I. PURPOSE
New York Medical College’s (“NYMC”) School of Medicine (“SOM”) values diversity and strives to reflect the breadth of backgrounds and diversity of the communities we serve. NYMC-SOM enrolls and supports Otherwise Qualified Candidates for admission, advancement, promotion, or graduation (“Candidates”) of any race, color, national or ethnic origin, sex, age, disability, religion, sexual orientation, gender identity, veteran status, marital status, or other protected class. All Candidates are entitled to the same rights, privileges, and equal access to all programs and activities made available to Candidates in the SOM.
At the same time, the practice of medicine requires certain essential observational, communication, physical, cognitive, behavioral, professional, and other skills and characteristics in order to provide highly effective patient care. Accordingly, the NYMY-SOM has set forth certain minimum standards required of Otherwise Qualified Candidates, which must be met throughout medical school in order to progress and graduate. The purpose of this policy is to define these minimum standards (the “Technical Standards”) for admission and continued enrollment at NYMC-SOM, as well as procedures related to the evaluation of a Candidate’s ability to meet the Technical Standards.
II. POLICY
A. Curriculum Core Competencies
Candidates must demonstrate core competencies, including achievement of academic milestones and completion of required coursework, with or without Reasonable Accommodations. These competencies fall into seven categories and are summarized below:
1. Patient Care - The Candidate must provide patient-centered care that is respectful, compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
2. Medical Knowledge - The Candidate must synthesize and apply knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences to patient care.
3. Interpersonal and Communication Skills - The Candidate must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients and families.
4. Interprofessional Collaboration - The Candidate must demonstrate the capacity to engage with an interprofessional team in a manner that optimizes safe, effective patient- and population-centered care.
5. Practice-Based Learning and Improvement - The Candidate must demonstrate the capacity to evaluate one’s care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant assessment and life-long learning.
6. Systems-Based Practice - The Candidate must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the capacity to effectively utilize other resources in the system to provide optimal health care.
7. Professionalism - The Candidate must demonstrate a commitment to carrying out professional responsibilities in a responsive and compassionate manner, as well as in adherence to ethical principles.
B. Technical Standards
To best achieve the foregoing competencies, Candidates must demonstrate skills within the following technical domains with or without Reasonable Accommodations. As both medical education and the provision of patient care can be delivered in person and via digital platforms (e.g., remote learning, telemedicine), the skills described in the following technical domains pertain to both physical and electronic student experiences.
1. Perception/Observation Skills: The Candidate must have the capacity to learn information presented, accurately observe patients, and assess diagnostic material both at a distance and close at hand. The Candidate must have the capacity to observe and participate in activities, including but not limited to observing demonstrations in the classroom, laboratory, and clinical settings, as well as viewing microscopic and gross specimens of normal and pathological anatomy, tissue, and cultures. Observation necessitates the use of vision, hearing, touch, and smell - or the functional equivalent.
2. Communication Skills: The Candidate must have the capacity to effectively communicate in oral and written form (paper or electronic) with patients, families, healthcare team members, faculty, and administrators. The Candidate must have the capacity to demonstrate appropriate verbal and nonverbal communication and interpersonal skills to accurately elicit information and enable effective patient care. The Candidate must also have the capacity to convey and collect information rapidly, accurately, and with clarity and sensitivity. Examples include, but are not limited to, taking and documenting a patient's history; assessing a patient’s mood, posture, and intellectual functions; teaching and learning from patients, faculty, and peers; delivering difficult information to patients with empathy; and presenting a case history, physical, and treatment plan.
3. Motor and Tactile Skills: Candidates must have motor and tactile function capabilities to meet the demands of medical education and the demands of total patient care. They must be able to independently demonstrate a range of abilities and skills. The Candidate must have the capacity to demonstrate fine and gross motor skills sufficient to perform quick and precise movements, operate medical instruments, tools, and devices, manipulate patients' limbs and bodies, and maintain equilibrium and sustained forceful movements. In addition, the Candidate must have sufficient stamina to complete normal duty hours, courses, and clinical rotations within the time frame required by NYMC with or without Reasonable Accommodations. Examples of motor skills include, but are not limited to: performing venipuncture or other procedures to obtain diagnostic materials; performing anatomical dissections; performing basic and advanced cardiac life support; performing a complete physical examination on a patient utilizing a stethoscope, otoscope, ophthalmoscope, and speculum for a pelvic examination; delivering a baby; and participating in surgical procedures. Participating in surgical procedures includes scrubbing one’s hands for sterile procedures; dressing in protective gowns, gloves, and other garments; standing for extended periods of time; placing, tying, cutting, and removing sutures; and manipulating surgical instruments.
4. Intellectual, Conceptual, and Cognitive Skills: The Candidate must have the capacity to demonstrate conceptual, integrative, and quantitative skills sufficient to learn, teach, create, analyze, synthesize, extrapolate, make objective and subjective judgments, solve problems, organize, and implement plans. Examples include, but are not limited to, performing statistical analysis of data; calculating dietary requirements; applying critical thinking to develop a clinical treatment plan; performing satisfactorily on all exams and reading, written, and digital/electronic assignments; and demonstrating the capacity to understand abstract concepts and three-dimensional spatial relationships between anatomical structures. When these skills are assessed in an examination format, Candidates who qualify will be permitted to utilize Reasonable Accommodations to demonstrate competency.
5. Behavioral Attributes, Social Skills and Professional Expectations: Candidates must maintain and display ethical and moral behavior commensurate with the role of a physician in all interactions with patients, faculty, staff, students and the public. Medical students should understand and function within the legal and ethical aspects of the practice of medicine. The Candidate must have the capacity to behave in an ethical, professional, and trustworthy manner with honesty, integrity, and accountability. Examples include, but are not limited to: adapting to changes in required learning activities, work environments, and teams; prioritizing tasks and maximizing productivity to achieve multiple educational, administrative, and patient care goals in a timely fashion; developing mature, sensitive, professional, responsible, and effective relationships with others; maintaining appropriate and timely lines of communication with patients, peers, supervisors, faculty, and staff; demonstrating cultural sensitivity and responsiveness to a diverse patient population and healthcare workforce; respecting patient privacy and autonomy; accepting feedback and responding with appropriate modification of behavior; and functioning proficiently in the face of uncertainties while demonstrating appropriate self-care.
C. Equal Access to NYMC-SOM
NYMC-SOM will consider for admission and ongoing enrollment any Otherwise Qualified Candidate who meets the criteria to perform the skills listed in this document, with or without Reasonable Accommodations, consistent with the Americans with Disabilities Act as amended (1990), Section 504 of the Rehabilitation Act (1973), and the ADA Amendments Act of 2008, Otherwise Qualified Candidates will not be excluded from admission, ongoing enrollment, or participation in the SOM MD program based solely on their status as a person with a Disability.
NYMC-SOM is committed to providing Reasonable Accommodations to Candidates who disclose documented Disabilities to the Division of Student Accommodations and Accessibility. While an accommodation plan can be made for Candidates with Disabilities who are Otherwise Qualified, the Candidate must have the capacity to perform in a reasonably independent manner and complete the Technical Standards of the entire curriculum of required courses, clerkships, and electives. The use of a trained intermediary to substitute for any of the functions above is not permitted because the Candidate’s judgment would be mediated by someone else’s power of observation, selection, and interpretation.
III. SCOPE
This Policy applies to all Candidates considered for NYMC-SOM MD program admission, advancement, promotion, and graduation, including applicants for admission, matriculated students, and visiting and transfer students.
IV. DEFINITIONS
A. Reasonable Accommodation: a modification or adjustment to an instructional activity, facility, program, or service that enables an Otherwise Qualified Candidate with a Disability to have an equal educational opportunity. An accommodation is not reasonable if it would fundamentally alter the curriculum, eliminate essential program elements, lower academic standards, pose an undue administrative or financial burden on the NYMC-SOM.
B. Disability: A physiological or mental disorder that substantially limits an individual in a major life activity.
C. Candidate: An individual considered for SOM MD program admission, advancement, promotion, and graduation, including applicants for admission, matriculated students, and visiting and transfer students.
D. Technical Standards Committee (“TSC”): A committee empowered to review the reasonableness of accommodations requests and/or the ability of individual Candidates to meet the Technical Standards, comprising the Dean of Undergraduate Medical Education, Dean of Admissions, Dean of Students, and Vice Chancellor of Campus Engagement, or their designees in the event of unavailability or conflict.
E. Otherwise Qualified: The ability to meet essential program requirements with or without Reasonable Accommodations.
V. PROCEDURES
A. Attestation: Candidates must attest to their ability to adhere to these Technical Standards twice before admission to the NYMC-SOM, then yearly thereafter. Knowingly falsifying any of these attestations could lead to dismissal from the SOM.
B. Denial of Admission/Dismissal: If a Candidate, with or without Reasonable Accommodations, cannot meet these Technical Standards, then the Candidate may be denied admission/dismissed, or a previously extended offer may be rescinded, as applicable.
C. Accommodations: A Candidate who has an existing Disability and requires Reasonable Accommodation(s) to participate in and complete the medical education curriculum should initiate discussions with the Division of Student Accommodations and Accessibility as soon as the offer of admission is received and accepted. A Candidate who acquires a Disability after matriculation and requires Reasonable Accommodation(s) to continue to participate in and complete the medical education curriculum should initiate discussions with the Division of Student Accommodations and Accessibility as soon as the Disability is identified. Medical documentation remains confidential throughout the process of consultation, registration, and coordination of approved accommodations.
D. Technical Standards Review
1. Request for Review:
a. If the Division of Student Accommodations and Accessibility has any questions regarding a Candidate’s ability to meet the Technical Standards and/or whether requested accommodations are reasonable, it shall request a review by the TSC by contacting the Dean of Students.
b. If a dean or faculty member has a concern that there is a Candidate who is unable to meet the Technical Standards, the dean or faculty member should immediately contact the Dean of Students. Examples of these concerns may include, but are not limited to: inability to perform clinical skills, clinical errors, poor judgment, concern regarding substance abuse, incompetence or neglect, and unprofessional behavior.
i. The Dean of Students shall conduct an initial evaluation of the concern and will determine whether the issue should be referred to the TSC or to another appropriate group or stakeholder.
ii. If, after this initial evaluation, it is the opinion of the Dean of Students that there is a risk of harm to self, faculty, or staff, and/or that a patient safety concern exists, a temporary suspension of a Candidate’s participation in coursework or “removal from duty” may be made. The Candidate and any relevant course or clerkship director will be notified of this action.
2. Conduct of Technical Standards Review: If a Technical Standards review is requested pursuant to the foregoing paragraphs, the TSC will be convened to determine whether the Candidate can meet the Technical Standards and, if not, whether Reasonable Accommodation would allow them to meet the Technical Standards.
a. In making its determination, the TSC may require medical or psychological evaluations, including drug testing, at the Candidate’s expense. If a Candidate refuses such an evaluation, the Candidate will be deemed to be unable to meet the Technical Standards.
b. The TSC may also seek counsel and recommendations from any appropriate group, stakeholder, or advisor.
c. If the TSC determines that the Candidate cannot meet the Technical Standards with or without Reasonable Accommodations, (1) a Candidate who is not yet enrolled shall be denied admission or have a previously extended offer rescinded, or (2) a Candidate who is already enrolled shall be placed on a leave of absence, if the inability to meet the Technical Standards is temporary, or be dismissed from the NYMC-SOM.
i. For Candidates who have not yet matriculated, decisions of the TSC are final.
ii. For Candidates who are currently enrolled, if an adverse action decision is made (i.e., a decision that affects advancement, graduation, or dismissal), the Candidate will have the right to appeal pursuant to the SOM Policy on Adverse Action Appeals.
VI. EFFECTIVE DATE
This policy is effective immediately.
VII. POLICY MANAGEMENT
Executive Stakeholder: Dean, School of Medicine
Oversight Office: Office of Student Affairs
VIII. REFERENCES
LCME Element 10.5: Technical Standards: A medical school develops and publishes technical standards for the admission, retention, and graduation of applicants or medical students with disabilities, in accordance with legal requirements.
