Academic Difficulty

In order to provide support in a timely manner for students in academic difficulty, a system is in place that tracks a student’s performance across all four years of medical school. Based on a student’s performance, a student may remain in Satisfactory Academic Status, may be designated as Monitored Academic Status, or may be put in Serious Academic Status. A student who fails a course must undergo a remediation or an equivalent course, as determined by the Course Director. First year students must achieve a Pass in the remediation or equivalent course by August 1 in order to progress on to the next academic year. Second year students must achieve a Pass in the remediation or equivalent course by June 15 in order to progress to the next academic year. Remediation of courses may not occur while a student is taking another 

Year 1 and 2 Policy

course, and typically occurs during spring break or the summer and must be planned in conjunction with the Course Director, and the Offices of Curricular Affairs and Medical Student Affairs. Year 1 students participating in research during the summer is dependent on the timing and extent of any remediation. A failure in a course is listed as “F” on the transcript. Once the student has successfully remediated the course, it is listed as “FP.” Students who fail to pass the remediation for a failed course will be in Serious Academic Status and will be required to appear before the Promotions Committee.  

Year 3 and 4 Policy

Students who fail a shelf exam are required to remediate the shelf exam during a specified make-up date in July, or by special arrangement during vacation or elective time. Students may not make up a shelf exam for a clerkship while they are taking another clerkship or during FlexTime on a clerkship. All failures must be remediated before the student can do a required Year 4 course or clerkship. 

A failure on a NBME shelf exam is listed as a “C” on the transcript. Once the student has successfully remediated the shelf exam on the second attempt, the clerkship grade is listed as a “P” or “HP”. Students who fail a shelf exam are not eligible for a grade of Honors.  Repeat failure of the shelf will result in a failing grade in the clerkship.  Students who fail a clerkship are required to appear before the Promotions Committee, who will decide timing and type of remediation.  A failure in a clerkship is listed as “F” on the transcript. Once the student has successfully remediated the clerkship, it is listed as “FP.” 

USMLE Step Policy

Medical students who have failed to pass one of the USMLE Step exams are required to stop clerkship or course activities and dedicate a period of study and retake the exam before they will be able to continue to the next phase of their education. Students will work with the Offices of Curricular Affairs and Medical Student Affairs to determine the nature and timing of this remediation. 

To receive a Doctor of Medicine from ISMMS, students must pass USMLE Step 1, USMLE Step 2 CK and Step 2 CS, each within a maximum of three attempts. 

Federal Regulations require all students receiving federal financial assistance to maintain standards of Satisfactory Academic Progress (SAP). SAP is the successful completion of degree requirements according to established increments that lead to awarding the degree within published time limits. The SAP policy applies to all MD students enrolled at the Icahn School of Medicine at Mount Sinai.

  • Frequency of SAP – The Office of Enrollment Services and the Promotions Committee will assess each student’s academic progress on an annual basis. Each academic year is composed of two terms (fall and spring).
  • Quantitative Measures of SAP (pace and progression) - The timeframe to complete the MD program is 4 years of full-time enrollment, and many students elect to do a 5th year of Scholarly Year. The maximum time limit a student may be enrolled to meet their degree requirements is 7.5 years. A Scholarly Year or a decelerated year will count in the assessment of pace. Leave of absence and Extended Scholarly Status will not be counted in the assessment of pace.
  • Qualitative Measures of SAP (successful completion) - Academic progress is not measured by a cumulative grade point average. In Years 1 and 2, academic progress is measured by grades of Pass/Fail. In Years 3 and 4, academic progress is measured by grades of Honors, High Pass, Pass, Fail in selected courses.
    • Year 1: All courses must be completed with a grade of pass to advance to year 2.
    • Year 2: All courses must be completed with a grade of pass and take USMLE Step 1 to advance to year 3.
    • Year 3: All third year clerkships must be taken and completed with a grade of Pass or higher to advance to year 4.
    • Year 4: All fourth year rotations must be taken and completed with a grade of Pass or higher. Students must pass Step 2 CK and CS as well as complete 28 weeks of elective credit prior to graduation.
  • Failure to Meet the Requirements for SAP- A student who fails to meet one or more of the standards for SAP is ineligible for institutional and federal financial aid beginning with the term immediately following the term in which the SAP requirements were not met.
  • Appeals - Students who do not meet the minimum standards for Satisfactory Academic Progress may appeal to an ad hoc committee comprised of representatives from Enrollment Services, Curricular Affairs and Student Affairs for reinstatement of financial aid eligibility. The appeal must first be submitted in writing to the Associate Dean for Enrollment Services within 10 days of notification of ineligibility. The appeal must include what has changed in the student’s situation that will allow him or her to meet the requirements for SAP at the next evaluation. Circumstances which may be considered as a basis for an appeal may include family emergency, death in the student’s immediate family, a student’s medical illness or injury, or other undue hardships. If the committee determines that the student’s appeal should be approved, the student’s financial aid will be reinstated.
  • Financial Aid Probation - Once an appeal has been approved, a student is placed on financial aid probation and is eligible for financial aid. The Promotions Committee will develop an academic plan for the student that will ensure, if followed, that the student is able to meet SAP standards. A student must be enrolled in at least 50 percent of course load to remain eligible for financial aid. A student shall become eligible again for financial aid when he or she has successfully completed sufficient coursework to meet the standards of progress within the maximum time frames delineated above.
  • Loss of Financial Aid Eligibility - A student who does not meet the SAP requirements by the end of the financial aid probationary period is ineligible for financial aid. The loss of financial aid eligibility will continue until the student has met both the qualitative and quantitative standards established for their level of study.

Academic Progress is related to Academic Standing. A student will be considered in “Good Standing” if they meet the following requirements:

  • Is not in Serious Academic Status (see Academic Status section below) or academic probation (see Academic section of Graduate School Handbook).
  • Passes licensing examinations by graduation;
  • Pays all bills on time including tuition, fees and, if applicable, housing.
  • Meets school standards and deadlines for health assessments, immunization status, PPD testing, BLS training, and other requirements as determined by the Office for Medical Student Affairs.

A student who fails to meet one or more of the components above will be placed on registration hold preventing a student from advancing to the next year of training, from receiving an official copy of their transcript or from receiving a letter of recommendation from the administration. Please see the Registrar section of this handbook for a more detailed explanation of holds.

At the Icahn School of Medicine, academic status falls into three categories: Satisfactory Academic Status, Monitored Academic Status, and Serious Academic Status.

Satisfactory Academic Status

Satisfactory Academic Status means that a student has met all course/clerkship requirements or has successfully remediated any course/clerkship failures or other issues pertaining to academic performance as detailed in the following sections.

If a student is not meeting Satisfactory Academic Progress, they will be at risk of not being eligible for federal student aid.

The bottom five percent of students passing each course will be internally designated as having a marginal pass. The grade is recorded as a pass on the transcript and the designation of marginal pass is NOT reflected on the transcript or MSPE. A student’s Faculty Advisor will reach out to him or her in the event of a marginal grade on an examination or in a course to determine the significance of the grade and the need for support. A student with three or more marginal course passes will be considered in Monitored Academic Status.

Monitored Academic Status

Students will be considered in Monitored Academic Status in the event of any one of the following:

  • A course failure in Years 1 or 2.
  • Three marginal performances in an academic year. Marginal is defined as falling in the bottom five percent of passing grades.
  • A failure of USMLE Step 1 or Step 2 CK.
  • Failure of two NBME subject examinations in Year 3 clerkships.

Students in Monitored Academic Status will be notified in writing of this determination and will be required to meet with their Faculty Advisor and the Director of Programs and Resources for Academic Excellence to help plan appropriate interventions, and if necessary meet with the financial aid office to understand the impact on any federal and intuitional aid. This status is an internal designation only and will not be noted on the transcript or the MSPE. Students who meet one of the criteria for Monitored Academic Status as specified above will be advised to prioritize studying for courses, but will not be required to relinquish school-related extracurricular activities. Students are permitted to take a Scholarly Year but must remediate any failures before starting the time away from the standard curriculum.

For Year 1 students in Monitored Academic Status, participation in summer research activities will depend on the nature and timing of any necessary remediation. Students should meet with their Faculty Advisor and the Medical Student Research Office to plan their projects.

Students in Monitored Academic Status can return to Satisfactory Academic Status if they complete one semester in Year 1 or 2, or six months of clerkships in Year 3 or Year 4 without any evidence of the above criteria, or, if they are in Monitored Academic Status for a failure on a USMLE exam, they pass it on the second attempt. A student who was once in Monitored Academic Status in Year 1 or 2 will return to that status if he or she has an additional marginal grade in Year 1 or 2.

Serious Academic Status

Students will be considered in Serious Academic Status in the event of any one of the following:

Two-course failures in an academic year during Year 1 or 2.

  • A repeated failure of a Year 1 or 2 course.
  • A failure on USMLE Step 1 or Step 2 CK on a second attempt.
  • A Year 3 or 4 clerkship failure.
  • Failure of three NBME subject examinations in Year 3 clerkships.
  • Multiple occurrences of unprofessionalism or one serious occurrence as determined by the Office for Medical Student Affairs.

Students in Serious Academic Status will be required to appear before the Promotions Committee, will be subject to its decisions and will be notified in writing of this determination (see Promotions Committee section for more information). This status will not be noted on the transcript or the MSPE unless mandated by the Promotions Committee, but students risk being placed on financial aid probation if they are unable to demonstrate that they can maintain Satisfactory Academic Progress.

A student who fails three (3) or more courses in a year may be required to repeat the entire year, at the discretion of the Promotions Committee.

Remediation of any course may include tailored and/or external remediation programs (at the student’s expense), and/or repetition of the semester or year (tuition required).

Students in Serious Academic Status will not be permitted to participate in any Icahn School of Medicine extra-curricular activities. Year 1 students in Serious Academic Status will need to discuss the timing of remediation and summer research with their Faculty Advisor and the Medical Student Research Office. Students in Serious Academic Status are not considered to be in “Good Standing” (see above) and therefore will not be permitted to take a Scholarly Year.

While in Serious Academic Status, clerkship directors will be notified of their changed academic status, referred to as ‘forward fed’.

In addition, any student in Serious Academic Status who experiences an additional course or clerkship failure must be presented again to the Promotions Committee. Failure of remediation may be grounds for dismissal.

Students will remain in Serious Academic Status until they complete remediation and complete one semester in Year 1 or 2, or six (6) months of required clerkships in Year 3 or 4 without any course or clerkship failures or marginal course grades, or if they pass a USMLE exam on the third attempt. Students will be changed to Monitored Academic Status and from Monitored Academic Status to Satisfactory Academic Status as specified above.

Information regarding a student’s marginal or failing academic performance and any documented issues related to professionalism may be forwarded from the Office for Medical Student Affairs to a course or clerkship director at the discretion of the Senior Associate Dean for Medical Student Affairs and/or the Promotions Committee. Students in Serious Academic Status will be forward fed as long as they remain in that status. Forward-fed information will be of a general nature to alert the course or clerkship director to be aware of any issues that may arise with the student. Personal information will not be forwarded except when requested by the student. The student will be notified that this transfer of information is taking place. Information will flow from the Office for Medical Student Affairs to course or clerkship directors, not between course directors or clerkship directors.

Forward feeding allows for monitoring of a student’s performance and to provide support and remediation as necessary. The student should receive regular feedback throughout the new course or clerkship.

The forwarding of any material to a subsequent course or clerkship directors will continue as long as monitoring is necessary for educational purposes. There will be no mention of any of the forwarded information in the student’s evaluation from that clerkship. It will be documented in the student’s internal school file that information has been forwarded and to whom and specifically what information. This will not be reflected on the transcript nor will this be mentioned in the Medical Student Performance Evaluation (MSPE).