"Nuts & Bolts 2" - A Guide to the Clinical Years Section 1: General Information Table of Contents Where to go for Help! How To Complain! As hazardous as clerkships can seem, it may feel even more hazardous to complain about a rotation. Most student concerns relate to their evaluation, although other actions by residents or attendings may result in complaints. Students should not be harassed, sexually or otherwise, discriminated against, belittled, humiliated, or expected to perform tasks they don't feel prepared for. Clerkship directors know that such behaviors occur and are committed to correcting them, but must first be made aware of them. Therefore, speaking directly with the clerkship/site director is one means of handling a concern. If you feel uncomfortable doing this, there are other avenues. People are often unaware that their behaviors are offensive. In addition, house staff who were trained elsewhere often have different expectations of medical students. Therefore, speaking directly with the offending person is another potentially effective method for ending inappropriate behaviors. Other means for handling a complaint include: speaking with another faculty member on the team who can then discuss it with the offender; talking with your Advisory College Mentor; and going to see one of the Associate Deans (Loeser or Papadakis). For sexual harassment or sex discrimination, additional resources include the Center for Gender Equity and the Office of Sexual Harassment Prevention and Resolution. For other types of discrimination, the Office of Affirmative Action/Equal Opportunity/Diversity hears complaints and provides advice. Evaluations: It is important for you to know on what criteria you are being evaluated (see relevant policies and specific resources elsewhere in this guide). To learn this, ask! Ask the clerkship director, the attending, and the resident. When you request feedback, if you get the ubiquitous response, "you're fine," try to follow-up with a request for areas in which you could improve. Ask for specific, concrete suggestions. We firmly believe that when you read your evaluations, you should only encounter pleasant surprises. (Remember, you can log into E*Value at any time, and your academic file is open for your perusal in Curricular Affairs.) About the person writing your evaluation: Your performance is observed by residents and attendings, all of whom are asked for input into your final evaluation. The summary evaluation form is usually completed by the overall clerkship director or the site director. Students are often concerned that the person writing the evaluation was not the same person who actually observed them on the wards. The evaluation is meant to be a composite, integrating all available opinions. Those responsible for writing evaluations are well aware of this, and accurately reflect divergent views. Because so many people evaluate you, the final evaluation is often not completed for several months. Log into E*Value, check your file in OCA, and call the site or clerkship office after eight weeks if your evaluation is still not available. The more time that has passed, the more difficult it is to discuss details. If you feel you have a problem with either the teaching or the evaluation process, it is best to resolve your problems quickly while they are still fresh in your mind and while you still have the opportunity to improve your situation. Start with the object of your concern: the resident or the attending in question. All too often we are afraid of confrontations, yet most teachers want to know when they have done a good job and when they have not. The next person to approach is the site director where you have completed the clerkship, and following that, the overall clerkship director (though this is sometimes the same person). If you do not know who that is, try to remember who ran your clerkship orientation. If that fails, call Curricular Affairs 415-476-2346 and ask. You can also ask the department chair for assistance if all else appears to have failed. If you still have not resolved the problem, or if you are concerned that your complaint will reflect poorly upon you when the time comes for your evaluation (a common concern), ask one of the associate deans or your Advisory College Mentor for help. Individualized and informal intervention at this level is usually successful. Finally, there is a formal grievance mechanism, which could result in the Student Welfare Committee conducting a formal hearing. This student-faculty committee is appointed by the Faculty Council and has full authority to resolve disputes. A formal grievance is different than the informal one, where students have an informal discussion with a clerkship director about a grade or language in an evaluation. While a student has eight weeks following the submission of a completed evaluation to the Office of Curricular Affairs to get a clerkship grade or comments revised, one only has 30 days following submission of an evaluation to file a formal grievance. The official policy is posted at http://www.ucsf.edu/senate in Bylaws, Appendix VII and reads as follows: "Within 30 days of the time at which the student could be reasonably expected to have knowledge of the alleged violation, or, when the violation occurs at the end of an academic quarter, within 30 days after the beginning of the succeeding academic quarter, the student may request a Chairperson or supervisor to inform the Dean of the School or appropriate Administrative Officer of the desire for a review." The 30 day formal grievance period is a UCSF campus-wide policy. While it may seem confusing to have different timelines for formal and informal deadlines, it is to the student's advantage to have the extra time to informally discuss an evaluation. The procedures for conflict resolution need to be clearly understood by everyone involved. If you have any questions or concerns, contact Curricular Affairs, Student Affairs, or your Advisory College Mentor. Advisory Colleges: The Advisory College system has been developed as a formal infrastructure to support students, led by pairs of faculty mentors (Drs. Ellen Hughes and Martin Holland, Lee Jones and Lisa Everson, Carol Miller and Mohammad Diab, Andrew Murr and Renee Navarro, and Flavia Nobay and Sharad Jain) who have demonstrated excellence in advising and counseling students. Mentors are available throughout the year for individual meetings for general advising, career counseling, problem resolution, and student advocacy. The Advisory College program has four goals, which are to provide personalized academic advising, facilitate communication among peers and faculty, provide guidance regarding career options, and provide guidance regarding school, professional, and community resources. Medical Student Well-Being Program: The Medical Student Well-Being Program, under the direction of Dr. Rachel Goldstone, promotes a healthier learning environment at UCSF and assists medical students with a broad range of difficulties that may arise during their education. Services include individual and couples therapy, consultation, and referrals. There are numerous prevention programs. The service is free, confidential, and is kept strictly separate from the Dean's Office. As an additional protection of privacy, the program is located a short distance from the main campus at 735 Parnassus Avenue (near 5th Ave). Review http://medschool.ucsf.edu/studentwellbeing for the latest information, or call 415-476-0468. Policy on Student Mistreatment: Students have the right to be treated respectfully by their attending physicians, residents, members of the health care team, and their colleagues and peers. Those who feel that they are being subjected to sexual harassment or physical, racial, or verbal abuse should speak with the site or clerkship director. Students who do not feel comfortable discussing this issue with the site or clerkship director should contact one of the following: Associate Dean Maxine Papadakis; Associate Dean Helen Loeser; your Advisory College Mentor; or Dr. Rachel Goldstone. It is extremely important that the School administration be aware of inappropriate and/or abusive interactions so that steps can be taken to eliminate this unacceptable behavior.