who will determine whether the allegations fall under the jurisdiction of the Breach of Professionalism Policy or the Standard of Student Conduct in Non-Academic Matters and Procedures for Resolution of Complaints and Appeals (October 2008). The decision of the Secretary will be final and not subject to appeal.1
  5. Where this policy applies, the Associate Dean, Education shall deliver a copy of the allegation along with a copy of these rules:
    1. to the student against whom the allegation is made (hereinafter through Section 4 below, the respondent); [to ensure clarity when the reporter is also a student]
    2. to the Phase Chair for the phase in which the respondent is registered;
    3. to the instructor of the course, when the alleged offence involves the course; and
    4. to the Director of Student Affairs.
  6. If the allegations concern conduct that may significantly impact the safety or wellbeing of others, particularly patients, the Associate Dean, Education may interrupt the participation of the respondent(s) in clinical activities pending investigation of the allegations. In such cases, the Panel would proceed as quickly as possible and, as soon as safety is established, would communicate to the Associate Dean, Education that the respondent(s) could resume clinical activities.
  7. Normally a complaint will not be accepted beyond one year after the alleged misconduct or the informal procedures referenced above, unless the Professionalism Panel considers that there are grounds to extend that time limit.2

1 The transfer of a matter out of College of Medicine jurisdiction is intended, in part, to enable and ensure appropriate support by College of Medicine support personnel and processes for all students involved, without creating role-related conflicts of interest.

2 This parallels the University of Saskatchewan Standard of Student Conduct in Non-Academic Matters and Procedures for Resolution of Complaints and Appeals (October 2008)

3. Investigation of Allegations

  1. All Panel proceedings should be based on sound principles to ensure a fair hearing within a reasonably short period of time. The respondent is to be treated as being innocent until proven guilty and there must be both perception and reality that all hearings are open and transparent. The following are principles to be followed by the Panel.
    1. The primary goal of the process will be educational, leading to the successful remediation of unprofessional conduct and the subsequent successful completion of the program.
    2. Except as delineated in clause 2.f. or in the course syllabus for a course that assesses professionalism within the course itself, no respondent will receive academic sanctions for unprofessional conduct without a Panel hearing and a decision for sanction by the Panel.
    3. If it appears that unprofessional conduct warrants formal intervention and possible sanctions, the incident must be reported in writing to the Associate Dean, Education in the College of Medicine.
    4. The incident report shall be specific as to details of the incident and be filed as soon as is possible after the occurrence of the incident or after the discussion with the respondent.
    5. Upon receipt of this incident report, unless the University Secretary directs otherwise (see 2.d), the Associate Dean, Education will refer it to the Professionalism Panel, as defined in clause 3.b. The Panel is to receive the evidence, determine the validity of the allegation and, if warranted, determine, implement and monitor appropriate remedial action. The Panel will also determine whether there should be academic repercussions. Where possible, the Panel should meet within four weeks from the receipt of the incident report.
    6. The Associate Dean shall write to the respondent as soon as possible advising him/her of the allegation, the date and place of his/her meeting with the Panel, and the Panel membership so that potential conflicts of interest can be identified. This notification will consist of both a letter to the respondent’s current postal address on file with the University, plus an email to the respondent’s usask email account, and it shall provide the respondent with approximately two weeks notice of the meeting date. The meeting could be rescheduled if necessary to accommodate the respondent’s schedule, with the guideline that the hearing should be held within four weeks of the receipt of the incident report. If the reporter is a member of the community from outside the College of Medicine or the University of Saskatchewan, every effort shall be made to minimize the inconvenience of his/her participation in this process.
    7. All information provided to the Panel in writing in advance of the meeting by any party should be shared with the other parties appearing before the Panel in advance of the meeting. In a case of multiple or group accusations, the Associate Dean, Education will determine whether the identity of co-accused students or associated students can be kept confidential.
  2. Upon receipt of an allegation as provided in clauses 2.c. and d., the Associate Dean shall convene the Professionalism Panel, composed of a chairperson who shall be an MD faculty member named by the Faculty Council, and two members of the faculty of the college, at least one of whom shall be an MD. Subject to clause 3.c., the Professionalism Panel will be a standing committee of the college appointed for this purpose. Faculty members will be appointed to staggered three-year terms, and may be re-appointed for a second term. It is recommended that at least one Panel member be experienced in the assessment of professionalism through prior or current participation in relevant activities of the College of Physicians and Surgeons of Saskatchewan. The Panel shall maintain its own records, separate from respondents’ academic files. Clerical support will be provided through the office of the Associate Dean, Education. The chairperson shall be appointed as an ex-officio member of the Undergraduate Education Committee.
  3. The Associate Dean, Education, in consultation with the Student Medical Society of Saskatchewan executive, shall appoint to the Professionalism Panel a more senior student from the MD program or, in the case of a respondent who is a final year student, from the first postgraduate year of medical training. The selection of the student may be challenged by the respondent if there is reasonable apprehension of bias or conflict of interest. Further, the respondent may choose to waive the requirement for student representation.
  4. The Panel may proceed at the discretion of the members. However, before reaching a conclusion, the Panel shall take into consideration all relevant evidence available to it. The Panel will meet with the respondent and, in most cases, with the person making the allegation. See clause 3.g. for exceptions.
  5. The Panel may, at its discretion, meet with any other person who, in the opinion of the board, can provide relevant evidence bearing on the matter.
  6. Panel hearings will be governed by the following.
    1. Except as provided for in clause 3.g., when the Panel meets, the respondent and the reporter shall be present before the Panel at the same time. The Panel may set its own procedures. A suggested order of proceeding is as follows: The reporter shall outline the evidence before the Panel followed by questions and points of clarification asked by the Panel members. The respondent shall then be allowed to express his/her side of the question followed again by questions and points of clarification asked by the Panel members. Questions for clarification purposes may then also be asked through the Panel chair by the respondent and by the reporter. After all questions have been answered and all points made, the Panel will meet in camera to decide on the question of validity and, if valid, an appropriate response/remediation plan. The decision and plan, if applicable, shall be communicated to the respondent and the reporter in writing as soon as is possible after the hearing. The respondent and the reporter shall be advised that either may appeal the Panel results to the Undergraduate Education Committee.
    2. At the hearing, the respondent should have the right to be accompanied by another person of his/her choice. The Director of Student Affairs is available for this purpose, but the respondent may make a different choice. Note that, unless the respondent explicitly requests that the Director of Student Affairs be excluded from the hearing, the Director of Student Affairs shall attend the hearing as an observer.
    3. Similarly, the reporter may be accompanied by a person of his/her choice. On request, the Associate Dean will provide information and assistance in the identification of a suitable escort who is familiar with the procedures associated with this policy.
    4. If the respondent does not respond to the written notification of the hearing, or refuses to appear before the Panel, or does not attend the hearing, the Panel has the right to proceed with the hearing. It is obviously in the respondent’s interests to be present for the hearing, but the Panel should not be prevented from holding a hearing because the respondent has not appeared.
  7. When the reporter is a not a member of the university community, and with the agreement of the Panel members, the respondent may waive the requirement that the reporter be present in person; this assumes that the written documentation is clear and uncontested. In addition, a teleconference or a videoconference may be considered.
  8. In circumstances in which the reporter is particularly vulnerable, the Chair of the Professionalism Panel may, at his/her discretion, permit the reporter to name a proxy to act on the reporter’s behalf.
  9. When a set of circumstances has led to allegations of unprofessional conduct against two or more respondents, the investigation shall include an opportunity for any or all of the respondents to be interviewed separately.
  10. In a case where the unprofessional conduct is ascribed to a group of students, the Panel will try to determine if one person is responsible, or whether varying degrees of responsibility can be delineated. If individual responsibility cannot be determined, the whole group may be sanctioned.
  11. In circumstances where previous Informal Reports may influence the Professionalism Panel’s current decision-making, the respondent will be offered the opportunity to formally address those prior incidents as part of the current hearing.

4. Finding of Unprofessional Conduct and Determination of Response(s)

  1. If a majority of members of a Panel conclude that the allegation of unprofessional conduct is supported by the evidence before the Panel, it shall recommend one or more of the following responses:
    1. that a remediation plan specific to the issues at hand be implemented, to be developed and monitored by the Panel;
    2. that there be a referral for assessment of possible medical and/or psychosocial issues at play, to be reported back to the Panel for further action and/or referral as necessary;
    3. that there be a record of the event(s) placed in the respondent’s academic file for use in the Medical Student Performance Record;
    4. that the respondent be required to repeat the phase of the MD program during which the unprofessional conduct was identified;
    5. that the respondent be suspended from the program for a specified period of time;
    6. that the respondent be expelled from the University; or
    7. that the conferral of a degree, diploma or certificate be postponed, denied or revoked.
  2. When determining the appropriate response, the Panel shall take into account responses imposed for similar unprofessional conduct as recorded by the Associate Dean, Education, as well as any record of previous reports of unprofessional conduct by the respondent(s). (See also clause 10.b.) It is intended that most incidents be addressed in a remedial fashion, without adverse impact on the respondent’s academic progress or record. However, repeated and refractory unprofessional conduct, or single incidents of particularly egregious conduct, may lead to the recommendation for academic repercussions as delineated above.
  3. Except as provided otherwise in clause 4.e., the chairperson of the Panel shall prepare a report of the board's deliberations which shall summarize the evidence on which the board based its conclusion that unprofessional conduct occurred and state the recommended response(s).
  4. Not later than 15 days after the Panel has completed its deliberations, the chairperson shall deliver a copy of the report to the following persons:
    1. to the respondent;
    2. to the reporter;
    3. to the Phase Chair in which the respondent is registered;
    4. to the instructor of the course, when the alleged offence involves the course;
    5. to the Director of Student Affairs;
    6. to the Associate Dean, Education;
    7. to the Chair of the Undergraduate Education Committee, only if it is the decision of the Panel to recommend academic repercussions;
    8. to the Registrar of the University of Saskatchewan, only if it is the decision of the Panel to recommend academic repercussions.
  5. When a Panel concludes that an allegation is not supported by the evidence, the report referred to in (c) shall so state.
  6. A recommendation of a Panel is deemed to have been adopted unless it is appealed as provided by the following rules

5. Appeal - College Level

  1. A respondent against whom action has been recommended (see Rule 4) may appeal the recommendation of the Professionalism Panel by delivering to the Associate Dean, Education a notice of appeal before the expiry of 15 days from the date a copy of the Panel report was delivered to that person.
  2. The Undergraduate Education Committee (UEC) is the academic promotions committee of the College of Medicine. It is the role of the UEC to receive and assess the recommendations of its academic subcommittees, ensuring that the respondent has received due process in evaluation of academic performance. The recommendations of the academic subcommittees must be approved by the UEC before taking effect.
  3. Upon receipt of a notice of appeal, the Associate Dean, Education shall send a request to the Chair of the UEC to hear the appeal. Upon receipt of such request, the Undergraduate Education Committee shall convene within 15 days to consider the appeal.

6. Appeal Procedure - College Level

  1. The UEC shall convene to hear the appeal as soon as is practicable, but not later than 15 days after receipt of the appeal.
  2. The UEC shall determine its procedures subject to the following:
    1. all parties involved shall be given adequate notice and full opportunity to participate in the proceedings other than the deliberations of the UEC;
    2. the recommendation of the Professionalism Panel and the reasons for it shall be presented by the Chair of the Professionalism Panel;
    3. a respondent shall be entitled to be accompanied by one other person of his/her choosing. (The Director of Student Affairs is available for this purpose, although the respondent may make a different choice);
    4. the respondent or his/her representative may speak to the issue;
    5. the respondent or his/her representative may question the Chair of the Professionalism Panel;
    6. the Chair of the Professionalism Panel may question the respondent;
    7. the respondent and the Chair of the Professionalism Panel may be questioned by members of the UEC.
  3. The hearing shall be in camera unless the respondent requests that it be open in which case the respondent is entitled to up to five observers. A request for more than five observers would require the approval of the chairperson.
  4. The proceedings shall be recorded according to usual UEC procedures

7. Disposition by the Undergraduate Education Committee

The UEC may, by majority:

  1. conclude that the findings and recommendations of the Professionalism Panel are unfounded and exonerate the respondent; or
  2. affirm the findings of the Panel and impose one or more of the following actions:
    1. that a remediation plan specific to the issues at hand be implemented, to be developed and monitored by the Panel;
    2. that there be a referral for assessment of possible medical and/or psychosocial issues at play, to be reported back to the Panel for further action and/or referral as necessary;
    3. that there be a record of the event(s) placed in the respondent’s academic file for use in the Medical Student Performance Record;
    4. that the respondent be required to repeat the phase of the MD program during which the unprofessional conduct was identified;
    5. that the respondent be suspended from the University for a specified period of time;
    6. that the respondent be expelled from the University; or
    7. that the conferral of a degree, diploma or certificate be postponed, denied or revoked.
  3. When determining the appropriate penalty, the UEC shall take into account responses to similar incidents of unprofessional conduct as recorded by the Associate Dean, Education.
  4. Except as provided otherwise in clause 7.f., the Chair of the UEC shall prepare a report of the committee’s deliberations which shall summarize the evidence on which the committee based its conclusions that unprofessional conduct occurred and state the penalty imposed. The report shall be delivered to the Associate Dean, Education.
  5. Within 15 days from the date the UEC has completed its deliberations, Associate Dean, Education shall deliver a copy of the chairperson’s report to the persons mentioned in clause 4.f. and to the Chair of the Professionalism Panel.
  6. When the UEC concludes that the findings and/or recommendations of the Professionalism Panel are not supported by the evidence, the report referred to in clause 7.d. shall so state.

8. Appeal - University Level

  1. Should unprofessional conduct fall under the University of Saskatchewan definition of Academic Misconduct (see Appendix Two), the ruling of the UEC is subject to automatic appeal as provided in the University of Saskatchewan Regulations on Student Academic Misconduct of the University of Saskatchewan Council.

    Otherwise, there is no appeal to the University against the findings and ruling of the UEC except on grounds as provided in the document Student Appeals in Academic Matters.
  2. Where grounds exist, the findings and ruling of the UEC may be appealed according to the procedures delineated by the Bylaws Committee of University Council for the appeal of adverse academic decisions. (See http://www.usask.ca/university_council/reports/12-06-99.shtml)

9. Endorsement on Student Records

At the conclusion of the deliberations as described above, including all applicable appeals, the Registrar shall:

  1. in the case of a report ordering expulsion of a student, endorse on the record of the student and on any transcript of the record the following: "Expelled for unprofessional conduct on the _______ day of _______, 20__."
  2. in the case of a report ordering suspension of a student, endorse on the record of the student and on any transcript of that record the following: "Suspended for unprofessional conduct for ___________" (period of suspension).

10. Reports

  1. Reports referred to in clauses 4.c. and 7.d. that record findings of unprofessional conduct shall be kept as confidential records by relevant University employees, except when the policy has led to sanctions in the respondent’s academic file. In that case, reference to the unprofessional conduct may be included in the Medical Student Performance Record.
  2. As described in 4.b., all prior records pertaining to the application of this policy will usually be reviewed by the Professionalism Panel when determining its response to subsequent finding of unprofessional conduct. However, in rare circumstances, the Panel may determine that the respondent has been the target of a frivolous, vexatious and/or wholly unfounded allegation. In such cases, the Panel may specifically direct that the record of the proceedings will be kept confidential and used solely for the protection of the respondent.3

3 This clause is not intended to apply to allegations that remain unproven, but only to those allegations that have, in the judgment of the Panel, been proven to be false.

11. Delivery of Documents

Delivery of any document referred to in these rules to a respondent may be made in person or by registered mail addressed to the address of the respondent as set out in the records of the Registrar. Delivery is presumed to have been made when it is received by the respondent or 5 days after the date of registration. Delivery of any document referred to in these rules to anyone else may be made in person or by Campus or regular mail services.

12. Professional Conduct

Appendix One provides specifications that are examples of expected professional conduct, failure of which may be the subject matter of an allegation under Rule 2. There may be instances of unprofessional conduct that resist such specification but, at the discretion of the Associate Dean, Education, may be reviewed according to this policy. See also clause 2.d.

Appendix 1 - Specifications of Professional Conduct

1. Honest / Integrity

2. Responsibility / Reliability

  • is dependable and fulfills commitments; e.g., reliably completes assigned duties and meets deadlines
  • is punctual and is not late or absent without justification

3. Compassion

  • shows a caring attitude; e.g., as evidenced by feedback from patients/relatives/staff/peers
  • strives to understand the needs of others, and attempts to meet the physical and emotional needs of patients, as appropriate

4. Self-Appraisal

  • recognizes own abilities and limitations; admits and handles errors and criticism appropriately
  • recognizes and declares conflicts of interest
  • maintains professional standards and performs procedures according to ability
  • balances personal and professional life, and recognizes the need to work safe hours
  • recognizes the need for appropriate care of physical and mental health, and seeks help where necessary
  • recognizes that use of alcohol or drugs may impair performance and takes appropriate action where necessary

5. Doctor / Patient Relationship

  • respects the patient’s privacy and dignity and maintains patient confidentiality
  • protects the patient’s rights and avoids emotional, sexual, physical or financial exploitation

6. Discrimination

  • behaves equitably towards all, irrespective of gender, age, culture, social and economic status, sexual preferences, beliefs, contribution to society, illness-related behaviours or the illness itself

7. Respect

  • shows respect for beliefs, rights, roles, responsibilities, abilities and cultural values of others
  • shows sensitivity in all interactions with patients and is not aggressive, hostile, derogatory or demeaning
  • respects the personal and professional integrity and roles of other health professionals
  • respects and co-operates with peers, patients, staff and other members of the community

8. Relating To Others

9. Participation

  • willingly participates and contributes in group community activities
  • facilitates the learning of others and does not inhibit their efforts
  • teaches others who are at earlier stages of learning

* Adapted with permission from the School of Medicine, University of Queensland (see Parker, Malcolm (2006), ‘Assessing professionalism: theory and practice’, Medical Teacher, 28:5, 399 – 403).

Appendix 2 From the University of Saskatchewan Regulations on Student Academic Misconduct Effective January 1, 2010

Appendix 3 - Report Forms

See the Forms section at the top of the page