Areas of Concern

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Full Policy Contents

Policy Statement
Reason for Policy

Additional Contacts

Effective: 11/1/2016
Last Updated: 2/3/2017

Responsible University Office:
Medical Student Education

Responsible University Administrator
Senior associate dean for medical student education

Policy Contact:,,

RESPONSIBLE Competency directors, course and clerkship directors
ACCOUNTABLE Curriculum Council Steering Committee
SUPPORT Medical Student Education
CONSULT General counsel
INFORM Lead advisors
Learning Technology, Medical Student Education

LCME Standards

3.5 Professionalism


This policy provides information on policies and procedures for the assignment, remediation and tracking of the Area of Concern notification throughout all phases of medical education training. Course directors (management team), clerkship directors and coordinators are expected to comply with the reporting requirements. All faculty members, resident physicians, fellows, and volunteer faculty members are expected to be knowledgeable and mindful of these guidelines while medical students are experiencing their respective courses/clerkships/electives.

Policy Statement

The Area of Concern notification can be assigned during pre-clerkship courses and clinical clerkships and outside of course work. A student may be evaluated by the IUSM Dean’s Office of Education or a designee for personal and/or competency-based misconduct that occurs:

  1. On or off university property, and/or
  2. Is documented through an Area of Concern report in their course/clerkship/ elective duties.

During courses/clerkships/electives, the notification may be made as part of the mid-point feedback; at the end of the course/clerkship/elective; or at any other point during the course/clerkship/elective. The Area of Concern notification is not a failing grade; it is intended to formally indicate concern with a student’s abilities in a competency area.

The AOC notification will not be included in the Medical Student Performance Evaluation unless it progresses to a failure or a serious violation of the professional conduct policy or academic integrity policy. The AOC notification is not appropriate for an egregious event. Such concerns may be brought before the Competency Committee, but will be referred to the Student Promotions Committee.

A notification of Area of Concern may be assigned to any of the following six competency areas or to “outside course/clerkship/elective.”

  • Patient Care (PC).
  • Medical Knowledge (MK).
  • Professionalism (P).
  • Interpersonal Skills and Communication (ISC).
  • Practice-Based Learning and Improvement (PBLI).
  • System-Based Practice (SBP).

Reason for Policy

The IUSM uses a competency-based curriculum. Rapid identification of students with challenges in these competencies enables educators to quickly intervene to help these students meet the identified milestones for their successful completion of the selected competency.

This policy is intended to recognize and identify “low level” concerns in a course/clerkship/elective and to facilitate the opportunity for additional coaching by the lead advisor before these behaviors lead to a significant impact on grades.

The goals of the policy are to:

  • Provide early notification of a potential issue to students to encourage early behavioral change.
  • Decrease assignment of Isolated Deficiency and failing grades.
  • Provide a formal process for the course/clerkship/elective directors to identify “non-failing” behaviors or trends.

Provide opportunities for early intervention.


Revised, reviewed, and approved by the Curriculum Council Steering Committee 12/20/2016.


When an Area of Concern is recognized by an educator, he/she should discuss his/her concerns with the student and may initiate an AOC within the school management system. This information is disseminated automatically to the assistant dean of academic advising and the Competency Committee. The assistant dean of academic advising contacts the student; the student’s lead advisor; the course/clerkship/elective director; and the regional campus associate dean and assign the AOC to a specific competency director.

The competency director issues a Concern Intervention Plan Tracking Form to the lead advisor that contains the appropriate intervention from the online competency tool box. The lead advisor coaches the student through the interventions under the guidance of the specific competency director. The intervention must be completed within 30 days. Once the lead advisor completes the AOC intervention plan form, the competency director notifies the faculty member who initiated the AOC, the regional campus associate dean and the assistant dean of advising that the intervention is completed. If the intervention plan is not successfully completed within 30 days, the student will be referred to the Competency Committee and possibly the Student Promotions Committee.


Outside course/clinical/elective: This category is to be used for concerns that are not associated with the six competency areas mentioned above.


Referral to the Student Promotions Committee:

  • If the remediation is not started or the student disagrees with the identification of the Area of Concern, the student is referred to the Competency Committee and possibly the Student Promotions Committee.
  • If the remediation is started and not completed within the 30-day time frame, the student is referred to the Competency Committee and possibly the Student Promotions Committee.
  • If a student has received three AOC notifications or two in the same competency, the student is referred to the Student Promotions Committee.

Additional Contacts

Subject Contact Phone Email
Technical assistance Joel Smith 317-278-1762


Approved by Curriculum Council Steering Committee 10/11/2016.
Moved to the policy template 11/29/2016.
Name changed from Satisfactory with Concerns to Area of Concern 12/13/2016.
Friendly amendments made and approved by CCSC 2/14/2017.