MD: Washington University School of Medicine Policy for Review of Student Attainment of Competency


In collaboration with the Office of Medical Student Education, the Office of Student Affairs, and the Registrar and charged by the Committee for Academic Promotion, the Competency Attainment Committee (CAC) at Washington University School of Medicine regularly reviews and renders recommendations about the academic progress of all medical students in the Gateway Curriculum. This policy is in line with LCME element 9.9: Student Advancement and Appeals Process.


Students for whom this policy applies include students enrolled in any phase of the Gateway Curriculum and students enrolled in dual- and joint-degree programs currently participating in the Gateway Curriculum.

In order to successfully complete their studies at Washington University School of Medicine, a student must demonstrate the ability to become a safe and effective physician by demonstrating competence in the WUSM MD Program Objectives:

  • Foundational knowledge for practice 
  • Patient care 
  • Systems-based practice  
  • Practice-based learning and improvement 
  • Interpersonal and communication skills 
  • Professionalism 

Progress toward and attainment of competence in the Medical Education Program Objectives within these domains is evaluated by the CAC via a review of evidence provided through multiple student assessments. Full documentation of the domains, of the relevant Phase and Program Objectives, and of the assessment evidence used to determine competence are known to students, reviewed regularly by students with the guidance of their coaches at portfolio review, and made available via standard methods of communication.

Student progression toward successful competency attainment is reviewed by the CAC at multiple times within each phase of the Gateway Curriculum to allow for the early identification of students not on trajectory to meet competency attainment, thereby providing early support for successful competency attainment and the timely release of financial aid (Standards of Satisfactory Academic Progress for Financial Aid Eligibility). 

Based on the totality and sufficiency of evidence regarding a student’s performance in each of the WUSM MD Program Objectives, the CAC evaluates whether the evidence supports that a student has attained competency.

The CAC makes recommendations to the Committee for Academic Promotion (the committee charged with ratifying final competency decisions), and these recommendations include one of the following for each student: 

  • Promotion, with or without ongoing remediation, to the next phase of training 
  • Remediation without promotion  
  • Dismissal or other sanctions, including but not limited to probation or suspension, which may occur throughout the enrollment of a student  
  • Qualification to receive the Doctor of Medicine degree 

Situations may exist in which a CAC member has a conflict of interest such that the CAC member is unable to objectively evaluate a particular student. In such a case, the CAC member must recuse themselves from participation in deliberations and decisions regarding that student.

The Washington University School of Medicine Policy for Review of Student Attainment of Competency was last approved by the Academic Affairs Committee on Nov. 11, 2021. All substantive edits to this policy require approval by the Academic Affairs Committee.