University of Massachusetts School of Medicine Technical Standards for Medical School Admission, Continuation and Graduation

INTRODUCTION

The mission of the University of Massachusetts School of Medicine is to graduate skilled and effective physicians. It is the responsibility of the faculty to select applicants from among residents of the Commonwealth who are best qualified to complete the required training and most likely to become the best possible physicians.  Applicants are selected for admission to the school based not only on their scholastic achievement and ability, but also on their intellectual, physical and emotional capacities to meet the requirements of the school's curriculum and of a successful career in medicine. The faculty of the University of Massachusetts School of Medicine recognizes that academic competency is essential for success in medical school. Such things as intellectual curiosity, undergraduate grades, and the MCAT examination help to demonstrate academic competency. The Admissions Committee is instructed to exercise its judgment on behalf of the faculty in selecting the entering class. The committee is asked to consider not only academic ability but also character, integrity, extracurricular achievement, commitment to service, ability to contribute to  the advancement of medical knowledge and biomedical research, the likelihood of providing primary care in the Commonwealth, serving the health care needs of our underserved communities, and overall suitability for the medical profession based upon information in the application, letters of recommendation, and personal interviews.

The Liaison Committee on Medical Education, which accredits the medical school, requires that the curriculum provide a general professional education, enabling each student to pursue graduate training in a variety of disciplines.  Also, one of the missions of University of Massachusetts School of Medicine is to graduate a significant number of generalist physicians.  This requires the development of broad knowledge, skills, and behaviors, enabling ongoing self-directed learning, further training, and delivery of competent medical care.  The faculty of the University of Massachusetts School of Medicine believes that such a broad based and patient oriented curriculum is best suited for future generalists, specialists, and physician investigators. The basic sciences curriculum includes anatomy, biochemistry, histology, pathology, pharmacology, and physiology and is designed to establish a core of knowledge necessary for clinical training.  The clinical curriculum begins early in the first year and includes diverse experiences in primary care, family medicine, and ambulatory patient care. The third and fourth year include in-depth experiences in primary care, family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry, surgery, diagnostic imaging, pathology, emergency medicine, geriatrics, and rehabilitation medicine in ambulatory and in-patient settings.  These experiences  provide a broad basis for the practice of medicine, regardless of the future choice of specialty.  Each student is required by the faculty to successfully complete  each required course and clinical rotation to graduate.

The following technical standards specify those attributes the faculty considers necessary for completing medical school training, enabling each graduate to subsequently enter residency and clinical practice.  These standards describe the essential functions students must demonstrate in order to fulfill the requirements of a general medical education, and thus, are pre-requisites for entrance, continuation, promotion, retention, and graduation from medical school.

The University of Massachusetts School of Medicine will consider for admission any applicant who meets its residency requirement, academic criteria, and demonstrates the ability to perform or to learn to perform the skills listed in this document, with or without reasonable accommodations consistent with the Americans with Disabilities Act.  Any applicant with questions about these technical requirements is advised  to discuss the issue with the ADA Student Coordinator prior to the interview process.

Certain chronic or recurrent illnesses that interfere with patient care or safety are not compatible with medical practice or training.  Any student who is a carrier of a blood borne pathogen [including but not limited to Hepatitis B virus, Hepatitis C virus, and Human Immunodeficiency virus (HIV)] will not be permitted to perform some invasive procedures. This will restrict the student’s ability to perform fully in some clinical clerkships and to meet the requirements of some specialties; therefore, the student will possibly be prohibited from future training and practicing in those fields. Read the Addendum and Policy Statement on Blood-Borne Pathogens appended to this document.  Other conditions that may lead to a high likelihood of debilitating student illness should also be carefully considered before committing to a clinical career.  Deficiencies in knowledge base, judgment, integrity, character, or professional attitude or demeanor, which may jeopardize patient care, may be grounds for course/rotation failure and possible dismissal.

TECHNICAL STANDARDS

A student must possess aptitude, abilities, and skills in five areas:
1) observation; 2) communication; 3) sensory and motor coordination and function; 4) conceptualization, integration and quantitation; and 5) behavioral and social skills, abilities and aptitude.  These are described in detail below.  Students must be able to independently perform the described functions.

1. OBSERVATION

Students must be able to observe demonstrations and conduct experiments in the basic sciences, including, but not limited to: anatomic dissection of preserved tissues and cadavers, physiologic and pharmacologic demonstrations in animals, microbiologic cultures, microscopic studies of microorganisms and animal and human tissues in normal and pathologic states. A student must be able to observe patients accurately at a reasonable distance and close at hand, noting non-verbal as well as verbal signals. Specific observational requirements include, but are not limited to the following abilities:  detecting and identifying significant changes in colors of fluids, skin, culture media, and dipstick tests; perceiving with acuity and accurately discriminating findings on x-rays and other imaging tests; efficiently reading written and illustrated material; observing intracellular details through a microscope; observing demonstrations in the classroom, including projected slides, films, videos and overheads; observing and differentiating changes in body movement; observing anatomic structures; discriminating numbers and patterns associated with diagnostic instruments and tests, such as sphygmomanometers and electrocardiograms, and using instruments competently, such as the otoscope, ophthalmoscope, microscope, and stethoscope.

2. COMMUNICATION

Students must be able to relate effectively and sensitively with patients of all  genders; as well as all ages, races, life-styles, sexual orientations, and cultural backgrounds, and be able to convey a sense of compassion and empathy.  A student must be able to communicate clearly with and observe patients in order to elicit information, accurately describe changes in mood, activity, and posture; and be able to perceive verbal as well as nonverbal communications.  Communication includes not only speech but also reading and writing.  Medical education presents exceptional challenges in the volume and breadth of required reading and the necessity to impart information to others.  Students must be able to communicate quickly, effectively and efficiently in oral and written English with all members of the health care team.  Specific requirements include but are not limited to the following abilities: communicating rapidly and clearly with the medical team on rounds; eliciting a thorough history from patients; and communicating complex findings in appropriate terms to patients and to various members of the health care team (fellow students, physicians, nurses, nurses’ aides, therapists, social workers, and others).  Students must learn to recognize and promptly respond to emotional communications such as sadness, worry, agitation, and lack of comprehension of physician communication.  Each student must be able to read and to record observations and plans legibly, efficiently and accurately in documents such as the patient record and the electronic record.  Students must be able to prepare and communicate concise but complete summaries of individual encounters, including hospitalizations.  Students must be able to complete forms according to directions in a complete and timely fashion. Students must be computer literate and able to access patient records and medical information with facility.

3. SENSORY AND MOTOR COORDINATION OR FUNCTION

Students must be able and willing to perform with acuity, accuracy, and facility, a complete physical examination on any patient of all genders, utilizing palpation, auscultation, percussion, and other diagnostic maneuvers.  In general, this requires sufficient ability to observe with acuity and to process accurately:  visual, auditory, exteroceptive (smell, touch, pain and temperature) and proprioceptive (position, pressure, movement, stereognosis, and vibratory) phenomena, as well as the ability to manipulate with precision, at a fine level of movement, patients, and medical instruments and equipment. Methods of surgical instruction include practice on living or preserved animal tissues. A student must  be able and willing to provide general care and emergency treatment to any patient of all genders in a timely manner.  Furthermore, a student must be able to respond promptly to medical emergencies within the hospital, and must not hinder the ability of co-workers to provide prompt care. Examples of such emergency treatment reasonably required of physicians include arriving quickly when called and initiating cardiopulmonary resuscitation, administering intravenous medication, applying pressure to stop bleeding, opening obstructed airways, suturing wounds, and performing basic obstetrical maneuvers. Cardiopulmonary resuscitation may require moving an adult patient, repeatedly and rapidly applying considerable chest pressure, delivering an adequate volume of artificial respiration, and calling for help. A student must  be able to learn to perform basic laboratory tests, e.g., urinalysis, completed blood count, and diagnostic and therapeutic procedures, e.g., phlebotomy, arterial blood gas drawings, lumbar puncture, arthrocentesis. Students must be able to measure angles and diameters of various body structures using tape measure and goniometer, measure blood pressure and pulse, and interpret graphs describing biologic relationships. Clinical rotations in ambulatory care settings require the ability to transport oneself to a variety of ambulatory settings in a timely manner, and inpatient rounds require prolonged and rapid movement.

4. INTELLECTUAL-CONCEPTUAL, INTEGRATIVE AND QUANTITATIVE ABILITIES

These abilities include measurement, calculation, reasoning, analysis, judgment, and synthesis. The student must also be able to recognize letters and numbers quickly and accurately.  Clinical reasoning and problem solving are critical skills demanded of physicians requiring  all of these intellectual abilities, and they must be performed quickly, especially in emergency situations. Moreover, the effective physician often must deal with several tasks or problems simultaneously ("multi-tasking"). Students must be able to identify significant findings from history, physical examination, and laboratory data, provide a reasoned explanation for likely diagnoses, construct a reasoned and cost-effective diagnostic plan, and prescribe medications and therapy, recalling and retaining information in an efficient and timely manner. Students must be able to identify and communicate the limits of their knowledge to others when appropriate. The ability to incorporate new information from peers, teachers, and the medical literature in formulating diagnoses and plans is essential.  Good judgment in patient assessment, diagnostic and therapeutic planning is essential.

5. BEHAVIORAL AND SOCIAL ATTRIBUTES

Empathy, integrity, honesty, concern for others, good interpersonal skills, interest and motivation are all personal qualities that are necessary for any physician.  Students must be able in all clinical and academic settings to fully utilize their intellectual abilities, to exercise good judgment, to promptly complete all responsibilities attendant to the diagnosis and care of patients.  They must be able and willing to develop mature, sensitive, professional and effective relationships with patients of all genders, ages, races, life-styles, sexual orientations, and cultural background, as well as with their families, with other health care providers, and with all members of the learning and working community. At times this requires the ability to be aware of and appropriately react to one's own immediate emotional responses: e.g., students must maintain a professional demeanor, and be able to function at a high level in the face of personal fatigue, dissatisfied patients and their families, and tired colleagues.  Students must be able to develop professional relationships with patients and their families, providing comfort and reassurance when appropriate while protecting patient confidentiality. Students must be able to maintain professional conduct when interacting with patients and the families of patients suffering from catastrophic illness, trauma, and death. Students must possess adequate endurance to tolerate physically taxing workloads and to function effectively under stress.  All students must be able and willing to work on any day of the week and on any day of the year when called upon to serve in scheduled clinical activities or learning opportunities.  All students are at times required to work for extended periods, occasionally with rotating and overnight shifts.  Students must be able to adapt to changing environments, to display flexibility and to learn to function in the face of uncertainties inherent in the clinical problems of many patients.  Students are expected to accept appropriate suggestions and criticism and, when necessary, to respond by  modifying their behavior.