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 (see section on Academic Status below).

Academic Progress refers to the satisfactory completion of academic requirements, institutional requirements, and licensing examinations within the required timeframe.  Please review the Yearly Requirements and Graduation Requirements Sections to learn more about Yearly Requirements to Progress and Graduation Requirements. 

All students in the MD program are expected to complete eight (8) semesters, but students can take no more than 12 semesters (one-and-a-half times the accredited program length) of enrolled credit to complete the degree. A student who requires enrollment in more than 12 semesters is considered to not be making Satisfactory Academic Progress (SAP). Students must meet SAP in order to remain eligible for federal student loans and financial aid for that time period. A scholarly year (or years) and decelerated years (doing one year of academic requirements over 2 calendar years), will count as periods of enrollment (i.e., a scholarly year would count as 2 semesters of enrollment, and one decelerated year over two academic years will count as 4 semesters of enrollment.).  A leave of absence is a period of non-enrollment and does not contribute to the total number of semesters. Extended Scholarly Status is a period of non-enrollment and does not contribute to the total number of semesters. A Scholarly Year does count as an enrolled status and does contribute to the number of semesters.

Each student is assessed at the end of each year by Student Affairs and Enrollment Services to ensure that the student is meeting SAP.

Students must pass all Year 1 courses to move onto Year 2, and pass all Year 2 courses and pass USMLE Step 1 to advance to Year 3. Third-year clerkships must be taken and completed in Year 3 in order to advance to Year 4.

A student who fails a Year 1 course can remediate the course over the summer between Year 1 and 2. A student who fails a Year 2 course can remediate the course between the end of Year 2 and the beginning of Year 3. A student requires permission from Student Affairs and the course director to remediate a course at any other time. 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.

Please review the Yearly Requirements to Progress and Graduation Requirements Sections to learn more.

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 within the specified timeframe; medical students must pass USMLE Step 1 to progress to Year 3 and pass Step 2 CK and CS to graduate.
  • 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 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.

If after probationary semester a student hasn’t met the requirements they will lose their 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 in any official record. 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, (on probation) 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. 

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, Step 2 CK or Step 2 CS.
  • 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 Success 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 Year 3 or 4 clerkship failure
  • A repeated failure of a Year 1 or 2 course
  • A failure on USMLE Step 1, Step 2 CK or Step 2 CS on a second attempt
  • Multiple occurrences of unprofessionalism or one serious occurrence as determined by 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.

Remediation 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. Year 2 students in this status will not be able to apply for the special curricular programs in the third year, such as InterACT. 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’ (see below).

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.

Students will be granted designated time for remediation for coursework or exams as required. Students must pass a remediation in order to be promoted to the next academic year.

Students who fail two courses in Year 1, two courses in Year 2, a remediation of a course, a clerkship, or any USMLE exam more than once will be required to appear before the Promotions Committee to determine timing and type of remediation. This plan may require a student to take an Administrative Leave of Absence (see section on Major Life Events and Personal Circumstances for more information).

Clearance to return from a remediation plan is required. Students will be required to complete any outstanding compliance needs in order to return.

Years 1 and 2 Policy

A student who fails a course must undergo a remediation or an equivalent course, as determined by the Course Director. The student must achieve a Pass in the remediation or equivalent course by August 1 in order to progress on to the next academic year. Remediation of courses typically occurs during the summer and must be planned in conjunction with the Course Director, Curricular Affairs and Student Affairs. 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 may be required to appear before the Promotions Committee.

Years 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.

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 Exams 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 Curricular Affairs and 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.

Information regarding a student’s marginal or failing academic performance and any documented issues related to professionalism may be forwarded from Student Affairs to a course or clerkship director at the discretion of the Senior Associate Dean of UME and 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 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).

Students will be granted designated time for remediation for coursework or exams as required. Students must pass a remediation in order to be promoted to the next academic year.

Students who fail two courses in Year 1, two courses in Year 2, a remediation of a course, a clerkship, or any USMLE exam more than once will be required to appear before the Promotions Committee to determine timing and type of remediation. This plan may require a student to take an Administrative Leave of Absence (see section on Major Life Events and Personal Circumstances for more information).

Clearance to return from a remediation plan is required. Students will be required to complete any outstanding compliance needs in order to return.