Non-Involvement of Health Practitioners Policy

The purpose of the Non-Involvement of Providers of Student Health Services in Student Assessment Policy is to articulate the College of Medicine’s stance that health professionals who provide health services to a medical student must have no involvement in assessing their academic performance or participating in decisions regarding their promotion or graduation, excluding exceptional circumstances.

This policy ensures that the Undergraduate Medical Education program meets or exceeds the following Committee on Accreditation of Canadian Medical Schools (CACMS) and Liaison Committee on Medical Education (LCME) accreditation standards:

12.5 Providers of Student Health Services/Location of Student Health Records: The health professionals who provide health services, including psychiatric/psychological counseling, to a medical student have no involvement in the academic assessment or advancement of the medical student receiving those services, excluding exceptional circumstances. A medical school ensures that medical student health records are maintained in accordance with legal requirements for security, privacy, confidentiality, and accessibility.

*see definitions

Confidentiality: The College of Medicine is committed to maintaining the confidentiality and security of all undergraduate medical education student records, including health-related records voluntarily submitted by medical students.

Integrity:  The Non-Involvement of Providers of Student Health Services in Student Assessment Policy is intended to maintain the integrity of the Undergraduate Medical Education Program, by avoiding actual or perceived conflicts of interest related to an overlap of clinical responsibilities and student assessment and/or promotion.

Conflict of Interest: in relation to this policy, a situation in which a health care professional who provides health services to a medical student becomes involved in their academic assessment, promotion, or graduation decisions.

Course Administrator:  a module, course, rotation, or program director responsible for the overall administration of the academic activity.

Health Services:  for the purposes of this policy, unless otherwise specified, health services includes all care related to physical and mental health issues, including provision of psychiatric care and psychological counselling. 

This policy applies to all undergraduate students registered in the Doctor of Medicine (MD) program at the University of Saskatchewan irrespective of the geographically distributed site to which they are currently assigned.

Related policies include: Conflict of Interest During Student Assessment, Student Records Policy, Procedures for Academic Appeal, Health Information Protection Act.

1.0 Student Health Services, University of Saskatchewan

No clinician from the Student Health Services, University of Saskatchewan, shall assess a medical student’s performance or participate in decisions regarding their promotion and/or graduation if they have provided health services to the medical student.

2.0 Office of Student Services, College of Medicine

No clinician from the Office of Student Affairs, College of Medicine, shall assess a medical student’s performance or participate in decisions regarding their promotion and/or graduation if they have provided health services to the medical student.

3.0 Year Committees, College of Medicine

Medical student promotion and graduation recommendations are made on a case-by-case basis by individual Year Committees to the Student Academic Management Committee within the College of Medicine.

Any member of a Year Committee who has previously provided health services to a medical student whose case is under consideration for promotion or graduation must declare a conflict of interest, recuse themselves from that portion of the meeting, and abstain from commenting or voting upon the individual situation.

Where quorum cannot be obtained due to multiple conflicts of interest, the Associate Dean, Undergraduate Medical Education will temporarily appoint a faculty member to serve as a proxy for the committee member(s) who declared a conflict of interest. The proxy will only be authorized to consider and vote upon promotion or graduation decisions where a conflict of interest was declared. The proxy will be removed from the committee immediately afterwards.

4.0 Student Academic Management Committee, College of Medicine

Medical student promotion and graduation decisions are made on a case-by-case basis by the Student Academic Management Committee within the College of Medicine.

Any committee member who has previously provided health services to a medical student whose case is under consideration for promotion or graduation must declare a conflict of interest, recuse themselves from the portion of the meeting, and abstain from commenting or voting upon the individual situation.

Where quorum cannot be obtained due to multiple conflicts of interest, the Associate Dean, Undergraduate Medical Education or Academic Director will temporarily appoint a faculty member to serve as a proxy for the committee member(s) who declared a conflict of interest. The proxy will only be authorized to consider and vote upon promotion or graduation decisions where a conflict of interest was declared. The proxy will be removed from the committee immediately afterwards.

5.0 Conflict of Interest in Academic Assessment

5.1 Proactive Disclosure

 The Undergraduate Medical Education Office shall inform preceptors of the Non-Involvement of Providers of Student Health Services in Student Assessment Policy on an annual basis.

Preceptors are expected to review the student lists provided to them by the Undergraduate Medical Education Office well in advance of assessing medical students in courses, modules, or rotations. Any preceptor who has previously provided health services to a medical student should proactively disclose any perceived or actual conflict of interest pertaining to medical student assessments to the course administrator. The exact nature of the conflict does not need to be disclosed.

Medical students are expected to review individual course outlines well in advance of being assessed by a preceptor in a course, module, or rotation. Any medical student who has previously received health services from a physician who may be assessing them should proactively disclose any perceived or actual conflict of interest pertaining to academic assessment to the course administrator. The exact nature of the conflict does not need to be disclosed.

For forms of assessment in which there may be potential for subjectivity in the assessment, the course administrator shall arrange for an alternative assessor to complete the assessment. For objective forms of assessment (example: multiple choice questions) the assessment shall proceed as planned.

5.2 Reactive Disclosure/Exceptional Circumstances

While all efforts are made to ensure that health care providers are not involved in the academic assessment or advancement of medical students, there may be exceptional circumstances in which a health care provider finds themself in a situation where they are involved in the assessment of a student or in decisions regarding academic advancement.  Should a student or faculty identify such a conflict, the faculty will recuse themself from further assessment of the student.   This is especially important if the assessment is subjective in nature.  For objective forms of assessment (example: multiple choice questions) the assessment shall proceed as planned. If the faculty are involved in the advancement of a medical student to whom they provide health care, they will immediately recuse themselves from discussion the of the student’s academic progress.

In the situation that a preceptor or medical student recognizes a conflict of interest during supervision/assessment in the clinical setting, then the preceptor should arrange alternative clinical supervision as soon as is feasible to ensure student and patient safety, and inform the Module/Course Director (Pre-clerkship) or Rotation Coordinator/ course administrator (Clerkship) as soon as possible.

Medical students who identify a perceived or actual conflict of interest while being assessed must inform the preceptor who in turn shall cease the assessment. Both parties must inform the course administrator of the occurrence.

In the situation, for example in a rural learning site, where a student presents for health care services to a preceptor with whom they are being assessed in a longitudinal fashion, where feasible the preceptor will arrange an alternate care provider for the student.  In an urgent or emergent situation, if an alternate health care provider cannot be arranged, the preceptor should provide the necessary care to the student.  If feasible, ongoing assessment should subsequently be provided by a different preceptor.  If there is not another preceptor available for ongoing assessment, the preceptor should inform the SLIC Director, Associate Dean UGME and/or Academic Director who will work with preceptor and student to determine if the situation has resulted in a conflict of interest and to make alternative arrangements for assessment, if required.  To protect student confidentiality, details of the nature of the health issues will not be disclosed in this process.

5.3 Post-Assessment Disclosure

Medical students who identify a perceived or actual conflict of interest after having been assessed in a course, module, or rotation will be assigned the grade submitted by the preceptor. If the medical student is dissatisfied with their assigned grade then the student may request an appeal of the grade following the college-level Procedures for Academic Appeal.

6.0 Student Health Records

Student personal health information is governed by provincial legislation governing privacy and confidentiality of patient health records (the “Health Information Privacy Act”) as well as university-level processes designed to protect student privacy.

The Undergraduate Medical Education Office shall store any health-related information voluntarily submitted by a medical student in their individual file in Banner.  Access to the online files is restricted to administrative staff in the UGME in accordance with the Student Records Policy.

The Associate Dean, Undergraduate Medical Education, is responsible for providing oversight to the overall administration of the Non-Involvement of Providers of Student Health Services in Student Assessment Policy at the College of Medicine.

The Manager, Undergraduate Medical Education, with the assistance of the Undergraduate Medical Education Office, is responsible for the implementation, monitoring, and maintenance of the Non-Involvement of Providers of Student Health Services in Student Assessment Policy. This includes development and stewardship of the standard operating procedures associated with this policy. It also includes supporting medical students and course, module, and rotation directors as well as preceptors in complying with this policy.

The Student Academic Management Committee is responsible for evaluating, reviewing, and updating this policy every three years.

This policy will be housed on the College of Medicine Sharepoint, in the UGME Admin common folder.  It will also be housed in SAMC Sharepoint folder.  This policy will be posted on College of Medicine website, under the Policies tab of the students dropdown menu, as well as the policies tab of the Faculty Dropdown menu.  Any updates approved by SAMC will be distributed to the Year Chairs and all admin coordinators/support staff responsible for College of Medicine students across the province, who will distribute it to all faculty leads.

Instances or concerns of non-compliance with the Non-Involvement of Providers of Student Health Services in Student Assessment Policy should be brought to the attention of the Vice-Dean, Education or the Associate Dean, Undergraduate Medical Education, within the College of Medicine.

The Manager, Undergraduate Medical Education, provides overall stewardship to the standard operating procedures associated with the Non-Involvement of Providers of Student Health Services in Student Assessment Policy.

Academic Director, UME
Phone: 306-966-2750
Email: medicine.ugme@usask.ca