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Standards of Conduct for Treatment of Trainees
(Students, Residents and Fellows)

The Medical University of South Carolina is committed to maintaining an academic and clinical environment in which faculty, fellows, residents, students, and staff work together to further education and research and to provide quality patient care in the community in which MUSC is located, whether in the classroom, the laboratory, or clinical settings.  MUSC’s goal is to educate health care providers and scientists achieve high standards of professionalism and practice in an environment where effective, humane and compassionate patient care can be offered to all patients. 

MUSC recognizes that each member of the University community should be treated civilly, which entails mutual acceptance among autonomous individuals without regard to their race, color, religion, gender, sexual orientation, national or ethnic origin, age, disability or any other factor irrelevant to participation in the activities of the University.  The concept of educational pluralism embraces the idea that diversity in background, outlook and interest among faculty, fellows, residents, staff and students advances the University’s objectives. Appreciation and understanding of “pluralism” (diversity) is a vital aspect of health professional and graduate training. 

MUSC strives to impart the values of professional and collegial attitudes and behaviors in interactions among members of the University community. MUSC prohibits attitudes and behaviors toward students, residents and fellows that are unfavorable to the development of mutual respect.  Such prohibited behaviors may include, but are not limited t

1)  Discrimination and Harassment
a)  Denying the opportunity for training or rewards because of age, race, religious affiliation or any attribute other than merit or performance;
b)  Any conduct directly intended to insult or stigmatize;
c)  Exclusion from any reasonable educational opportunity for any reason other than performance or merit;
d) Requesting performance of personal services such as babysitting or shopping;
e)  Differential treatment based upon any attribute other than performance or merit that reduces educational opportunities;
f)   Grading or evaluating based upon any attribute other than performance and/or merit;
g)  Any inappropriate physical treatment, such as hitting, slapping or kicking, or threatening such treatment;
h)  Requesting performance of menial tasks with the intent to humiliate
i)  Creation of a hostile work place/environment by words or conduct
2) Harassment of a Sexual Nature
a)  Denying the opportunity for training or rewards because of gender;
b)  Requesting sexual favors in exchange for grades or other awards;
c)  Making unwanted sexual advances or inappropriate verbal comments of a sexual nature;
d)  Displaying sexually suggestive or pornographic materials; or
e) Grading or evaluating based upon gender rather than performance or merit.

In addition, sexual relationships between a trainee and a supervisor even when consensual are not acceptable regardless of the degree of supervision in any given situation.  The supervisory role for that particular trainee should be discontinued.  A new supervisor should be appointed to evaluate that trainee. 

3) Other Forms of Inappropriate Treatment 
a)  Public belittling
b) A consistent pattern of neglect or lack of communication
c) Taking credit for another individual’s work

Ongoing Education about Standards of Conduct
Part of a teacher’s responsibility is to maintain a positive atmosphere for learning.  In health professional and graduate education, an equally important role for teachers is to emphasize appropriate values, including an attitude of caring.  One of the effective ways in which teachers can emphasize this attitude of caring and promote a positive learning environment is to show an attitude of respect toward trainees.  Such an attitude can be demonstrated by providing support and encouragement to trainees and showing an interest in their educational development.  Inappropriate treatment of students represents the opposite of a supportive and caring approach to teaching.

Educating the MUSC community concerning appropriate treatment serves several purposes.  First, it promotes a positive environment for learning, characterized by attitudes of mutual respect and collegiality.  Second, it informs persons who believe that they have been treated inappropriately that avenues for seeking redress are available.  Third, it alerts potential offenders to the University’s policy about and responses to allegations of inappropriate treatment.

Methods of communicating the appropriate treatment policy to specific groups are as follows:

1)  Trainees

A section on appropriate treatment will be included in the University Bulletin.  Each year, this topic will be included in the agenda for the orientation of students.  Reference to this topic will be made in the course policies for all preclinical courses, clinical rotations, and graduate courses.  A university web site containing the policy and the contact information will be available.

2)  Faculty

Each year each Dean’s office will remind Associate Deans, department chairs and faculties of the policy. During orientation, Deans’ Offices are responsible for making available the contact information about the policy. The Deans’ Offices will designate a resource person whom trainees can contact for guidance about the policy.

3)  Health Professionals

An informative written message will be sent each year from the Provost’s Office to the office of the Administrator for Clinical Services to explain the policy.  In turn, the clinical directors will convey the policy to the nursing and health professional staff to ensure that they know and understand the policy.  A copy will be available on the Clinical Service’s Intranet web site with contact information.

Response Process
The following procedures will be used to respond to complaints about perceived mistreatment, but are not to be used in cases of sexual harassment.  MUSC has determined that all complaints that include allegations of gender inequity or sexual harassment involving faculty or trainees must be resolved according to the policies established by the MUSC Office of Gender Equity, without exception. If a trainee, mediator or faculty member is unsure of whether the complaint should be referred to the MUSC Office of Gender Equity, they should contact that Office for advice.  In cases that do not involve elements of sexual harassment or gender inequity, the following will apply:

1) Introduction

When an allegation of inappropriate treatment occurs, the parties directly involved should try to resolve the matter themselves, since most incidents are amenable to resolution in this manner.  In some situations, however, this informal approach might be hindered by various factors, including reluctance of the complainant to approach the respondent, intransigence of the respondent, or differing perceptions of the incident by the parties involved.  In such cases, a more formal process is available for resolving the matter.  This formal process can be initiated by requesting formal conduct standard mediation. This process is designed to be fair to both the complainant and the respondent and to be perceived by both parties as effective, impartial and unlikely to result in retaliation.

Participation in this process, or agreement to participate in this process, is in no way an indication of one’s desire or intention to set aside one’s right to due process under the law.  MUSC respects each person’s right to due process. MUSC will direct all behavior that may be criminal in nature to the proper governmental authority.

2) The Conduct Standard Mediators

The professional staff of the student Counseling and Psychological Services (CAPS) will serve in the primary role as conduct standard mediators.  Additional trained mediators as selected by CAPS may also perform mediation as needed. The role of the mediator is to mediate between the conflicting parties and strive for reconciliation.  Either the complainant or the respondent may contact CAPS staff in their role as conduct standard mediators to seek assistance in resolving the conflict and should do so as soon as possible.  The conduct standard mediator will encourage the parties to work out the problem between them, and will also be available as facilitator for this process.  Mediators will receive mediation training.

If mediation is successful, both parties will sign a written mediation agreement. The original agreement will be kept in a confidential file in the CAPS office. Copies of the signed agreement will be given to both parties.

3)  The Conflict-Resolution Council

It is anticipated that mediation will result in the resolution of most cases.  However, if a reasonable effort does not yield a solution, the complainant has the option to refer the matter to a Conflict Resolution Council. The Council becomes involved in a given case only after the mediator has made reasonable efforts to resolve it. The respondent does not have the right to prevent the Council from meeting.  The complainant may stop the process at any time. The purposes of the Council include the following:

a)  Ascertain the facts by interviewing other individuals with relevant knowledge review any documentary evidence or take other actions deemed necessary to establish the facts of the matter.
b)  Mediate between the parties
c)  Strive for reconciliation

The Council will assess the evidence as objectively as possible to protect the rights of the respondent and complainant.

The Conflict Resolution Council will be a university-wide committee appointed as needed by the Provost. It will consist of at least three faculty members from the colleges not involved in the conflict. The Deans of those colleges will recommend the faculty for the Council.  The Council will also contain at least three trainees not involved in the conflict as selected by the Provost from the University Honor Council and or House Staff Council. The Provost will name a chair for the Council.

Any member with a conflict of interest should not be selected to participate in the Council for that particular case. Before the Council meets, Council members will submit a signed written disclosure indicating they are free from conflict.  Neither CAPS nor any other participating mediator is involved in the Conflict Resolution Council process.

4)  Council Procedures

The Chair of the Council is responsible for notifying the parties concerning the time and place of the Council meeting. The complainant and the respondent both have an opportunity to speak and to bring witnesses to speak.  The order of speakers is as follows: (1) the complainant; (2) witness for the complainant; (3) the respondent: and (4) witnesses for the respondent. Unless the Council deems otherwise, speakers will be present only when they are called to give information in order to protect the confidentiality of the parties involved.  Both the respondent and the complainant can be harmed by breaches of confidentiality.  In some situations the Council might be justified in communicating ordinarily confidential information to other university officials, provided there is a legitimate “need to know.”  The complainant and respondent will not bring lawyers to council meetings, as advocates, advisors, or observers, as this process is administrative and academic rather than judicial.

It is in the interest of the respondent to meet with the Council, in an attempt to seek an appropriate resolution. If the respondent refuses to attend the Council meeting, the Council will still meet and consider the case.

At the conclusion of the Council’s deliberations, a letter will be sent from the Council to the Provost with a copy to the respective Dean, summarizing the findings of the Council. A copy will be provided to the complainant and respondent. The Provost, in consultation with the Dean, will then decide if any further action is warranted.

The Council chair should maintain essential records of the proceedings and forward for storage to the Provost’s Office.

5)  Protection from Retaliation

Retaliation against a complainant, a respondent or witnesses for exercising their rights under this policy and complaint resolution process is strictly prohibited.  Retaliation is grounds for disciplinary action, up to and including dismissal or termination of employment.
6)  Relation to Other University and Hospital Policies

This policy is intended to complement, supplement and clarify existing and future departmental, college and University policies aimed at informally resolving miscommunications or disputes between trainees and faculty members or supervisors. However, this policy regarding Standards of Conduct for Treatment of Trainees (Students, Residents and Fellows) shall be controlling.