Attainment of the MD degree signifies that its holder is a physician prepared to enter the practice of medicine within the context of post-graduate medical education. Thus those individuals receiving the MD degree must be able to assume the responsibility of safely and ethically providing care to patients. Because graduates of medical school must be prepared to assume care for patients in a wide variety of clinical disciplines, the education for the MD degree is, by necessity, broad in nature. An avowed intention to practice only a narrow part of the curriculum does not alter the requirement that all students take the full curriculum.
The University recognizes that federal and state laws prohibit discrimination against disabled applicants and students, and that otherwise qualified candidates for the MD degree may be able to meet the technical standards described in this document, if provided reasonable accommodation. It should be noted, however, that the use of a trained intermediary is not acceptable in situations where the candidate's judgment is impacted by the intermediary's powers of selection and observation. Thus, the use of personal aids, assistants, caregivers, readers, and interpreters may not be appropriate, particularly in clinical education settings. The University of California Irvine Disability Services Center will work with the candidate in determining whether reasonable accommodations are available.
To assure that students in the School of Medicine attain the desired level of competence prior to graduation, the faculty has established the following educational objectives:
I. UCI graduates will be knowledgeable. By the time of graduation students will have demonstrated relevant and sufficient knowledge in these broad areas:
a. Knowledge of the structure and function of the major organ systems, including the molecular, biochemical, and cellular mechanisms for maintaining homeostasis.
b. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease.
c. Knowledge of basic clinical skills to meet the skills objectives, including interviewing, physical diagnosis, communication, and clinical reasoning processes.
d. Knowledge of population health, epidemiology principles, and the scientific basis of research methods relevant to healthcare.
e. Knowledge of medical practice, including healthcare economics and health systems impacting the delivery and quality of patient care.
II. UCI graduates will be skillful. By the time of graduation, UCI students will demonstrate:
a. The ability to competently conduct a medical interview and counseling to take into account patient health beliefs, patient agenda, and the need for comprehensive medical and psychosocial
assessment.
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b. The ability to competently perform a complete and organ-system-specific examination including a mental health status examination.
c. The ability to articulate a cogent, accurate assessment and plan, and problem list, using diagnostic clinical reasoning skills in all the major disciplines.
d. The ability to search the medical literature, including electronic databases, and to locate and interpret up-to-date evidence to optimize patient care.
e. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate, and to advise on lifestyle practices.
f. The ability to function effectively within the context of complexity and uncertainty in medical care.
III. UCI graduates will be altruistic, developing and demonstrating professionalism and commitment. By the time of graduation UCI students will demonstrate attitudinal learning and behaviors in these domains:
a. Honesty and integrity reflecting the standards of the profession, in interacting with colleagues, patients, families and professional organizations.
b. Professional behaviors reflecting compassion and respect for patient privacy, altruism and a commitment to comprehensive, holistic medical care.
c. Sensitivity and awareness of diverse cultures, health beliefs, and social factors impacting patient health and illness.
d. The commitment to seek knowledge and skills to better serve the needs of the underserved in their communities.
IV. UCI graduates will be dutiful. By the time of graduation UCI students will show:
a. A commitment to lifelong learning and independently seeking new knowledge and skills in their own recognized areas of learning deficit.
b. A commitment to patient care and to the well being of patients and colleagues. c. A commitment to serve their community. d. A commitment to personal well-being and the well-being of family and friends.
In order to attain these objectives the faculty of the School of Medicine has determined that prospective and enrolled students must demonstrate an ongoing record of academic achievement. They must also demonstrate the ability to meet a predetermined set of intellectual, physical, and behavioral/social requirements described below as technical standards.
B. Technical Standards for the University of California Irvine, School of Medicine
1. Intellectual Abilities
A candidate for the MD degree (a prospective or enrolled student) must have sufficient intellectual cognitive capacities to assimilate a large volume of technically detailed and complex information presented through formal lectures, small group discussions, individual teaching sessions, clinical teaching sessions and independent learning activities. He/she must be able to critically analyze such information, to identify relevant material and appropriately apply such material to solve problems in a timely and effective manner. A candidate must be able to measure, calculate, analyze and synthesize data, appreciate three-dimensional spatial relationships among structures, and logical sequential relationships among events. He/she must also be able to form and test hypotheses.
2. Physical Abilities a. Observation
A candidate for the MD degree must be able to acquire a defined level of information as presented through demonstrations and experiential activities in the basic sciences including but not limited to anatomic dissections,
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microscopic examination of tissues and microbial organisms and physiologic and pharmacological demonstrations in animals. He/she must also be able to accurately observe a patient at a distance and close at hand, acquire information from written documents and visualize information presented in images from paper, films, slides or video. A candidate must be able to interpret radiological images, and other digital or analog graphic representations of anatomic, physiologic or pathologic data (such as ECGs). Such observation and information acquisition requires the functional use of visual, auditory, and somatic sensory functions.
b. Communication Abilities
A candidate for the MD degree must be able, after a reasonable period of training and experience, to communicate in an effective and sensitive manner with patients. The candidate must also be able, after a reasonable period of training and experience, to communicate with other health care providers effectively and efficiently in both oral and written forms and to in turn receive and understand oral and written communications.
c. Motor Abilities
A candidate for the MD degree must after a reasonable period of training and experience, possess the capacity to perform physical examination and diagnostic maneuvers including but not limited to palpation, percussion auscultation, digital rectal examination, pelvic examination, and obtaining blood urine and other basic body fluid or tissue samples. He/she must be able to respond to emergency situations in a timely manner and provide general emergency care such as airway management, CPR, placement of intravenous catheters, simple wound repair, and basic obstetrical procedures. Such activities require physical mobility, coordination of both gross and fine motor neuromuscular function, and balance and equilibrium.
3. Behavioral and Social Abilities
A candidate for the MD degree must possess the emotional health, maturity, discipline, and professional attributes necessary for the competent practice of medicine. Certain characteristics are particularly crucial to the attainment of this competence. They include but are not limited to integrity, honesty, attendance and conscientiousness, empathy, a sense of altruism, and a spirit of cooperation and teamwork. The candidate for the MD degree must accept responsibility for learning, and exercise good judgment. He/she must be able to tolerate physically taxing workloads, function effectively under stress, adapt to changing environments, display flexibility, and manage the uncertainty inherent in the care of patients. The candidate must be able and willing to be physically present for all required educational activities.
4. Safety
The University of California, Irvine and the School of Medicine have a responsibility to consider the safety of patients and others. Should a candidate for the MD degree pose a direct threat to the health or safety of patients or others, he/she may be denied admission or dismissed from the School of Medicine.
C. Evaluation and Determination of Adherence to the Technical Standards
All students entering and continuing in the School of Medicine must meet all of the technical standards, with reasonable accommodation if necessary, and each student will be expected to certify that he/she meets these standards. The School of Medicine or the Disability Services Center may require that a candidate for the MD degree undergo an evaluation to ascertain whether these technical standards can be met with reasonable accommodation, if necessary.
D. Responsibilities
Applicants and students should contact the Disability Services Center, if they have any questions about reasonable accommodations. Students with disabilities who require accommodation shall register with the Disability Services Center. Students who fail to register with the Disability Services Center, or fail to provide necessary documentation, shall not be considered to be claiming or receiving accommodations under the federal or state disability laws.
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The Disability Services Center shall work with applicants with disabilities or students who request accommodation. The Disability Services Center shall make recommendations to the Associate Dean for Medical Student Affairs concerning reasonable accommodations.
The Associate Dean for Medical Student Affairs shall be responsible for administering this policy and determining whether a reasonable accommodation can be provided without fundamentally altering the Schools academic standards and that the accepted or matriculated student can meet the Technical Standards with the accommodation.
The Chair of the School of Medicine Faculty Senate Executive Committee shall appoint an ad hoc Committee on Technical Standards to consider appeals concerning an alleged failure to reasonably accommodate an accepted or matriculated student with a disability. The Committee shall be comprised of two clinical COM faculty, two pre- clinical COM faculty, and one staff person knowledgeable of the disability laws and policies. The ad hoc Committee shall be appointed within five working days after the Chair of the Executive Committee receives notice of the appeal.
GUIDELINES APPLYING TO STUDENTS WITH DISABILITIES
Disability Documentation and Disclosure
Students with disabilities who request or qualify for reasonable accommodations must have the appropriate documentation on file at the UCI Disability Services Center (DSC). This documentation is confidential. UCI-DSC is responsible for determining the appropriate accommodations after consultation with the student. In rare cases when adjustments in academic requirements may be appropriate, the Disability Services Center consults with the academic department or school for proper review.
Students are responsible for directly contacting their instructors during the first week of each quarter to identify themselves, the nature of their disability, and accommodation needs. Students are not expected or required to provide faculty with detailed documentation about their disabilities; in fact, from a legal standpoint, it is strongly advisable that faculty not expect or request such detailed documentation from the student. It is, however, appropriate for faculty to request the student to provide verification from DSC as to the fact that he/she is registered with ODS and the required accommodations for the course.
The large majority of UCI students with disabilities have non-visible disabilities - learning disabilities, Attention Deficit Disorder, low vision, partial hearing loss, psychiatric disabilities such as major depression, and permanent medical conditions such as diabetes, multiple chemical sensitivities, Crohns Disease, lupus, chronic fatigue syndrome, or carpal tunnel syndrome. When students self-identify to faculty, suggest meeting with him/her during office hours so you can talk privately. During the meeting, invite the student to discuss his/her disability-related needs for appropriate accommodations in the class.
Some disabilities or the side effects of medication may result in marked fluctuations of behavior, performance, or stamina. It is not uncommon that a student with a disability such as this will need an accommodation on one occasion but will not need it at another time.
One of the most effective ways that a faculty member can indicate his/her availability and willingness to accommodate students with disabilities is to make a statement like the following on the written course syllabus or reading list:
Students with disabilities who may need reasonable accommodations for any sort of visible or non-visible disability are invited to make an appointment to see me.
Auxiliary Aids and Accommodations
University policy, State and Federal law require that students with disabilities be provided with effective and timely auxiliary aids and accommodations. For faculty, this means that when students with verified disabilities self- identify to you or request appropriate accommodations, you should immediately begin to work with them and the
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Disability Services Center (DSC), if necessary, to implement the aids or accommodations that will allow students to participate in all programs and activities on the same basis as students without disabilities.
DSC offers initial disability screenings to students who suspect their difficulty in the academic setting may be related to a disabling diagnosis. Referrals for assessment of Learning Disabilities, Attention-Deficit/Hyperactivity Disorder (AD/HD), Psychological Disabilities, and Acquired Brain Injuries are provided to students who need a comprehensive evaluation by a qualified licensed professional. The student is responsible for the expense of disability documentation and for providing documentation, which is appropriate and commensurate with the university's guidelines.
Following is a partial listing of services, auxiliary aids, and reasonable accommodations offered by UCI and DSC. All of the services are provided by DSC at no charge to the students. There must be a documented, disability-related need for provision of a service or accommodation. There are written procedures for the services and accommodations and it is the student's responsibility to contact DSC to discuss and review the procedures. UCI and DSC reserve the right to determine the most appropriate and effective disability accommodations after consultation with the student. The provision of any disability service or accommodation does not ensure or guarantee a certain level of success or achievement for the student on any test or in any course.
Early syllabus (to arrange readers or taped textbooks) Disability management counseling Advocacy for appropriate and reasonable accommodations Note taking assistance Readers, textbooks on tape, reading course handout material, Enlarged print material Part-time enrollment or reduced course load, extended time for completion of degree requirements if
necessary Document conversion (print material to large print, Braille, cassette tape, computer disk, scanning) Tutoring (certain limits and procedures apply) Testing accommodations (extended time, readers, taping of exams, computer access, large print, separate
space, completing scantron answer sheet, writing assistance) Special seating in classes Consulting with students or professors about disability accommodations for courses Screening interviews and referral for students suspected of having learning disabilities or Attention Deficit
Disorder, or other types of disabilities (the student is responsible for providing or paying the cost of any documentation or assessment)
Testing Accommodations for Students with Disabilities
Testing accommodations may be appropriate for written exams, in-class writing assignments, pop quizzes, or oral exams. It is the students responsibility to notify the Clerkship Director of special accommodation needs 30 days prior to the examination. Depending on the disability-related needs of the student, testing accommodations may include:
1. Extended time (this is usually double time but may be more for those with print or motor disabilities) 2. Reading or writing assistance, taped exam 3. Alternate format (convert to Braille, large print, cassette tape, converting an oral test to written format, reading
responses into tape recorder) 4. Computer access 5. Accessible writing surface 6. Accessible test site, and accessible seating 7. Special equipment (tape recorder, CCTV, special lighting, magnifiers, earplugs) 8. Quiet test space or space with minimal distractions 9. Completing scantron answer sheet 10. Rest period
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DSC can verify the types of testing accommodations appropriate to each student. Students and faculty should first discuss accommodation needs. Some faculty prefer to administer exams in their own office/department; if this is done, then faculty are responsible for all scheduling, space, or other accommodations needed, such as proctors, readers, computer access, quiet space. In these cases, the faculty is also responsible for ensuring that students receive the proper and fair accommodations.
While there are numerous testing accommodations that may be appropriate or legally required, there are some, which may be inappropriate, unfair or not legally required. This sometimes depends on how the class is tested and how the student with a disability can most effectively demonstrate their knowledge. Some testing arrangements not generally recommended by DSC as disability accommodations unless the method or procedure is offered to, or required of students without disabilities in class include:
1. Unlimited time for tests 2. Oral exams when other students in class have a written test 3. Different tests for students without disabilities 4. Clarification of test questions 5. Taking test at a different time or on a different day than the class 6. Take-home exams
For more information on disability laws, please refer to the publication University of California Policies Applying to Campus Activities, Organizations, and Students - Section 140.00: Guidelines Applying to Nondiscrimination on the Basis of Disability available on the Disability Services Center website,
www.disability.uci.edu.
Procedures for Accommodating Students with Disabilities
1. The student is to identify himself/herself to the course director at least 30 days in advance of the examination. 2. The course director is to contact the Associate Dean of Student Affairs to obtain verification of the students
request. 3. The student is to contact DSC to obtain written documentation of his/her disability and to determine the
appropriate accommodations. 4. The student is then responsible for informing the Association Dean of Student Affairs and the course director of
the determined accommodations. 5. The course director will make accommodations for the student.
