UNIVERSITY EQUAL OPPORTUNITY POLICY

The University of Southern California complies with all laws prohibiting discrimination against students or applicants on the basis of race, color, religion, gender, national origin, age, disability, sexual orientation or status as a disabled veteran. An otherwise qualified individual shall not be excluded from admission, employment, or participation in educational programs and activities solely by reason of his/her physical handicap, or medical condition.

This policy applies to all personnel actions such as recruiting, hiring, promotion, compensation, benefits, transfers, layoffs, return from layoff, training, education, tuition assistance and other programs.

Inquiries concerning the application of the various rules and regulations concerning equal opportunity and affirmative action should be addressed to Laura LaCorte, Office of Compliance, UGB 105, University Park Campus, Los Angeles, California, 90089-8007. The office can be reached by telephone at (213) 740-8258.

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UNIVERSITY POLICY ON ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES

The University of Southern California is committed to full compliance with the Rehabilitation Act (Section 504) and the Americans with Disabilities Act (ADA). As part of the implementation of this law, the University has adopted a policy that assures continued reasonable accommodation will be provided for students with disabilities so they can participate fully in the University's educational program and activities. It is the specific responsibility of the University Administration and all faculty serving in a teaching capacity to ensure the University's compliance with this policy.

The general definition of a student with a disability is any person who has "a physical or mental impairment which substantially limits one or more of such person's major life activities," and any person who has "a history of, or is regarded as having, such an impairment." Reasonable academic and physical accommodations include but are not limited to: extended time on examinations; time extensions on papers and projects; special testing procedures; advance notice regarding booklists for visually impaired and some learning disabled students; use of academic aides in the classroom such as note takers and sign language interpreters; early advisement and assistance with registration; accessibility for students who use wheelchairs and those with mobility impairments; and need for special classroom furniture or special equipment in the classroom. Other accommodations include the format or time allowed for an exam as well as substitution of similar or related work for a non-essential requirement. USC is not required by law to change the "fundamental nature or essential curricular components of its programs in order to accommodate the needs of disabled students," but the University must provide reasonable academic accommodation.

SERVICES

Disability Services and Programs are administered through the University Park Campus.

Students with learning disabilities as well as physical disabilities may register for accommodations at Disability Services and Programs on University Park Campus located in the Student Union Building, 3601 Trousdale Parkway, Room 301. The telephone number is (213) 740-0776. Students who anticipate the need for accommodation during exams should register with the Office of Disability Services and Programs well in advance of the testing date. Four weeks notice should be allowed in order that their needs may be appropriately evaluated and addressed by the Curriculum Office.

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UNIVERSITY POLICY ON OBLIGATION FOR PAYMENT

All students must register, settle their bills or make satisfactory arrangements to do so with the Collections Office by the assigned registration dates. The University currently assesses a late charge of $100/week for students not registered by the third week deadline and a monthly finance charge thereafter on all past due balances. A "Returned Check Charge" will be assessed by Financial Services for any check that is returned by the bank for any reason.

Students who are prevented from registering because of a legitimate activity restriction (registration hold) are not permitted to file an exception request (petition) to register late, whether or not their restriction is lifted at a later time. If such students are unable to clear their holds before the deadline, they must stop attending classes at the end of the third week. Students are urged to plan ahead and meet all financial aid deadlines and ensure that all needed documents are complete, have been signed, and have been submitted on time. If financial aid is still pending prior to a semester, the University Collections Office will work with the student and the Financial Aid Office to defer the amount due, or in other cases will often work out a payment plan, but students must initiate contacts with University Collections as early as possible and follow through with promises made before the end of week three! Failure to make payments of tuition, fees, deposits, or other amounts owed the University when they fall due, or to arrange for such payments before their delinquent dates, is considered sufficient cause, until the debt has been adjusted, to (l) bar the student from class or examinations, (2) withhold diploma, transcript of records and/or (3) suspend the student.

The Dean, Senior Associate Dean for Educational Affairs and Associate Dean for Student Affairs are responsible for the administration of this policy. Any request for any exception to the policy must be presented to the Associate Dean for Student Affairs in writing.

EMERGENCY LOANS

Interest-free emergency loans in amounts up to $500.00 are available to students with a good credit history through the University. Repayment of such loans must be made in 90 days or by the end of the academic year, whichever falls first. Loans must be paid in full before a diploma is released. Please contact the Financial Aid Office for further details, (323) 442-1016.

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STUDENT DISABILITY INSURANCE

All medical students enrolled full-time in the School of Medicine will be covered in an AMA-sponsored group disability insurance program ($61.00/year during 2005-2006), which will be added to your student fee bill. Should you become disabled due to illness (including pregnancy) or accidental bodily injury which occurs while you are insured, the plan will provide you with an income of approximately $1,000.00 per month, after a 90 day elimination period, during your disability. Students may continue their coverage upon entering a residency program by purchasing the conversion policy at a rate determined by the provider. Terms and cost cited above are accurate as of time of printing, but students should verify this information by consulting the actual policy.

A full description of your benefits while in school and, potentially for the remainder of your professional career, is contained in print materials distributed during orientation week furnished by the Guardian Life Insurance Company. Any questions regarding coverage may be directed to the Broker (Western Physicians Financial & Insurance Services, Inc., at 1-800-628-2861).

Enrollment in this program establishes a relationship between the student and the insurer independent of the University and the Keck School of Medicine. Changes in coverage, terms, fees and other attributes of this insurance are at the discretion of the insurer. Neither the School nor the University has responsibility for any aspect of the relationship between the student and the insurer.

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POLICY ON CORRESPONDENCE

Official correspondence from the Medical School to students will be considered to have been delivered if sent to the student's home, MDL mailbox, or University e-mail account. Students are responsible for checking these on a regular basis, and will be held accountable for materials sent via any of these routes. Communication from students to the School or University should be addressed to the department or administrative unit in question. If uncertain, students should address communications to:

Office of Student Affairs
Keck School of Medicine
University of Southern California
1975 Zonal Avenue, KAM 100-B
Los Angeles, CA90089-9020

For first and second year students, mailboxes are located in the MDL to which they are assigned. For third and fourth year students, mail is forwarded to the student's home address of record. Students should attempt to have all personal mail sent to their home address; however, if mail must be sent to the School in an unusual circumstance, address mail to:

The Keck School of Medicine encourages students to have publications and any other personal mail sent to the student’s home address.

TELEPHONE REGULATIONS

Incoming calls should be directed to the Office of Student Affairs (323) 442-2553. We will try to locate you for urgent calls; otherwise, phone messages for Years 1 and 2 students will be placed in their MDL boxes.

Students in Years 3 and 4 should be aware that the hospital switchboard is a direct dial system. All offices on the grounds may be contacted by dialing the appropriate station. Students may use the hospital phones for calls regarding their patients placed to other areas of the hospital or to areas outside the hospital which are within the metropolitan Los Angeles area. Long distance calls regarding patients must be placed through the Resident on the service. The hospital phone is not to be used for personal calls.

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RECORD RETENTION POLICY

Applicant Records

Admission applications are submitted electronically by each applicant. Letters of recommendation are sent to the Admissions Office, scanned into a PDF format and stored electronically. Original documents are destroyed once a year in the summer immediately following the application term. Electronic documents are destroyed once a year in the summer for the prior year’s term.

To balance effective resource use with professional standards and legal requirements, the following standards will guide document retention:

Admission documents will be purged according to the schedule above. The Registrar will be responsible for adhering to this schedule. Once each year, documents will be purged based on the retention schedule, with the process completed by the end of September.

Student Records

Official school records are kept in the Keck School of Medicine Office of Student Affairs. After graduation, portions of the student’s record are stored electronically. The original folder will be stored with contents intact for 5 years. After that time, all material except the electronic record of the items listed below will be destroyed.

Medical Student Performance Evaluation (Dean’s Summary Letter)
Transcripts (All years)
Original AMCAS application
Curriculum Schedule
CPX results
Photograph of Student
Other material, as designated by the Registrar

The University reserves the right to disclose education records without the student’s consent to officials of another school or educational program in which a student seeks or intends to enroll.

Questions regarding these procedures should be addressed to the Registrar of the Keck School of Medicine at (323) 442-2553.

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UNIVERSITY POLICY CONCERNING NARCOTICS AND DANGEROUS DRUGS
(Adapted from SCampus)

Federal and California Laws

Federal and State of California laws on drug abuse provide for stringent penalties for illegal use, possession, sale, transportation or administration of any drug; more stringent penalties for those convicted of previous narcotics offenses than for first offenders; and extremely stringent penalties for those who in any way involve minors in the use of narcotics. A person is subject to prosecution also if he/she illegally uses or is under the influence of narcotics, or if he/she knowingly visits a place where illegal narcotic use is occurring. Marijuana is covered by similar laws, and there is an additional injunction against the cultivation or processing of this drug in the state. The barbiturates (e.g., "yellow jackets," "red devils"), and amphetamines (e.g., "bennies," "dexies,” etc.) called "restricted dangerous drugs" in the California Narcotic Act are similarly covered; penalties for those convicted of illegal use, possession, sale, transportation or administration of these drugs are severe. In l966, LSD and related hallucinogenic drugs were added to the list of restricted dangerous drugs, and their use for other than authorized research was prohibited by California law. Whatever the merit and chances of success of proposals to legalize the use of certain drugs now defined as illegal, the hard fact is that at the present time possession, use or distribution of illicit drugs, including marijuana, makes anyone involved with such drugs, even in a single experiment or casually in social situations, liable to prosecution. Furthermore, a criminal record as a drug user or even an arrest record for narcotics law violation, may cause serious, long range harm to the experimenter by barring employment or educational opportunities where both the criminal record and the label of "drug user" may preclude his/her consideration. Conviction for illegal use of alcohol or drugs will wreak life-long difficulties with licensing and obtaining privileges, and may prevent successful licensure as a physician.

USC Position

The University’s policy is to conform to all applicable laws and follow the current stance of the medical and mental health professions regarding the use of other psychoactive substances including stimulants, depressants, narcotics, inhalants and hallucinogens including marijuana.
The University expects all students and student groups to comply with all local, state and federal laws. It is the responsibility of each individual to be aware of, and abide by, all federal, state and local ordinances and university regulations. Current laws provide for severe penalties for violations which may result in criminal records (taken from USC Drug-Free).

Counseling and Medical Assistance

In view of the University's interest in the educational welfare of the student, primary concern is given to remedial measures, using the full counseling and medical resources of the University to assist the student to meet constructively whatever problems the student may have, including possible addiction.

Every student concerned about problems resulting from his/her use of drugs is encouraged to seek help from the Student Health Service located in the Healthcare Consultation Center at (323) 442-5980. Regular Alcoholics Anonymous and Narcotics Anonymous meetings are held on campus. The staff will treat such voluntary relationships as confidential and not subject the student to disciplinary action on this basis.

In addition, the University has published the Drug-Free School and Communities pamphlet which provides a summary of policies and available assistance dedicated to preserving a drug free work and study environment. Copies of this pamphlet are available in the Office of the Vice President for Student Affairs for review

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UNIVERSITY POLICY CONCERNING ALCOHOL

The possession and consumption of alcoholic beverages on the University of Southern California campus and in university recognized living units is governed by appropriate state and municipal laws and is further governed by university regulations. All persons, regardless of age or status, are governed by these laws and regulations in their administrative practice as well as in personal conduct. The university expects that individuals and groups who operate within these laws and university regulations will engage in responsible drinking behavior and, if applicable, responsible hosting guidelines.

The university observes all appropriate state and municipal laws.

The university's policy with respect to alcohol follows state and municipal laws of California and the city of Los Angeles. The possession and consumption of alcoholic beverages on campus, in university recognized living units or sponsored by a university recognized group (regardless of location) is governed by the laws of the state and the municipal governments where the possession and consumption occurs. In most instances, this will be in the State of California and City of Los Angeles. These laws apply regardless of the state or country from which a person has come or in which the person maintains official residence.

These laws and regulations are found in the California State Constitution, the California State Business and Professional Code, the California State Penal Code, the California State Vehicle Code and the Los Angeles Municipal Code. It is the responsibility of the server or consumer of alcoholic beverages to be aware of, and abide by, all state and local ordinances and university regulations. These statutes and regulations are summarized and highlighted here for general use and may not cover all situations.

In addition, the university expects that every individual and any recognized student organization will follow additional regulations regarding the use of alcoholic beverages (including wine and beer) as set by the University of Southern California. As it is impossible to anticipate every situation that could involve alcohol, this list should not be considered to be all inclusive. For clarification of this alcohol policy and what activities are included, contact the Office of Student Activities or the Office for Residential and Greek Life. Among the provisions of the state and municipal laws are:

1. The purchase, possession, or consumption of any alcoholic beverages (including beer and wine) by any person under the age of 21 is prohibited.
   
2. It is not permissible to provide alcohol for anyone under the age of 21.
   
3. Selling, either directly or indirectly, any alcoholic beverages (including beer and wine) except under the authority of a California Alcoholic Beverage Control Board license is prohibited. This includes selling glasses, mixes, ice, tickets for admission, etc.
   
   A license to serve or dispense alcohol is not necessary if all of the following conditions are met:

   a. There is no sale;

   b. premises are not open to the public during the time alcoholic beverages are being served, consumed or otherwise disposed; and
   

   c. the premises are not maintained for the purposes of keeping, serving, consuming or disposing of alcoholic beverages.
   
   If all three conditions are met, then no license is required.
   If all three conditions are not met, a license must be secured from the Alcoholic Beverage Control (ABC) Department. Information on the ABC is found under State of California listings in the telephone book.

4. Serving alcohol to an intoxicated person is prohibited.
   
5. Serving alcohol to someone to the point of intoxication is prohibited.
   
6. The manufacture, use or provision of a false state identification card, driver's license or certificate of birth or baptism is prohibited.
   
7. Being drunk and disorderly in public view is prohibited.
   
8. Consumption of alcohol beverages in a public place (unless licensed for consumption of alcohol on premises) is prohibiited. This includes a prohibition of alcoholic beverages in public areas such as academic facilities, recreation fields, university housing corridors and lounges.
   
9. Driving a motor vehicle or a bicycle while under the influence of alcohol is prohibited.
   
10. Possessing an alcoholic beverage in an open container in a motor vehicle or bicycle is prohibited, regardless of who is driving or whether one is intoxicated.

Applicable university regulations include:

1. An individual or group which sponsors an event at which alcoholic beverages are made available is responsible for adherence to applicable laws (i.e., securing a license to sell/serve), university regulations, and the abuses arising therefrom.
   
2. Where alcoholic beverages are provided, ample non alcoholic beverages and food must be provided as well.
   
3. The intention to serve alcoholic beverages must be registered with the office or department administratively responsible for the facility or location where the event is to be held. Each office or department may have specific regulations which may prohibit the serving of alcohol beverages or may require the use of USC Dining Services. If there is a question as to the responsible person, the facilities coordinator of the Office of Student Activities, Topping Student Center 103, telephone (213) 740 2514, is to be consulted. Any club or class wishing to serve alcohol on campus by or to medical students MUST meet with the Associate Dean of Student Affairs and be registered with the Office of Student Affairs, (323) 442-2553.
   
4. Approval to serve alcohol on the USC campus must be obtained from Dining Services. If an outside caterer is to be used, a copy of their on site license must be filed with Dining Services. Contact Mike Stroud, General Manager Town and Gown, (213) 740-6565.
   
5. Alcoholic beverages may not be present at student organization recruitment efforts.
   
6. The use of university funds to provide alcohol to students under the age of 21 is prohibited. In addition, the student programming fees and residence hall/apartment fees may not be used to purchase alcohol.

Procedures for Dealing with an Alcohol Violation by a Recognized Student Organization

1. Anyone with information about an event or incident which violates the university policy regarding alcohol may report it to the Office for Student Affairs.
   
2. The university will contact the organization's president and advisor(s).
   
3. A review panel will be convened to determine whether or not the alleged alcohol violation did occur.
   
4. The university will decide on appropriate sanctions based on the findings of the review panel.

Definition of Possible Sanctions for a Student Organization

Following a proven allegation of violation of the alcohol policy, the student organization can generally expect a period of probation for a minimum of 60 days during the academic year. The probation will begin immediately after a decision finding a violation is finalized. Probationary status for an organization may include suspension of select group activities such as social events, membership drives, officer elections and alcohol use at events. Probationary status may also involve projects, programs and/or other criteria to be met by the organization. These stipulations will be designed to promote positive development of the organization and in particular with regard to responsible use of alcohol.

Following a proven repeat violation of alcohol policy (within a year of the previous incident), the student organization can generally expect its charter and/or recognition to be suspended for a minimum of 60 days during the academic year.

The suspension will begin immediately after a decision finding an alcohol violation is finalized. Suspension of a student organization may end such activities as membership drives, social functions, officer elections, use of the organization's offices, eligibility to schedule university facilities, campus posting privileges or any and all other operations of the student organization. The suspension will be followed by a period of probation for the organization as previously defined.


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POLICY REGARDING PERSONAL PROPERTY IN THE MULTIDISCIPLINE LABORATORIES

During Years 1 and 2, each student is assigned a desk and a chair in one of the multidiscipline laboratories in the McKibben or Bishop Buildings. All personal items, (i.e. laptop computer, books, or clothing) are expected to be stored and fully contained within the desk unit. Personally owned equipment, furniture, or animals will not be permitted in the laboratory. Prohibited items include, but are not limited to, chairs, beds, sleeping cots, rugs, drapery materials, electric hot plates or any items of large or unwieldy sports or exercise equipment. Exceptions to this policy will be made only for reasons relating to a medical or physical condition of individual students when items of medically related equipment are deemed necessary or advisable for the proper functioning or comfort of these students. Most house plants will be permitted in the labs and will not require approval. Any exceptions to the policy must be specifically approved by the laboratory director (Bishop 108).

Student desks within the multidiscipline laboratories are set in place prior to the beginning of the school year in such a manner as to allow maximum access by students and lab personnel. The desks may not be re-arranged without prior approval of the laboratory director. In addition, shared MDL equipment, (i.e. projectors, view boxes, slides, models, microscopes) may not be removed from the assigned MDL.

No materials may be attached to the outside of the student desks or to the walls of the laboratory. The tack board (bulletin board) on the desk is the only area where students may display photographs, drawings, art work, pictures from magazines, calendars, charts, etc.

All photographs and other visual materials which may be considered unsuitable for display in a physician's office or in a public waiting room are also unsuitable for display in a professional school; many persons find such materials offensive and therefore inappropriate. Individual students must realize and respect the fact that although individual space is assigned in the lab, it is intended primarily for study purposes and the lab facilities as a whole are used by many students and faculty. In addition, student family members, patients and visitors may enter the lab rooms and their sensitivities must also be considered.

The purpose of the policy regarding personal property or graphic material is to maintain a suitable working environment in the laboratory conducive to instruction and to individual student study. The addition of privately owned equipment or furniture to the laboratory may obstruct free flow of traffic and result in added congestion and inconvenience to other students and faculty and may violate the City of Los Angeles codes. Equipment and materials (including crepe paper streamers) constructed for home use are often unsuitable for use in a public building because they cannot meet City of Los Angeles codes for fire and public safety. USC is obligated to comply with these codes and is subject to unannounced inspections by City Fire Inspectors.

To prevent damage or theft, bicycles or mopeds may be brought into the building only with the permission of the laboratory director; when in the building, they must be stored or located in a manner which will be designated by the laboratory director so as not to interfere with the normal intended use of the lab rooms. Larger vehicles such as motorcycles may not be brought into the buildings; designated spaces are available for such vehicles in the parking structure.

Students should be aware that the University's insurance coverage does not include any personal belongings, even though permission may have been granted for the personal property to be used or stored within University buildings; students are advised that all financial responsibility for loss or damage rests solely with the owner or private insurer.

SECURITY IN THE MDL: MDL DOOR KEYS

MDL doors should be locked except during class times. Students are issued keys which will allow access to his/her own MDL at any time and should observe security standards, especially on evenings and weekends. No key deposit will be charged; however, if a key is lost or stolen, a replacement fee of $10.00 will be charged. For this reason, and for reasons of laboratory security, students should not leave their keys in visible areas.

Doors must not be propped open when a room is unoccupied. Any doors found open or unlocked after hours will be closed, and locked, so students should carry their keys when they leave the room. Students should note that it is possible to accidentally leave a door in an unlocked condition. Whenever a student enters, he/she should test the knob to verify that it is locked after the key is removed. Any trouble in the use of the lock should be reported to the MDL staff (Bishop 106; phone (323) 442-1119), or to the University Department of Public Safety. Public Safety officers may be summoned at any time by dialing 2-1200 on the phones located in the first and second floor hallways of the Bishop Building.

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KECK SCHOOL OF MEDICINE STUDENT MISTREATMENT PROCEDURE

I. INTRODUCTION

The diversity and complexity of the medical education environment require the medical school to reaffirm, on a periodic basis, its expectations of students, faculty, and staff. The spirit of this procedure is to promote dynamic personal and professional growth at all levels of the medical campus. This procedure seeks to limit any breach in the integrity and trust among students and professionals in the health care environment, by establishing standards of conduct, and a means of fairly dealing with problems of student mistreatment. This procedure is an important pillar of support to the mission statement of the university.

The Student Mistreatment Procedure (SMP) has been developed for the Keck School of Medicine with several goals in mind. Before stating those goals, however, it should be emphasized that this procedure is by definition subordinate to:

1. State and Federal Law
2. USC University Procedure
3. Affiliating Institutional Procedure (for problems in other medical education venues)

While the subordinate nature of this procedure is a legal necessity, the Student Affairs Committee believes that the medical education environment is unique and that this procedure may address several goals, including:

1. Explicate standards of conduct within the medical school and its research community.
2. Maximize the opportunity for “local” mutually satisfactory remedies to be reached.
3. Delineate an equitable method of investigating and adjudicating student mistreatment complaints.
4. Provide a means of monitoring complaint occurrences within the medical school so resources can be directed toward solutions.
5. Protect the rights of both the complainant and the accused.

II. A UNIQUE ENVIRONMENT: The need for a Keck School of Medicine Student Mistreatment Procedures.

The medical learning environment is more complex than the undergraduate environment for several reasons. These include:

1. Physical intimacy of medical examination and teaching;
2. Overnight call environment;
3. Prolonged hours in many medical arenas;
4. Patient outcome must supersede teaching and learning objectives;
5. Intimate partner relationships that may develop between members of the medical community;
6. Medical student vulnerability due to career aspirations, residency matching, and the subjective nature of medical education evaluation;
7. The teacher, student, and patient all have rights, which must be respected within the teaching and patient care framework.

The complex relationships of the medical education environment:
student mistreatment may occur along any bold arrow.

FIGURE 1

In response to these realities, and a perceived need for a more explicit procedure governing the medical campus, the Student Affairs Committee created the Keck SOM Student Mistreatment Procedure. This procedure is designed to maximize student protection in the complex medical learning environment, while providing an opportunity for local rapid solutions without necessarily resorting to legal remedies. To achieve this end the S.A.C. has sought to define the institutional standards, and to create a procedure for reporting and adjudication that does not conflict with other institutional procedures. Examples and definitionsof appropriate and inappropriate behavior (see part III) will help both the student and the teacher understand what is and is not professional behavior. This understanding will help all to maintain the value of professionalism, which the university represents and promotes.

Goals of this procedure:

1. Define our principles of community and standards of conduct;
2. Provide a means of determining if further investigation is warranted;
3. Establish a non-threatening and easily accessible mechanism for reporting alleged mistreatment;
4. Provide an equitable method of locally investigating and resolving complaints, consistent with other university procedures;
5. Guarantee the rights of due process; and
6. Appropriately protect both the complainant and the accused.

III. INSTITUTIONAL STANDARDS AND DEFINITIONS

Principles of Community

USC is a multicultural community of people from diverse racial, ethnic and class backgrounds, national origins, religious and political beliefs, physical abilities, and sexual orientations. Our activities, programs, classes, workshops/lectures, and everyday interactions are enriched by our acceptance of one another, and we strive to learn from each other in an atmosphere of positive engagement and mutual respect. As professionals, we are responsible for our behavior and are fully accountable for our actions. We each must take responsibility for our awareness of racism, sexism, ageism, xenophobia, homophobia, and other forms of oppression.

Bigotry will not go unchallenged within this community. No one has the right to denigrate another human being on the basis of race, sex, sexual orientation, national orientation, etc. We will not tolerate verbal or written abuse, threats, harassment, intimidation, or violence against person or property. In this context, we do not accept alcohol or substance abuse as an excuse, reason, or rationale for such abuse, harassment, intimidation, or violence. Ignorance or “it was just a joke” is also not an excuse for such behavior. Such behavior will be subject to the University’s disciplinary processes. All who work, live, study and teach in the USC community are here by choice, and as part of that choice, should be committed to these principles which are an integral part of USC’s focus, goals and mission. (We wish to acknowledge the roles played by the University of California, Irvine and Santa Cruz, in the evolution and wording of “Principles of Community”).

Standards of conduct in the Keck School of Medicine

Effective, caring and compassionate health care depends critically on the professional and collegial attributes acquired by medical students during their education. In this regard, the teacher-student relationship is one of the most important, since the teacher is responsible for both imparting information and guiding the personal development of the student. The teacher also stands as a potential role model for any student and it is therefore important that the teacher’s behavior towards her or his students is equitable and professional. At the core of an effective learning environment lies mutual respect between the teacher (including, but not limited to, faculty, residents and staff) and the student, and between each student and their student colleagues.

To this end, the Keck School of Medicine will not tolerate the harassment or abuse of, discrimination against, or favoritism towards a student by a teacher or a student colleague.
This includes, but is not limited to:

1. Harassment of a Sexual Nature

This includes, but is not limited to

(i) Unwanted sexual advances,
(ii) Unwanted and inappropriate touching,
(iii) Displaying sexually suggestive materials in an unreasonable and inappropriate manner,
(iv) Unreasonable and inappropriate sexual comments in the presence of, or directed to, any person,
(v) Making training, advancement, promotion or rewards contingent on sexual favors, and
(vi) Requesting sexual favors in return for grades.

2. Discrimination, Harassment and Abuse
Examples include:

(i) Denying opportunity of training or rewards based on gender, race, color, national or ethnic origin, sexual orientation (or perceived orientation), religious belief, age, disability or military service,
(ii) Conduct towards an individual intended to insult or stigmatize them,
(iii) Making inappropriate physical contact with the student,
(iv) Humiliating/denigrating the student, either privately or in the presence of other students, staff members, faculty or patients,
(v) Requiring students to perform personal services for a teacher,
(vi) Grading or evaluating a student’s performance on factors other than merit, and
(vii) Exclusion of a student from any usual education opportunity for any reason other than as a justifiable response to that student’s performance or merit.

3. Abuse of a student based on his/her failure to perform adequately

Upon occasion, the performance of a student may fall below that expected by the teacher. The teacher must ensure that his/her response to such an event is remedial, without being punitive or harsh. Under no circumstances will abuse directed towards the student be permitted. Abuse includes, but is not limited, to those items listed above.

4. Favoritism towards a student or group of students

Although instances may arise when an instructor comes to favor some students over others, this should in no way skew her or his teaching activities such that:

(i) Some students receive better access to information than others, or
(ii) Some students and their opinions are neglected in the teaching process.

Teachers are also cautioned against behavior that leads to the perception of favoritism. Any violation of these Standards of Behavior may be reported according to the procedure outlined below.

IV. REPORTING PROCEDURES

A student considering making a report should first, if at all possible, attempt to resolve the matter directly with the alleged offender. Should this fail, the student may then report the incident(s) to a Primary Contact. Primary Contacts shall include the:

1. Assistant Dean for Curriculum and Student Affairs, Basic Sciences
2. Assistant Dean for Curriculum and Student Affairs, Clinical Years
3. Associate Dean for Women and Disabled Issues
4. Assistant Dean for Minority Affairs
5. Director of Student Health Services

Complaints should be brought to a Primary Contact as soon as possible, but within 90 days of the incident(s). Delay in taking action with respect to an incident may foreclose other remedies.

A prompt report of harassment, mistreatment or retaliation is very important for several reasons. The Keck School of Medicine is better able to investigate and remedy complaints if they are immediately brought to attention. The recollection of witnesses generally diminishes over time. Many perpetrators will discontinue inappropriate behavior once they understand that it is objectionable. The School’s ability to impose a meaningful remedy dissipates with the passage of time. For all these reasons, the Keck School of Medicine urges that complaints be filed promptly.

Note: At any time in the process outlined below, the individual making the complaint may elect to prepare a report for the Designated Investigator in the Office of the University General Counsel as provided for in the Complaint Process of the University of Southern California. Alternately, if the alleged offender is an employee of Los Angeles County (or other health care facility), the individual making the complaint may elect to submit the report through the Office of Human Resources at the facility where the alleged violation(s) took place.

In the absence of a complaint, the Keck School of Medicine may initiate an investigation if it has reason to believe that its procedure prohibiting harassment, mistreatment or retaliation has been violated.

A. Informal Consultation

The reporting individual may consult informally with any Primary Contact for information and assistance. The Primary Contact’s duties shall include but are not limited to:

a) Counseling the student with respect to his/her rights.
b) Facilitating communication with the alleged offender, the alleged offender’s Program Director or other appropriate supervisors (at student request)
c) Serving as a sounding board, thus allowing the student to vent his/her feelings
d) Assisting the student in filing a formal complaint

Any such informal consultation will be confidential unless the student consents to mediation with the alleged offender, or if the alleged offense is reportable by law or otherwise required to be reported. An informal consultation may result in:

(i) no written record if so requested by the complainant or
(ii) (ii) a confidential memorandum generated by the Primary Contact and retained in the files of the Chair of the Student Affairs Committee. (Confidential memoranda may be made available to the other members of the Student Affairs Committee should more than 3 complaints arise against one individual over the course of a single calendar year, or if the nature or degree of the complaints cause the Chair to believe the matter merits review by the SAC) If a pattern of mistreatment is suspected, the Sub-Committee on Student Mistreatment may initiate an inquiry on its own. After 2 complaints have been received against the same individual, the alleged violator will be warned by the Committee that “some students” (no names given) perceive his/her conduct to be in violation of the School’s Behavioral Standards, and that should this conduct continue, further steps will be taken.

B. Formal Reporting

To make a formal complaint of an alleged violation of the Behavioral Standards, a written, signed description of the alleged violation should be submitted to the Primary Contact. The student has the option to suggest a possible remedy.

The Primary Contact shall then forward the written complaint to the Student Affairs Sub-Committee on Student Mistreatment. The report should be filed with the Primary Contact within 90 days of the occurrence of the alleged act. Early filing is encouraged so that the investigation can be more complete and more detailed. This 5-member sub-committee (consisting of 3 faculty and 2 student members of the Student Affairs Committee) will conduct a preliminary investigation, giving the reporting individual, the alleged offender, and any other persons the sub-committee identifies, the opportunity to express their views on the matter. The sub-committee shall make it clear to all parties that retaliation in any way against any participant in the process is forbidden. The sub-committee shall make a preliminary determination of the events documented in the complaint.

Thereafter, the sub-committee shall issue a written statement of its preliminary findings and recommendations for vote by the Student Affairs Committee. (Note: the Associate Dean for Student Affairs will abstain from voting at this time if the conflict involves 2 students). The decision of the Student Affairs Committee will be sent to the supervising Department Chair and Dean who, in consultation with the Student Affairs Committee, will decide on final disciplinary action. Discipline will be consistent with University and School of Medicine policies on disciplinary actions as set forth in the USC Faculty Handbook, the USC Staff Employee Handbook, and the Keck School of Medicine Student Handbook, as applicable.

The Student Affairs Committee will issue its recommendation as follows:

If a faculty member is the alleged offender, to:

Dean of the Keck School of Medicine
Department Chair
If faculty is an employee of LAC then Human Resources at LAC may also be advised of findings

If a student is the alleged offender, to:

Associate Dean for Student Affairs

If a University employee is the alleged offender, to:

Supervisor or Department Chair

If an LAC employee is the alleged offender, to:

Department Chair
Human Resources at LAC as indicated

The final decision will be issued in a statement by the Student Affairs Committee and provided to the individual making the report, the alleged offender, the Department Chair and appropriate Dean, the Vice President of Health Affairs, and the Chair of the Student Affairs Committee. If the sanction or corrective action is not in agreement with the remedy requested by the complainant, the reason for this decision shall be included in the written ruling. Sanctions shall go into effect against the person concerned no sooner than 10 calendar days after she/he has received a copy of the ruling, unless she/he files a written appeal with the Senior Associate Dean for Educational Affairs before 10 days have elapsed (time frames in accordance with the staff/faculty handbook). The Senior Associate Dean for Educational Affairs shall decide the appeal within 14 days of receipt and shall notify the individuals of his/her decision.

VI. PROTECTION OF COMPLAINANT AND ACCUSED

Students, hospital employees, patients, residents, fellows and faculty have individual rights, which should be recognized in the application of these procedures. With regard to allegations of student mistreatment, the student and teacher should remain vigilant to each other’s rights and responsibilities.

Since disputes of this nature can be career threatening, all must understand that false accusations must be avoided. Protection of the faculty from false accusation is essential for both the students and the faculty. For these reasons a local investigation to establish the nature of the problem by the S.A.C. (with both student and faculty input) is essential. This process will also provide the greatest likelihood of achieving a local solution which is satisfactory (and constructive) to both parties.

Finally, neither the faculty’s nor the student’s rights supersede the patient’s right for care. Both the teacher and the student must be aware of this priority at all times.

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STUDENT HEALTH REQUIRMENTS UPON ENTRANCE TO THE SCHOOL

Prior to matriculation, each student is required to submit a physical examination, health history, and proper medical documentation for the following requirements:

Tuberculosis (TB) clearance: A negative tuberculin skin test must be placed two months or less from your school start date. If the student has a history of a positive tuberculin skin test, he/she must have a negative chest x-ray performed six months or less from your school start date.

Measles, Mumps and Rubella (MMR): Positive IGG titer

Tetanus/Diphtheria (Td): Booster injection within the last 5 years
(Booster injection must be 5 years or less from your school start date)

Varicella: Positive IGG titer

Hepatitis B: 3 injections and positive Hepatitis B surface Antibody titer

*Note: Meningococcal vaccine is offered, but may be declined without restricting access to clinical rotations.

*Note: Failure to provide adequate documentation may be grounds for restricting patient contact and/or registration.

ONGOING STUDENT HEALTH REQUIREMENTS AFTER ENTRANCE TO THE SCHOOL

An annual tuberculin skin test (every 6 months for some facilities) is required for all students. An annual chest x-ray is required for those with positive tuberculin skin tests. The Student Health Fee will cover chest x-rays only for those students whose skin tests show conversion during their education on the Health Sciences Campus.

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AIDS POLICIES AT THE KECK SCHOOL OF MEDICINE

1. It is the policy of the Keck School of Medicine that all health care providers and all students involved in clinical care are expected to attend all patients, regardless of disease. Medical students, residents and faculty members have a fundamental responsibility to provide care to all patients assigned to them. A failure to accept this responsibility violates a basic tenet of the medical profession: to place the patient's interest and welfare first. Faculty have a special responsibility to model the professional behavior and attitudes expected of physicians in training, in their own willingness to provide competent, sensitive, and compassionate care to all patients.

Implementation Guidelines:

A. A copy of these policies will be circulated to all current students, house officers, and faculty.

B. A copy of these policies will be included in the Student Handbook; in the house officers manual; and in orientation materials to new faculty.

C. In the event that this policy is violated, such information will be provided to the Chair of the specific Department in question, if the violation has occurred by a faculty member. If such a violation has occurred by a student, or house officer, the Associate Dean(s) for Student Affairs and/or Post-Graduate Education will be informed.

1. Individuals who have had difficulty adhering to this policy will be referred for counseling and/or education.

2. If violations persist, despite the measures above, further refusal to care for such patients will result in disciplinary actions, including, but not limited to the possibility of interim and/or permanent suspension.

2. The Keck School of Medicine and its teaching hospitals must accept the responsibility of helping medical students, residents, and faculty members address and cope with their fears and prejudices in treating HIV infected patients. This responsibility includes providing the following: An accurate portrayal to medical student applicants of the personal risks involved in medical practice; up-to-date information on the modes and risks of transmission of the virus; training in the protective measures to be employed by health care workers in the clinical setting, monitoring compliance with protective measures, and defining procedures to be followed in the event of potential exposure.

   Implementation Guidelines:

   A."Universal Infection Precautions" will be adopted as the standard of practice throughout the School of Medicine, as well as its affiliated teaching hospitals. These precautions will be taught to the medical students. Each clinical Department will assume responsibility for training its Faculty and House Officers in the "Universal Precautions" policies, and will develop a plan of implementation, expanded as necessary for special hazards specific to that Department. The "Universal Infection Precautions" should be posted throughout all clinical facilities, in appropriate locations as set forth by the specific Medical Directors and/or Administrators.
   
   B. A mechanism to determine the effectiveness of the educational efforts will be designed and employed, to determine if a problem exists within our Faculty, House Officers and Students, and if so, to design an appropriate remedial program, including monitoring.
   
   C Support services related to HIV infection will be provided by the Keck School of Medicine and its affiliated hospitals to provide counseling, psychological support, and social support to Students, House Officers and/or Faculty who wish or require these services.
   
   D. A comprehensive plan of medical and social support will be provided to Medical Students, House Officers and/or Faculty who have had apparent exposure incidents to HIV, or who have become infected by HIV during the course of employment.
   
   E. Persons infected with HIV, whether they have AIDS, symptomatic HIV disease, or are asymptomatic and seropositive, will not be excluded from enrollment in the Medical School or employment in the Health Sciences Campus solely because of their HIV status. However, it may be that judgment in individual cases will establish that exclusion or restriction is necessary for the welfare of the individual, or other members of the Health Sciences community, or of patients.
   

The Eric Cohen Student Health Center offers the following advice on communicable disease exposure:

Upon exposure to a communicable disease, time is of the essence! It is imperative that the student report to Student Health as soon as possible after the injury. Failure to do so may unnecessarily expose the student to risk. Students should contact the Eric Cohen Student Health Center Administration at (323) 442-5980 and report to the Family Medicine Practice at the HCC for appropriate follow-up. Most often, these exposures are to tuberculosis, hepatitis, or HIV (by blood or blood product contaminated needlestick). Specific protocols for follow-up of communicable disease contacts have been established. At the place of exposure, delegate someone to collect all available information, including the date, time, place, and how the incident occurred, the patient's name and medical record number, the diagnosis and history (including history of hepatitis, liver disease, HIV status, blood transfusions and IV drug or alcohol abuse). Medications for some exposures give best protection if taken within two hours of the exposure. Starting doses are available at the Student Health Center. If after hours or over a weekend/holiday, telephone Student Health at (323) 442-5900 and ask for the physician on duty.

If a needlestick injury has occurred at L.A. County Hospital after our clinic hours, the student should go to Employee Health (or the Emergency Room) at County Hospital. Remember, time is of the essence!

Needlesticks that occur outside of University Hospital or L.A. County Hospital may be treated with the local facility’s protocols. Your insurance will cover this service at 90%. Also, be sure to follow-up with the Eric Cohen Student Health Center within 24 hours to avoid further costs to you.


References for Prevention of HIV and Bloodborne Pathogen Infection, and
Treatment Following Accidental HIV Exposure

Perspectives in Disease Prevention and Health Promotion Update: Universal Precautions for Prevention of Transmission of Human Immunodeficiency Virus, Hepatitis B Virus, and Other Bloodborne Pathogens in Health-Care Settings
http://www.cdc.gov/mmwr/preview/mmwrhtml/00000039.htm

Summary (from reference):

" The purpose of this report is to clarify and supplement the CDC publication entitled "Recommendations for Prevention of HIV Transmission in Health-Care Settings."

" In 1983, CDC published a document entitled "Guideline for Isolation Precautions in Hospitals" that contained a section entitled "Blood and Body Fluid Precautions." The recommendations in this section called for blood and body fluid precautions when a patient was known or suspected to be infected with bloodborne pathogens. In August 1987, CDC published a document entitled "Recommendations for Prevention of HIV Transmission in Health-Care Settings." In contrast to the 1983 document, the 1987 document recommended that blood and body fluid precautions be consistently used for all patients regardless of their bloodborne infection status. This extension of blood and body fluid precautions to all patients is referred to as "Universal Blood and Body Fluid Precautions" or "Universal Precautions." Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other bloodborne pathogens.

" Universal precautions are intended to prevent parenteral, mucous membrane, and non-intact skin exposures of health-care workers to bloodborne pathogens. In addition, immunization with HBV vaccine is recommended as an important adjunct to universal precautions for health-care workers who have exposures to blood.

" Since the recommendations for universal precautions were published in August 1987, CDC and the Food and Drug Administration (FDA) have received requests for clarification of the following issues: 1) body fluids to which universal precautions apply, 2) use of protective barriers, 3) use of gloves for phlebotomy, 4) selection of gloves for use while observing universal precautions, and 5) need for making changes in waste management programs as a result of adopting universal precautions.”

Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Post exposure Prophylaxis.
MMWR June 29, 2001 50(RR11);1-42
http://www.aidsinfo.nih.gov/guidelines/health-care/HC_062901.html

Summary (from reference):

“This report updates and consolidates all previous U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV).

"Recommendations for HBV postexposure management include initiation of the hepatitis B vaccine series to any susceptible, unvaccinated person who sustains an occupational blood or body fluid exposure. Postexposure prophylaxis (PEP) with hepatitis B immune globulin (HBIG) and/or hepatitis B vaccine series should be considered for occupational exposures after evaluation of the hepatitis B surface antigen status of the source and the vaccination and vaccine-response status of the exposed person. Guidance is provided to clinicians and exposed HCP for selecting the appropriate HBV PEP.

"Immune globulin and antiviral agents (e.g., interferon with or without ribavirin) are not recommended for PEP of hepatitis C. For HCV postexposure management, the HCV status of the source and the exposed person should be determined, and for HCP exposed to an HCV positive source, follow-up HCV testing should be performed to determine if infection develops.

"Recommendations for HIV PEP include a basic 4-week regimen of two drugs (zidovudine [ZDV] and lamivudine [3TC]; 3TC and stavudine [d4T]; or didanosine [ddI] and d4T) for most HIV exposures and an expanded regimen that includes the addition of a third drug for HIV exposures that pose an increased risk for transmission. When the source person's virus is known or suspected to be resistant to one or more of the drugs considered for the PEP regimen, the selection of drugs to which the source person's virus is unlikely to be resistant is recommended.

"In addition, this report outlines several special circumstances (e.g., delayed exposure report, unknown source person, pregnancy in the exposed person, resistance of the source virus to antiretroviral agents, or toxicity of the PEP regimen) when consultation with local experts and/or the National Clinicians' Post-Exposure Prophylaxis Hotline ([PEPline] 1-888-448-4911) is advised.

"Occupational exposures should be considered urgent medical concerns to ensure timely postexposure management and administration of HBIG, hepatitis B vaccine, and/or HIV PEP."

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POLICY FOR STUDENTS WITH CHRONIC VIRAL HEPATITIS
(Persistent Hepatitis B or C antigenemia)

Patients infected with viral hepatitis pose a potential threat to any health care provider caring for them. While this risk is variable depending on the patient and the clinical situation, it is imperative that students observe proper procedure when dealing with all patients. This should include use of Universal Precautions in all patient contact.

Health care providers infected with viral hepatitis can also pose a threat to patients. Cases of hepatitis transmission from physician to patient are documented in the literature, and therefore students infected with viral hepatitis may have additional matters to consider regarding their contact with patients. These considerations will likely extend throughout their education and careers, and form the basis for the following policy.

1. All medical students are required to obtain hepatitis B vaccination before beginning medical school, and certainly before any patient contact. The vaccine is highly effective at inducing immunity to hepatitis B, and its side effect profile is minimal.
   
2. Students infected with chronic viral hepatitis (hepatitis B or hepatitis C) are required to discuss their condition with a physician or physician assistant in the Student Health Service. This discussion should include an evaluation of their current health status (or review of data previously collected elsewhere), and consider the impact their hepatitis infection may have on patients seen during their training.
   
3. Students are encouraged but not required to meet with faculty advisors regarding the potential impact hepatitis may have on their future career and specialty choice. This is especially important for any student with chronic hepatitis infection who is considering a surgical career. Appropriate advisors include the Chair or Chief of the specialty being considered, faculty in the specialty being considered, and the Associate or Assistant Dean for Student Affairs.
   
4. Students are required to meet with the Director or another physician in the Employee Health Service of the LAC+USC Medical Center before beginning clinical rotations to discuss recommendations and potential restrictions on their clinical activities. This will generally take place prior to the beginning of the third year of the curriculum.
   
5. Students who are Hepatitis e antigen positive, and thus have the potential for significantly greater risk to patients, will not be allowed direct patient contact in operating rooms, burn units, the newborn nursery or other settings where immunocompromised patients would be at risk. Acceptable alternate educational experiences will be developed wherever possible to provide the student with the full educational benefit available, though there may be some instances where an equivalent experience will not be possible.
   
6. To comply with these policies, students are required to discuss their situation with the clerkship coordinator before beginning their rotation in Surgery, Pediatrics, Obstetrics-Gynecology, and other clinical rotations where their hepatitis status may have an impact on their clinical responsibilities. If the student and clerkship coordinator are unable to reach a mutually acceptable agreement regarding the student's activities, the Associate Dean for Student Affairs will be contacted by either party to arrive at a resolution. This resolution will follow consultation with the Campus Coordinator for Disabled Issues, and/or other individuals or resources as needed.
   
7. To the extent possible, this process will respect and maintain the confidentiality of all involved parties. The health status of the affected student will not routinely be released to other members of the health care team, staff, faculty or patients.

This policy was adopted November 16, 1995 following input and review by clinical faculty, the Student Health Service of the Health Sciences Campus, the Employee Health Service of the LAC+USC Medical Center, the Campus Coordinator for Disabled Issues, the Associate Dean for Student Affairs, and University legal counsel. Any questions should be directed to the Associate Dean for Student Affairs.