For Use by SOM Course and Clerkship Directors, Faculty, Staff, and Students. Complete this note if you have concerns about the professional behavior of a medical student or faculty member.
Student/Faculty Name {{ Cognito.resources["required-asterisk"] }}, { binding firstError.message }
A student/faculty with any of the following patterns of behavior is not meeting the personal or professional standards inherent to the profession of medicine. Please mark the area which best describes your concerns about this student/faculty. A space for comments is also provided below the selections.