Professional

Academic information

The academic progress of each student is monitored by the Academic Review Committee. Specific policies for handling misconduct (academic or nonacademic) are published in the Student Handbook available at <llu.edu/central/handbook>.

Communications

Communications to the medical student regarding academic and clinical assignments, scholarship opportunities, and other important information are routed through the Office of the Dean. A student bulletin board is located in the student lounge. It is the responsibility of students to check their e-mail daily.

Required supplies

Microscope

Microscopes will be provided to students and a rental fee will be charged. If a student chooses to use his/her own microscope, it must be approved  by the histology faculty in the Division of Anatomy.

Textbooks

Students are required to purchase the textbooks adopted by the School of Medicine Curriculum Committee.

Instruments

Students are required to purchase the instruments adopted by the physical diagnosis course.

Practice and regulations

Course exemptions

Students who seek exemption from registering for courses that they took prior to entering the School of Medicine must qualify for the exemption by passing a comprehensive examination covering the course material in question.

Should the student qualify, in lieu of the regular course, s/he will be required to participate in an advanced program that may include additional studies, research activities, and/or teaching. A written paper will be required from all students completing the advanced program.

The course director, the senior associate dean of medical student education, and the student will work together to determine the content of the advanced program. Full tuition, equivalent to that of the regular program, will be charged.

Examinations

In order to sit for an examination, students must be present when the chief proctor reads the examination instructions at the designated start time. Students who arrive late to an examination will be denied entrance. If, due to special circumstances, a student has been given permission by the Office of Medical Student Education to arrive late to an examination, the number of minutes the student is late will be deducted from their allotted examination time. Students who arrive after any other student has left the examination for any reason will not be permitted to take the examination. For national board subject examinations, students will be denied entrance once the examination has started, without exception.

Missed examinations

Students who have an excused absence for one day of a three-day midterm examination will receive their two-day score, and the percentage earned on the cumulative final examination (including NBME subject examinations) for each course will be substituted for the missed examination. Students who miss two or three days of a three-day midterm examination are required to take a makeup examination within two weeks of the missed examination dates at a date and time scheduled by the course director. Makeup examinations may differ in content and/or format from the missed examinations. In addition, course directors may require other remediation at their discretion.

Should a student miss an in-house final examination because of an excused absence, arrangements must be made with the course directors to make up the missed examinations. The course directors, at their discretion, may opt to have the student take an examination that is different in format, content, or length from the final examination that was administered to the class.

Should a student miss a national board subject examination because of an excused absence, the student will be allowed one opportunity at the end of the academic year to take and pass the subject examination upon completing all other course work for that year. Arrangements for the makeup examination must be made through the Office of Medical Student Education.

Conditions to be met for an excused absence

In order to have an excused absence, the student must get a written excuse from the Office of the Senior Associate Dean for Medical Student Education prior to the administration of the test in question. Students missing examinations for health reasons must provide written documentation of their illness from Student Health Center or another examining physician. Whether or not this documentation is an adequate excuse for missing an examination will be left to the discretion of the senior associate dean for medical student education. Under no circumstances are students allowed to take examinations early.

In the event of a bona fide emergency, where prior approval is not feasible, the Office of the Senior Associate Dean for Medical Student Education (909/558-4255) must be contacted as soon as possible. Failure to do so will result in an unexcused absence.

Students who miss examinations without prior approval from the Office of the Senior Associate Dean for Medical Student Education have an unexcused absence. As a result, the student will receive a zero for the missed examination(s). Missing more than one examination in any course or combination of courses could result in a student having to repeat the course(s) during the next academic year.

Grading policy

Course/Clerkship directors assign grades at the end of each course/clerkship. Grades reflect the success or failure of the student in meeting the objectives of the course in terms of knowledge, skills, attitudes, values, and behaviors.

The University transcript records grades for completed courses/clerkships as Satisfactory (S), Marginal Satisfactory (MS), or Unsatisfactory (U). For the purposes of determining eligibility for promotion, the School of Medicine utilizes grades of Satisfactory (S), Marginal Satisfactory (MS), Unsatisfactory (U), or In Progress (IP). Course/Clerkship directors assign a grade of Satisfactory (S) when a student's performance clearly exceeds the requirements of the course/clerkship. A grade of Marginal Satisfactory (MS) is assigned when the course/clerkship director judges that student performance meets but does not exceed the minimal requirements of the course. A grade of Unsatisfactory is assigned when a student's performance fails to meet the minimal requirements for the course/clerkship. A notation of In Progress (IP) is used to identify students having unfinished course/clerkship requirements. Subjective narrative descriptions of student performance are submitted to the Office of the Senior Associate Dean for Medical Student Education and may be used in the medical student performance evaluation (MSPE/dean's letter).

Students who wish to contest a grade should discuss the grade first with the course/clerkship director, then with the department chair. If the student is not satisfied, s/he may then appeal the grade to the Office of the Senior Associate Dean for Medical Student Education.

Determination of Dean's letter grade

For the Medical Student Performance Evaluation (MSPE/dean's letter), students will be assigned one of the following five designations for each course/clerkship:

  • H (honors)
  • HP (high pass)
  • P (pass)
  • MP (marginal pass)
  • U (unsatisfactory)

Each designation will be based on predetermined criteria established by the course/clerkship director in collaboration with the Office of Medical Student Education. The criteria for ranking may include student performance on faculty-generated examinations, national standardized subject examinations, active and computer-based learning activities, patient-care activities, objective structured clinical examinations (OSCEs), medical simulations, and other academic activities as set forth by the course/clerkship director. Students who have failed a course or clerkship-specific NBME subject examination are not eligible to receive dean's letter grades of honors or high pass in that course/clerkship.

Junior and Senior year medical students will not be ranked against each other. Clerkship grades and performance on school-required activities will be reported on the MSPE (dean's letter).

Promotion

Promotion from year to year is contingent upon satisfactory academic performance and attainment of competency milestones. Cognitive and noncognitive (including personal suitability to assume the responsibilities of the medical profession) academic progress are monitored by the Academic Review Committee. The committee evaluates cumulative academic performance, not just performance in current or most recent course work. Students must pass each course and/or attain competency milestones to demonstrate overall satisfactory performance.

The Student Handbook contains additional details regarding the criteria used by the Academic Review Committee for promotion decisions.

Decelerated program—freshman curriculum

Students who experience academic difficulty during their first year of medical school may be assigned to a decelerated program with a reduced load. This reassignment will ordinarily occur within the first two weeks following the second midterm examination when, in the judgment of the dean's office, it appears the student will be unlikely to pass the year while carrying out a full load.

Academic probation

A student whose overall performance is judged to be unsatisfactory by the Academic Review Committee is placed on academic probation. For more information concerning the terms of academic probation, please see the Student Handbook.

Withdrawal

To withdraw from a course(s), the student must meet with the senior associate dean for medical student education to determine educational appropriateness and file a change of program form. To completely withdraw from school, the student must complete the online withdrawal form. These forms should be completed and submitted on the last day of class attendance. The date of withdrawal used in calculating tuition refunds will be the date on which the properly completed form is submitted to the Office of University Records.

USMLE Steps I and II policy

States vary in the number of times a student can attempt USMLE examinations and still be eligible for licensure. A significant number of states allow no more than three attempts. The school has defined its own limits for number of attempts allowed. School policy requires students enrolled in the Loma Linda University School of Medicine to pass Step I in no more than three attempts.

Students must complete the clinical course work required for graduation within three years of starting the clinical curriculum; they are permitted a maximum of three sequential attempts to pass Step II of the USMLE. The student's first attempt at passing Step II of the USMLE must take place only after s/he has satisfactorily passed all junior clerkships and prior to his/her completion of all required senior clinical course work.

A student who has failed Step II but who has completed all course curriculum requirements must remain enrolled in the School of Medicine as a directed study student until s/he has either passed Step II of the USMLE or failed Step II of the USMLE for the third time. 

The Student Handbook provides conditions and deadlines for taking and passing USMLE examinations.

We are instituting a competency-based curriculum with full implementation in 2018.

Competencies for medical student education

Patient Care - Students must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health in the context of whole person care.

  • History Taking - Obtain relevant and accurate information about the patient.
  • Physical Examination - Perform appropriate, complete and accurate physical examination.
  • Oral Case Presentation - Effectively communicate case orally with content appropriate for the clinical case, context, and audience.
  • Medical Documentation - Document history and physical, differential diagnosis, problem list, and plan.
  • Procedures and Skills - Perform skills and procedures required for patient care.
  • Patient Management - Provide patient care that is compassionate, appropriate, and effective.
  • Psychosocial and Spiritual Care - Integrate psychosocial and spiritual care with patient care.

Medical Knowledge- Students must demonstrate the ability to effectively source and validate medical information, possess an adequate foundation of basic science knowledge, and apply this knowledge and information to the care of patients using clinical reasoning and problem solving skills with a whole person care approach.

  • Fundamental Medical Knowledge - Comprehend the established and evolving basic and clinical biomedical sciences, including epidemiological and social/behavioral sciences.
  • Health Promotion and Disease Prevention - Promote health and prevent disease.
  • Ethics and Spirituality - Employ ethical principles and knowledge of religious beliefs and spirituality of patients and their families to enhance patient care.
  • Sourcing and Evaluation of Medical Information - Use information technology to optimize delivery of patient care.
  • Problem Solving and Clinical Reasoning Skills - Demonstrate problem solving and clinical reasoning skills

Professionalism - Students must demonstrate professional behaviors, attitudes and beliefs that allow patients, colleagues, members of the healthcare team and society to approach each physician encounter with an expectation of trustworthiness.

  • Personal Attributes - Show ownership for one’s choices, attitudes and behaviors.
  • Relationship Attributes - Demonstrate compassion, integrity and respect for others, including sensitivity and responsiveness to a diverse patient population.
  • Societal Responsibilities -Fulfill obligation to patients, colleagues, and society.

Systems-Based Practice - Students must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources, including interprofessional teams, in the system to provide optimal health care.

  • Health Care Delivery Systems - Explain health care delivery systems and their potential effects on the health of patients and communities.
  • System Resources - Apply system-level approaches to improve quality of healthcare.
  • Interprofessional Education - Enable effective collaboration and improve health outcomes.

Practice-Based Learning and Improvement- Students must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning.

  • Evidence-Based Medicine - Use principles of evidence-based medicine to optimize patient care.
  • Feedback, Self-assessment and Reflection - Develop lifelong learning skills through seeking feedback, self-assessment and reflection.
  • Practice-based Quality Improvement - Engage in improvement of health care systems.

Interpersonal and Communication Skills - Students must be able to demonstrate culturally sensitive interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and professional associates.

  • Relationship-Building Skills - Demonstrate relational versatility in relationships with colleagues, patients, and their families.
  • Effective Listening Skills - Actively engage in the skill of listening.
  • Information Sharing Skills with Patients and their Families - Communicate effectively within the context of the cultural beliefs, practices, and needs presented by patients and their communities.
  • Information Sharing with Professional Associates – Present and document patient information to professional associates.
  • Communication with the Medical Team - Work cooperatively with interprofessional health care teams.

Whole Person Care – Through the study and application of whole person care, student will develop a knowledge of wholeness that can be applied to their personal and professional lies and the care of patients.

  • Whole Person Care of Patients - Apply whole person care model to the care of patients.
  • Personal Wholeness of Students - Implement wholes strategies for personal development.

Goals for each year

Medical education will begin to establish a foundation in the sciences basic to the practice of medicine, with emphasis on the principles and mechanisms of normal development, structure, and function--including normal changes of aging and the behavioral considerations that influence normal development. Course content will be organized around individual organ systems whenever possible. The first year will also begin to develop the skills, values, attitudes, and professional behaviors that are integral to the safe, competent, compassionate, ethical, and biblical practice of medicine--both now and in the future. The educational program will make use of a wide variety of pedagogical methods, including but not limited to: traditional lecture; small-group, problem-based, and case-based learning; personalized computer-based instruction; quantitative laboratory experiences; and patient care experiences.

The second year of medical education will continue to establish a foundation in the sciences--basic to the practice of medicine--with emphasis on the principles and mechanisms of abnormal structure and function, principles of therapy, and behavioral considerations that affect disease treatment and prevention. Course content will be organized according to individual organ systems whenever possible. The second year will also continue to develop the skills, values, attitudes, and behaviors that are integral to the safe, competent, compassionate, ethical, and Christian practice of medicine--both now and in the future. The educational program will make use of a wide variety of pedagogical methods, including but not limited to: traditional lecture; small-group, problem-based, and case-based learning; personalized computer-based instruction; quantitative laboratory experiences; and longitudinal patient-care experience.

The third year of medical education will establish a body of knowledge, skills, values, attitudes, and behaviors in seven core clinical science disciplines to build foundational and comprehensive experiences for patient care in ambulatory and hospital-based settings. Students will attain these experiences through a process of self-directed learning, independent study, and guided supervision and teaching by house staff and faculty. Students will have ample opportunity to learn the value of honor, shared responsibility, and accountability by directly participating in patient-care activities as junior colleagues on the health-care team.

The didactic program will emphasize: a) understanding the pathophysiology of disease, b) establishing diagnoses through interpretation of physical examination and diagnostic data, and c) the application of management principles to patients with acute and chronic conditions. Recurring experiences in whole person care, medical ethics, laboratory medicine, health maintenance, and disease prevention will be integrated into the seven core disciplines. Students will have the opportunity to explore an area of interest during an elective experience for the purpose of beginning the process of choosing a career in medicine.

The fourth year of medical education will require students to integrate the entirety of their medical knowledge, skills, values, and attitudes gained during the first three years and apply it more autonomously to patient care. Students will participate in mandatory supervised patient-care experiences in emergency medicine, intensive care medicine, preventive medicine and public health; and a subintern-level experience in internal medicine, surgery, family medicine, or pediatrics. Although repetitive clinical duties during the fourth year are a necessary part of preparing students for the rigors of postgraduate training, students will still have ample opportunity to pursue individual interests during the eighteen weeks of elective rotations. To reestablish the importance of science in medical practice, at least two weeks of electives will be in a basic science discipline of the student's choosing. Students will have adequate vacation time to study for Step II of the USMLE and successfully participate in the residency selection process.

Doctor of Medicine degree requirements

The School of Medicine requires that a candidate for a degree or certificate from the school must have met the following requirements for the Doctor of Medicine degree:

  • Completed all requirements for admission.
  • Attended an accredited medical school for four academic years, the last two of which must have been spent at this school.
  • Completed honorably all requirements of the curriculum, including specified attendance, level of scholarship, length of academic residence, and credit units.
  • Completed additional special examinations covering any or all subjects of the medical curriculum, as may be required.
  • Successfully completed USMLE examinations (Steps I and II), as specified--both clinical skills and knowledge components.
  • Given evidence of moral character, of due regard for Christian citizenship, and of consistent responsiveness to the established aims of the University and of the school.
  • Discharged financial obligations to the University.

The candidate is required to participate in graduation exercises upon completion of the academic program. If the candidate is out of sequence with his/her current class but would like to participate in the commencement exercises, s/he must have completed a minimum of three months of the required senior clerkships, i.e., medicine, pediatrics, family medicine or surgery subinternship, preventive medicine and public health, intensive care and emergency medicine by April 1 of the year of graduation. Consent for the student to be absent, granted by the president of the University, is contingent on the recommendation of the dean to the president.

The families and friends of graduates are invited to be present at the official conferring of degrees service.

Licensing examinations

National

The graduate who holds credentials from the USMLE may be granted a license by endorsement of the examining board of most states. Additional requirements made by some states are given in a pamphlet that may be obtained from the Federation of State Medical Boards, 400 Fuller Wiser Road, Suite 300, Euless, TX 76039-3855.

Graduate specialty medical education residencies

Loma Linda University is affiliated with a variety of accredited residency programs in two sponsoring institutions.  The first is Loma Linda University Medical Center and the second Loma Linda-Inland Empire Consortium for Healthcare Education. Additional nonaccredited fellowships are available.

Graduate physicians wishing to apply for entrance into these programs should contact the director of the program.

These programs are sponsored by Loma Linda University Medical Center and Loma Linda Inland Empire Consortium for Healthcare Education.

Postgraduate training

In harmony with the needs of medicine today, the curriculum leading to the Doctor of Medicine degree is planned with the assumption that all students will take standard postgraduate training in one of the fields of medicine. This means serving as a resident for a minimum of three years in a hospital approved for this training by the Council of Medical Education and Hospitals of the American Medical Association.

The Office of the Senior Associate Dean for Medical Student Education supplies information and assistance for the arrangement of residencies. Since the school participates in the National Residency Matching Program, selection through this means constitutes approval by the School of Medicine.

Continuing medical education

Recognizing the imperative of lifelong learning for professionals, the School of Medicine supports a program of continuing medical education for physicians beyond their formal postgraduate years. The Office of Continuing Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide Category I continuing medical education credit for physicians. Course offerings include weekly, bi-weekly, and monthly School of Medicine departmental grand rounds and a large number of one-day and multiday conferences and workshops that are presented locally and nationally for School of Medicine faculty, alumni, and practicing physicians within the geographic area in which the conferences are presented.

For more information please write to:

Dana Gonzalez, Administrative Assistant
Loma Linda University School of Medicine                                                                                                                                                                                                                                                                                                                                         Continuing Medical Education Office
11175 Campus Street, CP A1116G
Loma Linda, CA  92354
909/558-4963
909/558-0330 fax
<dmmgonzalez@llu.edu>

Clinical instruction takes place primarily at Loma Linda University Medical Center, which includes the Loma Linda University Children's Hospital, Loma Linda University East Campus Specialty Hospital, Loma Linda University Heart and Surgical Hospital, Faculty Medical Offices (FMO), and the Loma Linda University Behavioral Medicine Center. Additional local training sites include the Jerry L. Pettis Memorial Veterans Medical Center, Riverside County Regional Medical Center, and White Memorial Medical Center. Also utilized are Arrowhead Regional Medical Center; Kaiser Permanente; and Kettering Medical Center in Dayton, Ohio.

The instructional resources

Loma Linda University Medical Center (LLUMC)

Loma Linda University Medical Center is a major teaching center serving San Bernardino and Riverside counties. In addition to its large population of referred patients, the medical center is also a Level 1 trauma center for the region and is a tertiary care center for high-risk obstetrics and neonatal intensive care. An extension houses the Loma Linda Cancer Center and the Proton Treatment Center for cancer therapy. Patients in the medical center are available for medical student, resident, and fellowship training.

Loma Linda University Children's Hospital

Loma Linda University Children's Hospital provides a single, centralized location where newborns, infants, and children can receive comprehensive medical care. Being seen at a comprehensive center for children's health care assures parents and their children that all aspects of the child's health will be closely monitored and understood. Loma Linda University Children's Hospital staff—pediatric nurses, physicians, surgeons, anesthesiologists, radiologists, and other professionals—work together to assure that every patient receives the highest possible quality of medical attention.

The organization of a children's hospital also means that the hospital staff is chosen from among people who are specially trained and have a deep interest in children's health care. Every Loma Linda University Children's Hospital employee is highly skilled in dealing with children and has made the care of children a personal priority. The children's hospital is known as "the place for little faces."

Loma Linda University East Campus Specialty Hospital

East Campus Specialty Hospital (formerly Loma Linda Community Hospital) is a teaching resource for students in family medicine, physical medicine and rehabilitation, orthopaedics, and clinical neuroscience. In addition, it serves as the primary inpatient training site for house staff in family medicine.

Loma Linda University Heart and Surgical Hospital

Loma Linda University Heart and Surgical Hospital is a specialty hospital that serves as a teaching resource in the specialties of urology, gynecology, otolaryngology, and cardiovascular disorders.

Faculty Medical Offices

The Faculty Medical Offices (FMO) include facilities for multiple specialties and an outpatient surgery suite that handles approximately 30 percent of all the surgery done at the Loma Linda University Medical Center. The FMO is utilized for student outpatient experience in nearly all specialties.

Jerry L. Pettis Memorial Veterans Medical Center

The Jerry L. Pettis Memorial Veterans Medical Center serves a wide geographic area and cares for a large population of veterans. Outpatient clinics and inpatient wards are available for student and resident teaching. The residency programs are integrated with the Loma Linda University Medical Center and are under the supervision of the faculty of the School of Medicine.

Riverside County Regional Medical Center

The Riverside County Regional Medical Center is located ten miles southeast of Loma Linda in the city of Moreno Valley. The patient population reflects an inner-city profile with a large concentration of urgent medical and surgical, trauma, obstetrics, and pediatrics cases. Patients are available for student, resident training.

Loma Linda University Behavioral Medicine Center

Loma Linda University Behavioral Medicine Center—a freestanding, full-service psychiatric hospital—opened in early 1991. Loma Linda University Behavioral Medicine Center offers adult, child, adolescent, and chemical dependency services—including inpatient and partial hospitalization. Special emphasis is given to services that provide the integration of Christian faith with psychiatric care for patients desiring such.

White Memorial Medical Center

White Memorial Medical Center is located approximately sixty miles west of Loma Linda in the city of Los Angeles. The patient population reflects an inner-city profile with a large concentration of urgent medical and surgical, trauma, obstetrics, and pediatrics cases. Patients are available for student, resident, and fellowship training.