Academic: The CP3 continuously reviews student academic records, including, but not limited to, final pre-clerkship course grades, mid-course and mid-clerkship performance, required attendance, required examination results, and final clerkship evaluations. These reviews are conducted to identify deficiencies and assess continued fulfillment of the School of Medicine Standards for Performance and Satisfactory Progress (SAP).

Professionalism: The CP3 reviews professionalism concerns documented in formal grades and evaluations. Professionalism concerns may also be reported through the School of Medicine’s Professionalism Concern Reporting Process and are reviewed through that process. Depending on the nature, severity, or recurrence of a reported concern, the matter may be referred to the CP3 for further review.

Technical, Non-Academic Standards: For concerns regarding a student’s ability to meet the School of Medicine, Technical, Non-Academic Standards, the CP3 may review the matter directly or appoint an ad hoc committee to review the concern and provide recommendations to the CP3. Any review will consider the student’s ability to meet the applicable standards, with reasonable accommodations as appropriate.

Student Conduct: Alleged violations of Stanford’s student conduct codes, including the Honor Code and the Fundamental Standard, are adjudicated through a separate University process. Conduct that raises concerns regarding a student’s academic performance, professionalism, or ability to meet technical non-academic standards may also be reviewed by the CP3. The CP3 may consider the circumstances and determine an appropriate course of action independent of any action taken through other University processes.

The School of Medicine considers the following, among other circumstances identified under its academic, professionalism, technical standards, and program policies, to constitute individual deficiencies:

• Fail (F), Continuing (N), or Incomplete (INC) in a pre-clerkship course or clerkship.
• Failure to remediate a course, clerkship, or examination deficiency within the prescribed timeframe.
• Failure of a required examination (e.g., CPX Series or USMLE).
• Failure to meet required examination deadlines.
• Professionalism concerns that meet the criteria for CP3 review.
• Failure to meet CP3-established deadlines or requirements.
• Failure to meet Scholarly Concentration program deadlines.

This list provides examples of circumstances that may constitute individual deficiencies and is not exhaustive. Other academic, professionalism, technical standards, or administrative concerns may be identified as individual deficiencies based on the circumstances of a case.

The CP3 reviews substantive concerns related to academic performance, professionalism, technical standards, and other requirements for satisfactory progress toward the MD degree. Individual deficiencies may occur independently or as part of a broader pattern of concerns. In determining the appropriate level of review, the CP3 considers the nature, severity, recurrence, and cumulative impact of identified deficiencies and other relevant circumstances.

The thresholds below provide general guidance regarding circumstances that may initiate each tier of the CP3 process. They are not automatic triggers and do not limit the CP3’s discretion to initiate review at any tier when warranted, including when a single significant concern requires escalation. The tiers do not need to be initiated sequentially, and the CP3 may initiate a Tier 2 or Tier 3 review without a prior review at a lower tier when circumstances warrant.

Tier 1: Counseling Session with the Senior Associate Dean for Medical Education

Tier 1 provides an early opportunity to address substantive concerns and is intended to clarify the concern and identify appropriate support or guidance. The session is conducted with the Senior Associate Dean for Medical Education, the student’s Academic Advising Dean, and, as appropriate, any other individuals whom the CP3 Chair determines are relevant to the matter. A summary of the session will be provided to the CP3 for determination of any appropriate follow-up, including remediation, academic resources, or continued monitoring.

Tier 1 may be initiated when:

• A student has accumulated one to two individual deficiencies;
• A student demonstrates a repeated pattern of concerns that, while not yet meeting the threshold for an individual deficiency, raises sufficient concern to warrant additional support, monitoring, or intervention.

Tier 2: Student Meeting with the CP3

Tier 2 involves formal review of substantive concerns and provides an opportunity for the student and relevant individuals to meet directly with the CP3 to present information and respond to questions. Following the meeting, the CP3 may determine appropriate next steps, including a prescribed academic plan, remediation, continued monitoring, resolution of the matter, or progression to Tier 3.

Tier 2 may be initiated when:

• A student has accumulated three to four individual deficiencies;
• Prior remediation or Tier 1 action has not resulted in sufficient improvement; or
• New substantive concerns arise, including additional deficiencies.

Tier 3: Dismissal Hearing

Tier 3 involves formal review when significant or ongoing substantive concerns raise questions about a student’s ability to complete the MD program. The hearing provides an opportunity to determine whether a reasonable path forward exists or whether dismissal is warranted. The appropriate outcome may include a prescribed academic plan, remediation, continued monitoring, or dismissal.

Tier 3 may be initiated when:

• A student has accumulated five or more individual deficiencies.
• A student persists in failing to meet the Standards for Satisfactory Academic Progress (SAP).
• A student demonstrates recurring academic deficiencies, repeated professionalism concerns, or failure to successfully address prior CP3 actions.

• A student has two or more failures (F) in clinical clerkships.
• A student has two or more professionalism concerns that meet criteria for CP3 review.
• A student has three or more failures (F) in pre-clerkship courses.
• A student has three or more failures of required examinations (e.g., CPX Series, USMLE Step 1 or 2 CK).
• A student has four or more deficiencies in clerkships.
• A student has four or more deficiencies in pre-clerkship courses.
• A student is alleged to have engaged in conduct that, if substantiated, may warrant immediate dismissal.

The CP3 may take appropriate action or make recommendations based on the nature, severity, recurrence, and circumstances of an academic, professionalism, or technical, non-academic concern. The CP3 may determine that a concern requires action under an applicable policy identified in Section 6.5: Chart of Responses to Student Issues or warrants review under the CP3 Process for Addressing Substantive Concerns.

Academic, professionalism, or technical standards concerns may be reviewed by the CP3 at any time when warranted. When CP3 action or a recommendation directly affects a student, the student will receive a written response detailing the action taken or recommendation made and will have an opportunity to discuss the matter with an Academic Advising Dean and respond to the CP3 in writing.

A student may take one or both of the following steps if they are dissatisfied with a decision of the CP3 regarding an academic, professionalism, or technical non-academic concern:

Reconsideration Request of CP3 Decisions

A student who is dissatisfied with a decision of the CP3 may request that the decision be reconsidered by the CP3. The request must be based on relevant new information not available at the time the action was taken, not on a complaint expressing dissatisfaction with the outcome or with an underlying University or Stanford School of Medicine policy of general application. A request from the student to meet with the CP3 may also be considered at the discretion of the CP3 Chair. Any reconsideration request should be submitted in writing within 14 working days of receipt of the decision; the time frame may be extended for good cause at the discretion of the CP3 Chair.

Appeal of CP3 Decisions: Student Academic Grievance

A student who is dissatisfied with a decision of the CP3 may file a formal written grievance to the Dean of the School of Medicine under (and within the time limits of) the Student Academic Grievance Procedure, as outlined in the Stanford University Bulletin. The Student Academic Grievance Procedure serves as the appeal of CP3 decisions. The Student Academic Grievance Procedure is a university-wide procedure available to Stanford students to review academic decisions. Grievances must be filed within 30 days from the conclusion of the quarter in which the academic decision was made. The Dean may decide the matter or refer the matter to a grievance officer. The Dean generally has 60 days to reach a decision on a matter. If a student is dissatisfied with the Dean’s decision, a student may appeal the outcome to the Provost.

updated August 2026