I. Introduction
A. Overview
Dartmouth’s Geisel School of Medicine (“Geisel”) seeks to build a diverse and inclusive community to enrich learning, foster innovation, and tackle the most vexing challenges in health care. This involves our work with all students, including those with disabilities. Medical education requires that the accumulation of scientific knowledge be accompanied by the simultaneous development of specific skills and other competencies.
Geisel has a responsibility to society to graduate physicians who have met the school’s standards for competency and demonstrated a commitment to lifelong learning within the profession. Geisel’s Technical Standards for Matriculation, Promotion, and Graduation (“Technical Standards”) refer to both the academic and non-academic abilities, attributes, and characteristics of medical students that are required for the matriculation, advancement, promotion, and graduation from Geisel. The aptitudes and abilities represented by Geisel’s Technical Standards are extremely important in the field of medicine and serve as the foundation for academic success at Geisel and for the eventual practice of medicine itself. Geisel’s Technical Standards are described in detail in Section II.
Accordingly,
- admission to Geisel is offered to applicants who present outstanding qualifications for the study and practice of medicine, aligned with Geisel’s Technical Standards,
- successful completion of the entire medical school curriculum, with or without reasonable accommodations when indicated, is required of all students, and
- all students must meet both the Academic Standards, as defined in the Medical Student Handbook, and non-academic standards and abilities, to progress through the curriculum and graduate.
As a condition of acceptance to the MD program, each student is required to attest that they 1) have reviewed and understand this document, the “Technical Standards for Matriculation, Promotion and Graduation”, and 2) commit to fulfilling the expectations outlined herein, throughout the course of their studies at Geisel. Additionally, students are required annually to attest to their continued ability to fulfill the expectations of the Technical Standards. Attestation is required at the beginning of each academic year of the MD program. Students with disabilities who, after review of the Technical Standards, determine that they require reasonable accommodations to fully engage in Geisel’s educational environment, should initiate a request for accommodations by contacting Geisel Student Accessibility Services. Given the clinical nature of Geisel’s programs, time may be needed to thoroughly review the request, create and implement reasonable accommodations. Reasonable accommodations are never applied retroactively; therefore, timely requests are essential and encouraged.
B. The Americans with Disabilities Act and the Study of Medicine
It is our experience that individuals with disabilities (as defined by Section 504 of the Rehabilitation Act and the Americans with Disabilities Act, as Amended) are qualified to study and practice medicine with the use of reasonable accommodations. Accordingly, all students are required to meet the Technical Standards, with or without approved reasonable accommodations. Reasonable accommodations are intended to mitigate barriers that prevent equal access to Geisel’s educational environment. Reasonable accommodations allow students with disabilities to attain Geisel’s Technical Standards, not circumvent them.
C. The Use of Auxiliary Aids and Intermediaries
The Geisel School of Medicine will provide qualified students with documented disabilities reasonable accommodations to pursue their studies. Occasionally, reasonable accommodations may involve an intermediary or an auxiliary aid. Auxiliary aids and intermediaries are designed to allow equal access and not to provide 1) cognitive support, medical knowledge, or interpretive information; 2) substitutes for essential clinical skills; or 3) supplements for clinical and ethical judgment. That is to say, reasonable accommodations cannot eliminate essential program elements.
II. Technical Standards
Students at the Geisel School of Medicine at Dartmouth must have capacities in five broad areas:
- Perception/observation
- Communication
- Motor/tactile function
- Cognition
- Professionalism (Mature and Ethical Conduct)
A. Perception/Observation
Students must be able to accurately perceive the presentation of information through active engagement and participation in:
- Small group discussions and presentations
- Large-group lectures
- One-on-one interactions
- Procedural Demonstrations
- Laboratory experiments
- Patient encounters (at a distance and close at hand)
- Diagnostic findings
- Procedures
- Analysis of written material
- Incorporation of audiovisual material
B. Communication
Students must be able to effectively communicate with faculty members, members of the healthcare team, patients, families, and other students to:
- Elicit information
- Convey information
- Clarify information
- Create rapport
- Develop therapeutic relationships
- Demonstrate competencies
C. Motor/tactile function
Students must have sufficient motor function and tactile ability to:
- Attend (and participate in) all classes, groups, and activities that are part of the curriculum
- Read and write
- Examine patients
- Perform basic laboratory procedures and tests
- Perform diagnostic procedures
- Provide comprehensive patient care in ambulatory and inpatient settings including surgical suites
- Respond to urgent and emergent clinical situations at a level appropriate to undergraduate medical education and with appropriate supervision
- Perform independently and competently in all clinical environments, under appropriate supervision
- Demonstrate the ability to meet Geisel’s competencies for medical education
Given the unique location of Geisel’s educational program and the geographic distribution of educational sites for clinical instruction, students in the preclinical and clinical years are responsible for independently navigating to and from their residence and the Geisel School of Medicine teaching locations and affiliate sites throughout New Hampshire and Vermont for assigned clerkships, co-curricular community engagement experiences, and courses.
D. Cognition
Students must be able to demonstrate higher-level cognitive abilities, which include:
- Rational thought
- Measurement
- Calculation
- Visual-spatial comprehension
- Conceptualization
- Analysis
- Synthesis
- Organization
- Representation (oral, written, diagrammatic, three dimensional)
- Memory
- Application
- Clinical reasoning
- Ethical reasoning
- Sound judgment
E. Professionalism: (Mature and Ethical Conduct)
Students must be able to:
- Consistently display integrity, honesty, empathy, caring, fairness, respect for self and others, diligence, and dedication
- Promptly complete all assignments and responsibilities attendant to the diagnosis and care of patients (beginning with skill building assignments in the preclinical years)
- Communicate with, examine, and provide care for all patients—including those whose gender, ethnicity, culture, sexual orientation, spiritual beliefs, gender identity, language, or disability status may be different from students' own
- Develop mature, sensitive, and effective relationships, not only with patients but with all members of the medical school community and healthcare teams
- Maintain sobriety in all academic and clinical environments at all times
- Refrain from the illegal use of substances at all times
- Abide by all state, federal, and local laws, as well as all Geisel and Geisel’s major affiliate clinical training sites’ codes of conduct
- Perform competently in an environment that is physically, emotionally, and mentally demanding
- Function effectively under stress, and proactively make use of available resources to help maintain both physical and mental health
- Adapt to changing environments, display flexibility, and be able to learn in the face of uncertainty
- Take responsibility for themselves and their behaviors
Any student who has a question about whether he or she can meet these standards should contact the Geisel Office of Academic Advising and Accessibility at (603) 650-1125 or geisel.student.accessibility.services@dartmouth.edu.
- Reviewed by: Advisory Panel on Technical Standards for Geisel
Date: September 5, 2018
Revised: February 6, 2025
Approved by: Dean’s Advisory Board March 2025 Medical Education Committee March 2025