Interservice Physician Assistant Program (IPAP) < University of Nebraska Medical Center

Interservice Physician Assistant Program

Fort Sam Houston, Texas

This Section For Active Duty Military Students Only

In 1996 the University of Nebraska entered into an agreement with the Armed Force’s newly created Interservice Physician Assistant Program (IPAP) to provide administrative and faculty support services for the primary care physician assistant program operated by the U.S. Armed Forces. Students enrolled in the IPAP receive academic credit from the University of Nebraska for course work completed as part of the IPAP.

Beginning in January 2011, students in the IPAP will complete 16 months of didactic course work at the Army’s Academy of Health Sciences, located at Fort Sam Houston, Texas. This will be followed by 13 months of supervised clinical clerkships at military or affiliated medical facilities.

Faculty — The faculty of the IPAP are military or civilian personnel who qualify for volunteer faculty appointments in the Division of Physician Assistant Education, School of Allied Health Professions.

Admission Requirements — Students admitted to the IPAP are selected by the military selection board of their respective service. The IPAP students are then matriculated at the University of Nebraska provided they have previously earned 60 semester hours of transferable college credit.

Degree Requirements — Students enrolling from 1996 through 2002 in the Interservice PA Program received a Bachelor of Science degree from the University of Nebraska upon completion of the prescribed IPAP course work. Effective January 2003, IPAP students receive a Bachelor of Science degree upon completing Phase I of their training, and receive a Master of Physician Assistant Studies degree upon completing their PA training.

Mission, Vision, & Guiding Principles

Mission Statement

To provide the uniformed services with highly competent, compassionate physician assistants who model integrity, strive for leadership excellence, and are committed to lifelong learning.

Vision Statement

To be recognized as the world-class leader in physician assistant education

Guiding Principles

To provide leadership and education of the highest quality and greatest value to our students, thereby instilling a lifelong desire for growth and learning
To immerse faculty and students in an environment that fosters a sense of academic and professional excellence
To educate the future leaders of military medicine to become the most dynamic and highest-quality physician assistants possible
To demonstrate personal integrity and ethical conduct

IPAP Accreditation

At its September 2025 meeting, the Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA) placed the Interservice Physician Assistant Program sponsored by U.S. Army Medical Center of Excellence on Accreditation-Probation status until its next review in October 2027.

Probation accreditation is a temporary accreditation status initially of not less than two years. However, that period may be extended by the ARC-PA for up to an additional two years if the ARC-PA finds that the program is making substantial progress toward meeting all applicable standards but requires additional time to come into full compliance. Probation accreditation status is granted, at the sole discretion of the ARC-PA, when a program holding an accreditation status of Accreditation - Provisional or Accreditation - Continued does not, in the judgment of the ARC-PA, meet the Standards or when the capability of the program to provide an acceptable educational experience for its students is threatened.

Once placed on probation, a program that fails to comply with accreditation requirements in a timely manner, as specified by the ARC-PA, may be scheduled for a focused site visit and is subject to having its accreditation withdrawn.

Specific questions regarding the Program and its plans should be directed to the Program Director and/or the appropriate institutional official(s).

The program’s accreditation history can be viewed on the ARC-PA website.

ARC-PA Student Graduation Rates

These tables reflect different cohort definitions and reporting methodologies; therefore, rates are not directly comparable.

Program-Defined Graduation and Attrition Rates (Longitudinal Outcomes)

Includes students who complete the program after deceleration or remain in training at the time of reporting.

Program Defined Attrition	Graduated Classes
Program Defined Attrition	Class of 2023-1	Class of 2023-2	Class of 2023-3
Maximum entering class size (as approved by ARC-PA)	80	80	80
Entering class size	63	67	66
Graduates	60	66	53
* Attrition rate	4.8%	1.5%	19.7%
** Graduation rate	95.2%	99%	80.3%

Comments:

*Program Defined Attrition = % of students from original cohort that permanently left the program. The figures for 23-3 may change as 8 students from that cohort remain in training. The figures for 23-2 may change as one student remains in training. The figures for 23-1 may change, as one of the original students is still in training.

**Program Defined Graduation rate = # of students from the original cohort that complete the program (includes students moving into a different cohort but still finishing the program). 2023-1 may change as one student remains in training. 2023-3 had 53 out of the original 66 students graduate in Jan 2026. There are currently 8 students from that group still in training which may change the Program Defined Graduation Rate as those students matriculate. 23-3 completed training 30 Jan 2026, 23-2 3 Oct 2025, 23-1 6 Jun 2025.

*Attrition rate calculation: Number of students who attritted from cohort (decelerated + withdrawals + dismissals) divided by the (entering class size + number joining class cohort).

**Graduation rate calculation: Number of cohort graduates divided by the (entering class size + number joining class cohort).

ARC-PA Cohort Graduation and Attrition Rates (Cohort Snapshot at Expected Completion)

Reflects outcomes based on cohort status at the expected time of program completion.

Program Defined Attrition	Graduated Classes
Program Defined Attrition	Class of 2023-1	Class of 2023-2	Class of 2023-3
Maximum entering class size (as approved by ARC-PA)	80	80	80
Entering class size	69	66	79
Graduates	58	53	61
* Attrition rate	21.7%	19.7%	16.5%
** Graduation rate	84.5%	80.3%	83.5%

Comments:

Class 2023-1 completed the program June 2025, Class 2023-2 October 2025, and Class 2023-3 January 2026.

*Attrition rate calculation: Number of students who attritted from cohort (decelerated + withdrawals + dismissals) divided by the (entering class size + number joining class cohort).

**Graduation rate calculation: Number of cohort graduates divided by the (entering class size + number joining class cohort).

History of the Physician Assistant

The profession of "Physician Assistants" has only been recognized since 1966. The lack of medical doctors in both the military and civilian health care systems led to the development of the Physician Assistant. In a 1961 article in the Journal of the American Medical Association, Hudson first broached the subject of the "extern." This "extern" would be responsible for most of the technical procedures and some of the medical responsibilities of the medical doctor under whom they would work.

Dr. Eugene Stead, chairman of the Department of Medicine at the Duke University Medical Center in Durham, North Carolina in 1965, developed the first Physician Assistant program. Using four ex-Navy corpsmen, the two-year Physician Assistant program began. The curriculum was based on the fast-tracking of a doctor's program developed during World War II. In this program the first nine months were spent on sciences and clinical skills. The next 13 months were spent doing clerkships in a variety of hospital clinics. The final two months were spent with their preceptor learning their professional skills. The Public Health Service at Staten Island Hospital developed one early program. The merchant marines began a nine-month training program for purser mates (the people in the merchant marines responsible for overseeing ships' documentation and customs declarations, as well as medical care) in 1966. At the University of Washington, Dr. Richard Smith designed a program called MEDEX (Medicine Extension) to train former military medics to service areas of Washington State that were lacking in medical personnel. This program required three months of concentrated study and 12 months of preceptorship with University medical doctors.

Today, most programs are 27 months in length, with the first 12-16 months spent in the classroom. The subjects studied include anatomy and physiology, pathology, diagnosis, treatment, disease processes, communication, and patient assessment.

History of the Military Physician Assistant

The military Physician Assistant program was first developed by the United States Air Force in 1971 under the direction of the Air Force Surgeon General, Lieutenant General Alonzo Towner at Sheppard Air Force Base School of Heath Care Sciences in Texas and was modeled after the program developed by Dr. Eugene Stead at Duke University. The first enrollees in the program were senior enlisted medics. There was one year of didactic training followed by one year of on-the-job training; a four-year payback period was incurred. By 1978, the Air Force had 275 commissioned officers who were Physician Assistants. The United States Army began its Physician Assistant Program in 1971. The school that Army PA students attended was the Medical Field Services School PA program at Fort Sam Houston, Texas. The Navy began their Physician Assistant program in 1971 as a trial program and by 1973 the Navy and George Washington University developed a partnership to train Physician Assistants. In 1972 the Navy and the Air Force began training Physician Assistants at Sheppard Air Force Base in Texas. The United States Coast Guard did not institute their own PA program, but began accepting PAs from the civilian sector in 1974.

History of the Interservice Physician Assistant Program

In 1996, the military services combined their various Physician Assistant programs to form the Interservice Physician Assistant Program (IPAP), located at the Army Medical Department Center and school (AMEDDC&S), Fort Sam Houston, Texas.

The IPAP mission is to provide the uniformed services with highly competent, compassionate Physician Assistants who model integrity, strive for leadership excellence, and are committed to lifelong learning. Our graduates are commissioned into the officer corps of their respective service and take their place beside other military health care professionals in providing medical services to active duty military personnel, their dependents, and retirees.

In 1996, the IPAP at the AMEDDC&S reached an agreement with UNMC that the latter would provide faculty and administrative support for the IPAP. The IPAP graduate earns a Master of Physician Assistant Studies (MPAS) degree from the affiliated university.

On behalf of the Commander and staff of the AMEDD C&S, Fort Sam Houston, Texas, we welcome you to the IPAP. As you will learn, we are responsible for the education of outstanding Physician Assistants for the uniformed services of the United States Department of Defense and Department of Homeland Security. Our main campus is located on Historic Fort Sam Houston, Texas, in the heart of beautiful San Antonio, Texas. Here all IPAP students complete their 16-month didactic phase of training. Phase 1 consists of basic medical science courses intended to develop a student's knowledge of critical medical concepts (see Phase 1 curriculum). After completing this portion of the curriculum, students continue with their medical clerkships at one of 22 medical Phase 2 sites across the country. These Phase 2 sites are located at military installations with medical facilities adequate to support the base rotations required to be a successful Physician Assistant (see Phase 2 curriculum). Our Phase 2 Site Clinical Coordinators are responsible for the administrative support and ensuring that clinical preceptors provide appropriate clinical training. This training allows IPAP students to obtain the skills necessary for becoming a physician assistant in the uniformed services. If you have further questions or concerns after viewing this portal, you may contact us at: 210-221-8004

Do you have what it takes?

“We are looking for applicants who possess a genuine passion to help others, are committed to excellence, have maturity, integrity, intellectual curiosity, and a strong desire for lifelong learning. If you fit the bill, then you have a wonderful opportunity to join the PA profession. Complete your prerequisite coursework, submit your application through your respective Service, get selected, and join us here at the world’s largest & best PA program!” –CDR Perry, Former IPAP Director

Prospective Students

Only Military applicants are accepted
Army and Air Force applicants that hold professional credentials (68W's, 68C's, 4A's, etc) must have completed all CEU's required for upcoming re-certification period prior to course arrival.
Meet security clearance requirements
Under age 42 by commissioning
Meet medical standards for commissioning into the military services after both phase 1 and 2 (see DODI 6130.03)
Tuition– none
Student activity fees – none
Off duty employment not authorized while at IPAP
Advance placement - none. Once selected, all students will complete the entire 29 month program
Loaner laptops, medical equipment, and textbooks provided during phase 1
All applicants must have completed the following:
- A minimum of 60 semester hours, with emphasis in science course work
- SAT
- Basic Life Support (with current card)
- Service unique applicant package
Link to IPAP curriculum: IPAP Curriculum
Link to Individual Student Assessment Plan (ISAP): Individual Student Assessment Plan (ISAP)

Service Links

See provided links for service specific information and application specifics:

Physician Assistant Education Technical Standards

This program is dedicated to the education of students who strive to become competent and caring providers of primary health care services under the supervision of a licensed physician. The student must be able to achieve certain technical standards of knowledge and skill in order to successfully complete the Program. The technical standards stated in this document apply to satisfactory performance in all academic and clinical course work, as well as fulfillment of "non-academic" essential functions of the curriculum involving physical, cognitive, and behavior factors that are essential to a professional clinical practitioner. Students must have adequate abilities and skills in the following five areas: 1) Observation; 2) Communication; 3) Sensory and Motor Function; 4) Conceptual, Integrative and Quantitative Ability; and, 5) Behavioral and Social Attributes.

Observation

The student must be able to observe demonstrations and conduct experiments in the basic sciences. A student must be able to observe a patient accurately at a distance and close at hand. Observation necessitates the functional use of the sense of vision and other sensory modalities. A student must be able to integrate all information visually and through the other senses.

Communication

A student must be able to communicate effectively, sensitively, and rapidly in English with patients and members of the health care team. A student must be able to elicit information from patients, perceive nonverbal communications, and describe changes in mood, activity and posture. Communication includes not only speech, but writing, reading, interpreting tables, figures, graphs and computer literacy.

Sensory and Motor Function

The student must have sufficient sensory and motor function to elicit information from patients by palpation, auscultation, percussion, and other diagnostic maneuvers. The student will be required to coordinate both gross and fine muscular movements, equilibrium, and functional use of the senses of hearing, touch and vision. More specifically, the student must be able to exercise such fine motor skills as to adequately perform laboratory tests, including but not limited to, wet mount, urinalysis and gram stain. The student must exercise such level of dexterity, sensation and visual acuity as to accurately complete such processes as administering intravenous medication, making fine measurements of angles and size, measuring blood pressure, respiration and pulse, performing physical examinations, and performing therapeutic procedures such as suturing and casting. The student must be able to hear sufficiently to accurately differentiate percussive notes and auscultatory findings, including but not limited to, heart, lung, and abdominal sounds, as well as discern normal and abnormal findings using instruments such as tuning forks, stethoscopes, sphygmomanometers, and Doppler devices. A student must be able to transport him or herself in a manner which provides timely response in both general and emergency care situations. Moving patients and engaging in some procedures such as CPR will require a necessary level of strength.

Intellectual, Conceptual, Integrative and Quantitative Abilities

A student must have the intellect necessary to quickly analyze and resolve problems. These intellectual abilities include numerical recognition, measurement, calculations, reasoning, analysis judgment and synthesis. The student must be able to identify significant findings from the patient's history, the physical examination and laboratory data, provide a reasoned explanation for likely diagnoses, and choose appropriate medications and therapy. The ability to incorporate new information from many sources in formulating diagnoses and plans is essential. Good judgment in patient assessment, diagnostic and therapeutic planning is primary. When appropriate, students must be able to identify and communicate the limits of their knowledge to others.

Behavioral and Social Attributes

A student must possess the emotional health required for full use of his or her intellectual abilities, the exercise of good judgment and the prompt completion of all responsibilities attendant to the diagnosis and care of patients. The development of mature, sensitive effective and professional relationships with patients and members of the health care team is essential. Students must be able to tolerate physically taxing workloads and to function effectively under stress. They must be able to adapt to changing environments, to display flexibility and learn to function in the face of uncertainties inherent in the clinical problems of many patients. Compassion, integrity, interpersonal skills, interest and motivation are all personal qualities that are desired in a health professional and assessed during the admissions and education processes.

IPAP Goals with Measurable Standards

Deliver a curriculum that provides current, evidence-based medical education.
1. Measure 1: ≥90% Agree or Strongly agree to Phase 2 student survey question: “Did Phase 1 (Didactic) adequately prepare you for Phase 2 (Clinical)?”
  - Data collection is ongoing/results pending. (Source: Phase 2 Student Survey)
Provide a comprehensive educational experience that prepares graduates to serve as competent clinical practitioners.
1. Measure 1: First time PANCE pass rate at or above the national average.
  - Current Year (2025): 82%
  - Five Year Running Average 2020-2025: 92.17% (Source: PANCE Score Report)
2. Measure 2: Overall PANCE pass rate at or above the national average.
  - Current Year (2025): 93.6%
  - Five Year Running Average 2020-2025: 99.81% (Source: PANCE Score Report)
Produce PAs who are prepared for success in a military career.
1. Measure 1: The promotion rate of IPAP graduates, at first promotion opportunity post-graduation, is commensurate with military peers.
  - Most recent year with complete data (2024): Army 99% Navy: 100% Air Force: 100% Coast Guard: 99%
  - Five Year Running Average (2019-2024): Army: 99% Navy: 100% Air Force: 100% Coast Guard: 99% (Source: Service Specialty Consultants)
2. Measure 2: ≥90% of graduates are successfully employed within 6 months of graduation.
  - Five Year Running Average (2019-2024): Army: 98% Navy: 100% Air Force: 100% Coast Guard: 96% (Source: Service Specialty Consultants)

IPAP Competencies

PC-1 Interpersonal Skills

Demonstrate effective and empathetic communication with patients, their families or caregivers, and other members of the healthcare team with consideration for the social determinants of health.

PC-2a Clinical and Technical Skills

Demonstrate the ability to obtain an accurate patient history, perform a comprehensive physical examination, and select and interpret appropriate diagnostic studies essential to provide quality patient care.

PC-2b Clinical and Technical Skills

Demonstrate the ability to obtain an accurate patient history, perform a comprehensive physical examination, and select and interpret appropriate diagnostic studies essential to provide quality patient care.

PC-3 Medical Knowledge

Apply comprehensive knowledge of biologic and clinical sciences to provide acute, chronic, urgent, and emergent, patient-centered care to include women’s health, prenatal care, and care across the life span (infants, children, adolescents, adult, and the elderly).

PC-4a Clinical Reasoning and Problem-Solving Abilities

Demonstrate application of basic science principles, clinical and technical skills, and evidence-based clinical judgement to develop and justify an appropriate differential diagnosis.

PC-4b Clinical Reasoning and Problem-Solving Abilities

Synthesize a comprehensive, patient-centered management plan for the promotion of wellness and disease prevention.

PC-4c Clinical Reasoning and Problem-Solving Abilities

Demonstrate medical professional written and communication skills as evidenced by the production and presentation of oral and written projects.

PC-5 Professional Behavior

Adhere to ethical standards and demonstrate professional conduct and accountability in patient interactions and teamwork.

Didactic, Phase I

Semester 1 (4 Months)

Course List
Code	Title	Credit Hours
IPAP 500	ANATOMY & PHYSIOLOGY I	7
IPAP 501	ANATOMY & PHYSIOLOGY II	7
IPAP 502	BIOCHEMISTRY	4
IPAP 503	MICROBIOLOGY	5
IPAP 601	MEDICAL HISTORY	1
IPAP 608	RESEARCH EVALUATION	2
IPAP 633	CLINICAL SKILLS I	1
Total Credit Hours		27

Semester 2 (4 Months)

Course List
Code	Title	Credit Hours
IPAP 504	CLINICAL LABORATORY	4
IPAP 505	PATHOLOGY	3
IPAP 602	PHARMACOLOGY I	3
IPAP 603	RADIOLOGY	2
IPAP 604	PSYCHIATRY	3
IPAP 628	HEAD, EYES, EARS, NOSE & THROAT	3
IPAP 634	CLINICAL SKILLS II	3
Total Credit Hours		21

Semester 3 (4 Months)

Course List
Code	Title	Credit Hours
IPAP 605	ORTHOPEDICS	4
IPAP 607	PULMONARY	2
IPAP 609	GASTROENTEROLOGY	2
IPAP 610	CARDIOLOGY/EKG	6
IPAP 611	ENDOCRINOLOGY	2
IPAP 612	CLINICAL CORRELATIONS I	1
IPAP 619	INFECTIOUS DISEASES/MILITARY PUBLIC HEALTH	4
IPAP 620	NEUROLOGY	2
IPAP 630	PHARMACOLOGY II	4
Total Credit Hours		27

Semester 4 (4 Months)

Course List
Code	Title	Credit Hours
IPAP 506	MED/LAW ETHICS	2
IPAP 600	HEMATOLOGY/ONCOLOGY	1
IPAP 613	CLINICAL CORRELATIONS II	1
IPAP 614	PEDIATRICS	3
IPAP 615	SURGERY	4
IPAP 616	DERMATOLOGY	3
IPAP 617	OBSTETRICS AND GYNECOLOGY	3
IPAP 618	EMERGENCY MEDICINE	5
IPAP 622	GENITOURINARY	2
IPAP 624	PA PROFESSIONAL ISSUES	1
IPAP 712	MASTER'S SEMINAR/CAPSTONE	1
Total Credit Hours		26

Clinical Rotations, Phase II

Semester 5 (13 Months)

Course List
Code	Title	Credit Hours
IPAP 700	SURGERY ROTATION	5
IPAP 701	DERMATOLOGY ROTATION	4
IPAP 702	OBSTETRICS AND GYNECOLOGY ROTATION	4
IPAP 703	ORTHOPEDICS ROTATION	6
IPAP 704	PSYCHIATRY ROTATION	3
IPAP 705	INTERNAL MEDICINE ROTATION	3
IPAP 707	PEDIATRICS ROTATION	5
IPAP 709	EMERGENCY MEDICINE ROTATION	6
IPAP 710	FAMILY MEDICINE ROTATION	4
IPAP 711	CLINICAL ELECTIVE ROTATION	4
IPAP 713	CAPSTONE PROJECT	1
IPAP 714	HEENT ROTATION	6
Total Credit Hours		51

Individual Student Assessment Plan (ISAP)

DEPARTMENT OF THE ARMY
HEADQUARTERS, U.S. ARMY MEDICAL CENTER OF EXCELLENCE
3630 STANLEY ROAD, SUITE 301
JBSA FORT SAM HOUSTON, TEXAS 78234-6100

ATMC-WBB-GI (350-1U2)

15 Feb 2023

MEMORANDUM FOR RECORD

SUBJECT: Individual Student Assessment Plan (ISAP) for the Interservice Physician Assistant Program (IPAP), 6H-65D (US ARMY), B-300-0031 (Phase 1 US Navy), B-300-0032 (Phase 2 US Navy), L9OQA42G1-01AA (Phase 1 US Air Force), L5OBO42G1-02AA (Phase 2 US Air Force), 200655 (US Coast Guard)

1. References.

Army Regulation (AR) 12-15, (Joint Security Cooperation Education and Training).
AR 135-200 (Active Duty for Missions, Projects and Training for Reserve Component Soldiers).
AR 350-1 (Army Training and Leader Development).
AR 351-9 (Inter-Service Training).
AR 600-9 (The Army Body Composition Program).
AR 600-20 (Army Command Policy).
AR 614-200 (Enlisted Assignments and Utilization Management).
AR 623-3 (Evaluation Reporting System).
National Guard Regulation 351-1 (Individual Military Education and Training).
Office of the Chief of Naval Operations Instruction (OPNAVINST) 1500.27G, (Inter-Service Training).
OPNAVINST 6110.1J (Physical Readiness Program).
Bureau of Naval Personnel Instruction (BUPERSINST) 1610.1OF (Navy Performance Evaluation System).
Air Force Instruction (AFI) 36-2606 (Reenlistment and Extension of Enlistment in the United States Air Force).
AFI 36-2406 (Officer and Enlisted Evaluations Systems).
Commandants Instruction (COMDTINST) 1020.8H (Coast Guard Weight and Body Fat Standards Program Manual).
COMDTINST M1500.10C (Performance, Training, and Education Manual).
COMDTINST 1560.3 (Recoupment of Advanced Education Costs in the Event of Separation before Completion of Obligated Service).
U.S. Army Training and Doctrine Command (TRADOC) Regulation (Reg) 350-70 (Army Learning Policy and Systems).
TRADOC Pamphlet 350-70-14 (Training and Education Development in Support of the Institutional Domain).
U.S. Army Medical Center and School, U.S. Army Health Readiness Center of Excellence (AMEDDC&S HRCoE) Memorandum 12-16, (International Military Students Administration).
U.S. Army Center of Excellence (MEDCoE) Reg 351-19 (Testing Procedures and Policies).
MEDCoE Reg 351-10 (Student Achievement Recognition).
MEDCoE Reg 351-12 (Enrollment, Relief, Recycle, Administrative Disposition, and Counseling of Student Personnel).
Interservice Training Review Organization (ITRO) Memorandum of Agreement, 05 Jun.
Army Directive 2022-06 (Parenthood, Pregnancy, and Postpartum).

2. Overview.

a. This ISAP establishes each student’s responsibilities during this training experience and the mandatory course completion criteria. It also states the policies and procedures used for student evaluation.

b. This ISAP identifies the requirements for all course examinations, performance standards, general standards, counseling, remedial training, remedial testing, and relief/removal from the course, academic performance ratings and appeal process.

3. Student Responsibilities.

a. Read and acknowledge your understanding of this ISAP by completing Appendix F — Student Acknowledgement of ISAP.

b. Abide by the policies and procedures stated in this ISAP.

c. Abide by the standards of conduct and academic requirements stated below.

Standards of Conduct	Conform to the rules and standards of conduct established by the Uniform Code of Military Justice (UCMJ) and MEDCoE Reg 351-12. Actions such as substance abuse, disruptive behavior in or out of class, and other actions that display the military service in an unfavorable manner is unacceptable. Students engaging in these actions/behaviors will be subject to elimination from the program through the service-specific chain of command, and may result in actions under the UCMJ.
Academic Requirements	Phase 1 academic success in IPAP requires student achievement of a minimum grade of 75% in each course and an overall total point average (TPA) of 80% in each semester. (See Appendix B for a full list of Phase 1 courses.) Phase 2, academic success in IPAP requires student achievement of a minimum grade of 75% in each rotation examination and clinical preceptor evaluation and 80% overall TPA. Additionally, students must earn a grade of 75% or higher on the Thesis/Capstone Project, and must earn a grade of 75% or higher on the summative Objective Standardized Clinical Exams (OSCE), conducted at near the end of both Phase 1 and Phase 2.
Non-Academic Requirements	Class attendance is vital to student success in IPAP. Any student who misses 25% or more of scheduled class meetings in one or more courses will be removed from training and considered for relief/recycle in accordance with (IAW) applicable policies. All students must be medically qualified for commissioning as an officer in their respective services. Students of all Services must maintain standards of physical fitness and height/weight standards IAW service-specific standards and regulations. Training events and requirements will comply with directives as outlined in Army Directive 2022-96 (Parenthood, Pregnancy, and Postpartum), 19 April 2022.

Table 3-1, Student Conduct and Academic Requirements

4. Course Information.

a. The IPAP is a two-phased, degree and credential-producing program, the purpose of which is to develop leaders able to assume the diverse responsibilities as an Interservice Physician Assistant in support of military operations. The IPAP provides students with the knowledge, skills, and problem-solving abilities to deliver evidenced-based physical care in fixed medical treatment facilities and in the operational setting, outpatient clinics, medical homes, installation health promotion, and military readiness activities.

b. Scope.

(1) The IPAP is a 29-month, federally funded graduate program, and consolidated via the Interservice Training Review Organization (ITRO) in 1996. Phase 1 of IPAP is 64 weeks in length (66 total to include leave/holidays), conducted at the Graduate School, U.S. Army Medical Center of Excellence (MEDCoE), Fort Sam Houston, Joint Base San Antonio. Successful completion of all academic and non-academic requirements for Phase 1 culminates in the award of a Bachelor of Science (BS) degree from the affiliated university. Phase 2 is 55 weeks in length (57 total to include leave/holidays), conducted at designated Army, Navy, and Air Force medical treatment/training facilities (MTFs). Successful completion of all academic and non-academic requirements for Phase 2 culminates in the award of a master’s degree from the affiliated university. All students must be commissioned/commissionable to receive the academic degree.

(2) The IPAP is dedicated to educating and developing qualified students as Physician Assistants (PAs). In order to accomplish this, the program’s curriculum and standards must comply with civilian regulatory agencies as well as the policies and regulations of the participating military branches. The Council on Occupational Education accredits the MEDCoE. The Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA) accredits the IPAP.

(3) The entire 29-month program of instruction (POI) meets the needs of the Army, Navy, Air Force, and Coast Guard (CG); preparing graduates who meet uniformed services credentialing standards and are ready for clinical practice upon program completion and national certification. The competency-based curriculum supports the PA Competencies and the PA National Certification Examination (PANCE) blueprint administered by the National Commission on Certification of Physician Assistants (NCCPA). (See Appendix B.)

(4) The program philosophy uses a cohort model. All students take a common core curriculum and share a consistent course load throughout the 29-month program. IPAP does not authorize advanced placement.

c. Course Administrative Data:

Program Length	Phase 1: 66 weeks (Didactic). Phase 2: 57 weeks (Clinical).
Program Prerequisites	Be a uniformed service member. Have completed a minimum of 60 transferable college credits from an accredited educational institution(s), and accepted by the affiliated university. Be screened by the affiliated university, and selected via a service-specific selection board. All incoming students must meet the program-defined minimum standard of 60 college credits, Scholastic Assessment Test within five years, minimum overall grade point average (GPA) of 2.5, minimum sciences GPA of 3.0, minimum of 40 hours of PA shadowing, Basic Life Support for Healthcare Providers certification, and all sciences completed within ten years.
Service Obligation	U.S. Army: 60 months. U.S. Army Reserve: 72 months. U.S. Army National Guard: 72 months. U.S. Navy: Navy Selectees entering a training program will incur a minimum active-duty obligation of three years for the first year of any part of the first year of training, and six months for each additional six months or any part of six months of training. U.S. Air Force: 54 months IAW AFI 36-2107, Active Duty Service Commitments, Table A3.1. Health Professions Officer ADSCs, Rule #14. U.S. Coast Guard: 53 months.
Examinations and Assessments	This program includes graded examinations and assessments used to monitor academic progress and determine student mastery of program requirements in order to receive the degrees and be eligible to take the PANCE. This program uses examination and assessment results to support decisions for special recognition, counseling, probation, and relief/removal procedures. Refer to Appendix A for specifics on examinations and assessments, as well as grading procedures and criteria.
Special Recognition and Programs	To be eligible for academic honors at the end of Phase 1 or Phase 2, students must meet all standards of performance specified in this ISAP. Students must pass their service-specific physical fitness assessment and meet height/weight standards. Students are ineligible for special recognition if they have ever been placed on academic or non-academic probation, or have received disciplinary action or counseling for improper behavior/personal conduct. Students who have been recycled are also ineligible for academic honors. Distinguished Honor Graduate and Honor Graduates: Class ranking is calculated based on total earned academic points upon conclusion of Phase 1, with the top 10% of students being considered for academic honors. One Distinguished Honor Graduate may be designated from within this cohort, and up to three honor graduates may be recognized IAW 351-12. Pi Alpha Honor Society: Pi Alpha is the PA honor society (administered by the Physician Assistant Education Association), and exists for the promotion and recognition of significant academic achievement, leadership, research, community/professional service, and the encouragement of a high standard of character and conduct among Physician Assistant students and graduates. The program is limited to selecting a maximum of 15% students for induction per cohort.
Sponsoring University and College Credit	The University of Nebraska Medical Center sponsors the Interservice Physician Assistant Program as the degree-granting institution. Letter grades are calculated and reported to the affiliated university. Grades for courses attempted by students who are relieved, recycled, or resigned receive record of status in accordance with the affiliate university policies. Students receive a BS degree from the affiliated university upon successful completion of all academic and non-academic requirements of Phase 1. Students receive a MEDCoE certificate of completion, and a master’s degree from the affiliated university upon successful completion of all academic and non-academic requirements of Phase 2. Students must meet all service branch requirements in order to receive the certificate of completion and master’s degree. Phase 1 Credit Hours: 100 Phase 2 Credit Hours: 52
Documentation of Academic Completion	Academic transcripts are available from the affiliated university. Program graduates must contact the affiliated university’s registrar office and pay any applicable transcript fees. The MEDCoE does not provide transcripts.
Medical Policy	Should a student enter the IPAP with a medical condition restricting him or her from full participation in the program or become so restricted, the Program Director may recommend, to the Graduate School Dean, that the student be relieved, recycled, or permitted to remain in course. A medical condition will not be a barrier to the continuation of education unless necessary or the student will miss 25% or more of the scheduled class meetings in one or more courses. Pregnancy will not be a barrier to continuation of training unless (1) medically would be harmful to pregnant student; (2) the student will miss 25% or more of the scheduled class meetings in one or more courses. Should a student enter the program while pregnant, or should she become pregnant during the program, her service chain of command and a credentialed provider will counsel her. If the credentialed provider or Program Director determines the pregnancy will negatively affect the student’s ability to complete the program successfully, a recommendation action for relief/recycle occurs.

Table 4-1, Course Administrative Data

5. Academic Standards.

a. In Phase 1, academic success is achievement of a minimum grade of 75% in each course and an overall test point average (TPA) of 80% in each semester. Phase 1 accomplishment is evaluated through written, oral, and practical (performance) examinations, to include writing assignments each semester.

b. All students are required to earn passing scores for each component of the Thesis/Capstone Project, oral and written presentations, professional attributes, and summative Objective Standardized Clinical Exam (OSCE).

c. In Phase 2, academic success requires an overall TPA of 80%, passing each rotation exam with a minimum of 75%, successful completion of each clinical rotation with a grade of at least 75%, and a grade of at least 75% in the Thesis/Capstone Project.

6. Non-academic Standards.

a. General Standards of Conduct. Students are required to conform to the general rules and standards of conduct established by the Uniform Code of Military Justice (UCMJ), AR 600-20, TRADOC Reg 350-6, MEDCoE Reg 351-12 and assigned Battalion policies.

b. Cheating will not be tolerated. Students caught cheating will be relieved from the course. Examples of cheating include, but are not limited to;

(1) Looking at another student's written/computer-based examination.

(2) Talking to another student without instructor permission during an examination.

(3) Copying another student’s homework or assignment.

(4) Claiming to have performed a task that the student did not perform.

(5) Using or having direct access to unauthorized notes or information during a written/computer-based examination.

(6) Cheating in any other form (e.g., passing exam questions and class notes/study guides to students in other classes). 7. Student Counseling.

a. Assignment of counselors. In Phase 1, students have a principal faculty member as their Academic Counselor. In Phase 2, the Phase 2 Site Clinical Coordinator serves as Academic Counselor.

b. Counseling sessions. Counseling gives the student regular time throughout the program to review academic progress. It affords frequent opportunities for counselors to affect the academic and professional development of students. Students may request counseling with program faculty at any time.

(1) Routine counseling. Initial counseling sessions occur upon arrival and continue on or about the 8, 12, and 16-week marks throughout the duration of Phase 1, and NLT the close of each rotation in Phase 2. The student's progress is discussed, summarized in writing on the routine counseling form (MEDCoE Form 123-E-R), and presented to the student. The student has the opportunity to take an active part in self- evaluation and express his/her view in writing on the counseling form.

(2) Threshold counseling. Students may receive counseling in addition to routine counseling. Students on probation status must meet with their Academic Counselor for counseling a minimum of twice monthly.

(3) Students may have various issues (physical, mental health, family, financial, etc.) impacting their performance at any time during the course. The student may seek the guidance of their Academic Counselor, Class Advisor, Senior Service Representative (SSR), Medical Director, and/or Program Director as needed.

(4) Students must seek counseling after each examination failure and for any semester TPA less than 80%. Any student failing an examination is required to complete remediation with the course instructor within two (2) business days of completing the examination. The student must also make an appointment with their Academic Counselor after they have seen the course instructor.

c. Counseling session documentation. Each counseling session must be documented, dated, signed by the faculty member, and signed by the counselee along with a statement such as, “I have been counseled on this date’, or “| concur/non-concur with this counseling statement.” The student signs the counseling form to indicate the counseling session event and review of the written statements, even if the student does not concur with this written evaluation.

d. All unscheduled counseling must be documented in the counseling record and should be countersigned by the student within 24 hours. This provides proof that the student is aware of any negative or positive information on record about him/her.

8. Probation.

a. Probation can be academic or non-academic. Probation serves to help identify performance problems and the potential consequences should improvement not occur. Any personal behavior interfering with the conduct of class; failure to meet the prescribed standards of conduct, or habitual disciplinary problems as defined in this ISAP, will be grounds for probation. The purpose of probation is to:

(1) Identify your performance problems and their potential consequences.

(2) Advise you to improve performance.

(3) Provide you a means to measure your improvement.

b. Procedures for probation. The Academic Counselor notifies the student of probationary status verbally and by written documentation in the student academic record. Documentation will include the category of probation (academic vs. non- academic), reason(s) probation was initiated (i.e., failure to meet specific objectives), the anticipated duration of the probation, and suggestions for improving academic or non-academic performance. The student acknowledges by signing the counseling statement.

c. Students who have ever been on probation are ineligible for any favorable actions such as academic awards or honors.

d. Academic Probation.

(1) Phase 1.

(a) Students will be placed on academic probation in accordance with the flow chart in appendix E-1.

(b) Test failure cap. Students failing six (6) exams total in a single semester, after final adjudication, will be referred to the program director.

(2) Phase 2. Students receive academic probation status when the end-of- rotation examination grade is less than 75%, or if the clinical preceptor evaluation grade is less than 75%. Students will remain on academic probation until they successfully pass the rotation retest, and the following rotation examination and clinical preceptor evaluation.

e. Non-academic Probation.

(1) Any student, who displays personal behaviors that interfere with the conduct of the class/rotation, fails to meet the prescribed standards of behavior, constitutes a habitual disciplinary problem, or in any way demonstrates unsuitability for the PA

profession, may receive nonacademic probation status. These cases will be referred to the appropriate SSR and Program Director. Students placed on non-academic probation will remain on non-academic probation at the discretion of the Program Director.

(2) Readiness. This applies to students failing to maintain body weight and physical fitness standards IAW service-specific guidelines. Affected students will remain on non-academic probation until the student meets service-specific standards. SSRs will initiate actions, with status updates provided to Program Director.

9. Remedial Training.

a. Phase 1

(1) Students who fail a written examination (score of less than 75%) must seek counseling and remediation with their Course Instructor and Academic Counselor. Retesting is not offered in Phase 1. Counseling and remediation are documented in the student’s academic file IAW the procedures outlined above.

(2) Students who fail a hands-on performance examination, (e.g. Physical Evaluations, Clinical Correlations, or OSCE) must seek counseling and remediation, followed by a retest. One retest is allowed for each performance examination. Students must have at least one day of preparation between the review session and the second evaluation.

b. Phase 2.

(1) Students who fail the hands-on Summative OSCE must seek counseling and remediation, followed by one additional opportunity to retest and pass the Summative OSCE. Students who fail a clinical rotation exam must seek counseling and remediation, followed by one retest opportunity to retake another version of that clinical rotation examination.

(2) Students who fail a clinical rotation (preceptor evaluation less than 75%) do not receive an opportunity to repeat the rotation and must be referred to the Performance Review Board (PRB).

10. Relief/Removal from Course.

a. Students may be relieved from this program for academic and/or non-academic reasons. Depending on the reason for relief from the program, a student may receive a negative service evaluation. Relief measures will be recommended to the Dean, Graduate School, when a student fails to maintain the standards of performance as outlined in this ISAP. Relief may be processed for a combination on academic and/or

non-academic reasons IAW MEDCoE Reg 351-12 and the ITRO Memorandum of Agreement provide guidance.

b. Phase 1.

(1) If a student fails to achieve an end of course grade of at least 75%, or if the TPA is below 80% at the 16-week mark, the student will be referred to the PRB for review. The PRB recommendation for relief or recycle will be forwarded to the Program Director.

(2) Inability to achieve a minimum grade percentage of 75% (C) or higher in each course.

c. Phase 2.

(1) Academic success in Phase 2 requires an overall TPA of 80%, passing each rotation exam with a minimum of 75%, successful completion of each clinical rotation with a grade of at least 75%, and a grade of at least 75% in the Directed Studies course.

(2) A student scoring less than 75% on any end-of-rotation examination will be placed on probation and given one opportunity to retest. If the student passes the retest, regardless of the grade, a grade of 75% will be documented as the final test grade, and the student progresses to the next rotation. If the student fails the retest, he/she will meet a Phase 2 PRB for consideration of recycle or relief. A student will only be allowed one retest during the entirety of Phase 2. Students failing two end-of-rotation exams will meet a Phase 2 PRB for consideration of recycle or relief.

(3) A student scoring less than 75% on the clinical preceptor evaluation will be placed on academic probation and will meet a Phase 2 PRB for consideration for relief or recycle. If student is allowed to continue in the program, he/she will repeat the failed rotation. The maximum grade on a repeated rotation will be 75%. If the time spent on the repeated rotation exceeds 14 days, the student must be considered for relief or recycle.

d. Non-academic Relief (Phase 1 and 2).

(1) Non-academic relief procedures are to be initiated by the student’s Senior Service Representative, Program Director, or Component Commander in Phase 1 IAW service-specific rules, regulations, and/or standards. In Phase 2, non-academic relief procedures are to be initiated by the Phase 2 Site Clinical Coordinator, Phase 2 Site Medical Director, or Phase 2 Component Commander. Non-academic reasons for relief may include, but are not limited to the following:

(2) Violation of the IPAP Academic Honor Code (see Appendix C).

(3) Dishonesty. Possible relief for academic dishonesty applies not only to the student guilty of such behavior, but also to students who knowingly observe or tolerate such behavior without reporting it to a faculty member or Program Director.

(4) Unauthorized absence from an assigned place of duty and training.

(5) Repeated tardiness or repeated absences from class, labs, clinical rotations, and/or examinations.

(6) Serious breaches of academic ethics such as plagiarism, cheating, or unauthorized collaboration in any form IAW MEDCoE Reg 351-12.

(7) Disruptive behavior.

(8) Substance abuse.

(9) Fraternization.

(10) Sexual harassment.

(11) Failure to maintain established service-specific physical fitness and weight standards.

(12) Behavior unbecoming a healthcare professional.

(13) Failure to comply with established standards for patient, procedure, and rotation hours logging.

(14) Disciplinary. The student’s service-specific command will investigate and notify the Program Director. If the specific command determines that there is no evidence of misconduct, the student may continue in the program. If the student has been determined to have engaged in misconduct, the specific command will pursue either non-judicial or UCMJ action. The student’s command will either disenroll the student from the program or allow the student to continue in the program.

e. In Phase 2, in collaboration with the program Phase 2 Site Coordinator, MTF Education Department / command may suspend Phase 2 training within the facility resulting in a hold status and referring the student back to the Program Director for determination of continuance in the program IAW MEDCoE Reg 351-12. While in a hold status, the student is responsible to the chain of command for accountability during the period of consideration of further proceedings.

f. Both Phase 1 and Phase 2 students may either accept the Program Director’s recommendation, appeal the decision to the Dean, Graduate School, or elect to request resignation from the program.

g. A student has the right to appeal a relief/removal action IAW MEDCoE Reg 351- 12.

11. Student Appeal Process. Students who experience difficulty in meeting the course standards and are recommended for /recycle or relief from the course have a right to appeal through appropriate channels IAW MEDCoE Reg 351-12. Students must exercise this right within seven duty days after being notified of pending actions.

a. Appeal Request. A student recommended for relief may request a meeting with the department director (Dean of the graduate school) to appeal the decision. If the department director sustains a recommendation for academic relief, the student may make a final written appeal to the Deputy Commandant, Office of the Commandant IAW MEDCoE Reg 351- 12.

b. Remain in Training. During the request for an appeal, the student will remain in training until all appeal procedures are exhausted.

12. Academic Evaluation Report. Student performance and behavior are noted on the appropriate service-specific evaluation form, and will become a part of each service member’s permanent record.

a. Army students will receive a DA Form 1059, Service School Academic Evaluation Report, at the end of Phase 1 and again at the end of Phase 2.

b. Navy students will receive a NAVPERS 1070/613, Administrative Remarks and a “Non-observed” enlisted evaluation report NAVPERS 1616/26, Evaluation Report & Counseling Record at the end of each phase.

c. Air Force students who are commissioned officers will receive an AF Form 475, Education/Training Report at the end of Phase 1 and Phase 2. All students will receive an AF Form 494, Academic/Clinical Evaluation Report, at the end of Phase 2.

d. Coast Guard students who are commissioned officers will receive a Duty Under Instruction Officer - evaluation report annually during Phase 1 and Phase 2. All students will receive a CG 3307, Administrative Remarks upon completion of Phase 2.

14. Point of Contact.

The point of contact for this ISAP is the IPAP Academic Coordinator, Mr. Jeffrey Bateman, Department of Graduate Education, at phone number: DSN 471-9622, Commercial (210) 808-9622.

MELANIE J. ELLIS Colonel, USAF, BSC Director, Interservice Physician Assistant Program	BRIAN E. BURK Colonel, SP Deputy Commandant, U.S. Army Medical Center of Excellence (MEDCoE)
NEVA R. FUENTES Captain, NC, USN Deputy Chief of Staff, N7, Naval Medical Forces Support Command	SHERRY D. HERNANDEZ Deputy Chief, Competencies Division HQ AETC/A3J
LEAH A. SIBBITT Deputy Training Division Chief Coast Guard Force Readiness Command

Appendix A

Examinations/Assessments and Grading Procedures

This appendix provides additional information regarding examinations and assessments for this program, including grading criteria.

1. Phase 1 Didactic Evaluation.

Students receive evaluation for didactic knowledge and skills using a variety of methods, which may include examinations (oral and written, performance/practical), quizzes, papers, oral presentations, projects, group activities, and class participation.

a. Letter Grades.

Grades	Percentage Equivalent
A+	97.00-100%
A	90.00-96.99%
B+	87.00-89.99%
B	80.00-86.99%
C+	78.00-79.99%
C	75.00-77.99%
F	Less than 75.00%

b. Percentage grades are taken directly from Canvas and are rounded automatically to the hundredths place. No further rounding will be necessary.

2. Phase 2.

a. Phase 2 Clinical Evaluation. Students are evaluated for didactic knowledge, clinical knowledge, and skills using a variety of methods which may include examinations (oral and written, performance/practical), quizzes, papers, oral presentations, projects, group activities, clinical rounds, patient & procedure logging, and clinical preceptor evaluations. Clinical rotation written examinations normally occur through the learning management system. Clinical preceptor evaluations will normally be administered via the clinical management system.

b. Grading. In Phase 2, students must score at least 75% on the written examination given at the end of each rotation and at least 75% on the clinical preceptor evaluations submitted by the preceptors at the end of each rotation. The score on the clinical preceptor evaluation will count as 75% of the final rotation grade, and the score on the written examination will count as the remaining 25%.

(1) Exceptions: PA Professional Issues Pass/Fail.

(a) Elective Rotation. There is no written examination, so the clinical preceptor evaluation accounts for 100% of the rotation grade.

(b) Directed Studies (IPAP712). Students must earn a passing grade of at least 75% in each component in order to pass the course. The course grade is computed as follows:

Investigation Research/Review Paper = 30%
Objective Standardized Clinical Exam (OSCE) = 30%
Defense of the above cited Investigational Research/Review paper = 10%
Disease of current military significance presentation = 10%
Disease or medical topic of personal interest presentation = 10%
Professional Attributes = 10%

(2) Phase 2 percentage and letter grades are the same for Phase 1.

Appendix B

University of Nebraska Medical Center School of Allied Health Professions

Interservice Physician Assistant Program Curriculum

(Effective Spring 2021 and thereafter)

Phase I. Freshman Semester

Course #	Course Title	Credit Hours
IPAP 500	Anatomy and Physiology I	7
IPAP 501	Anatomy and Physiology 2	7
IPAP 502	Biochemistry	3
IPAP 503	Microbiology	5
IPAP 506	Med / Law Ethics	2
IPAP 608	Research Evaluation	2
	Total Semester Hours for Freshmen Semester	30

Phase I. Sophomore Semester

Course #	Course Title	Credit Hours
IPAP 504	Clinical Laboratory	4
IPAP 505	Pathology	3
IPAP 602	Pharmacology I	3
IPAP 603	Radiology	2
IPAP 604	Psychiatry	3
IPAP 606	EKG	2
IPAP 609	Gastroenterology	2
IPAP 623	Military Public Health / Dental	2
IPAP 631	Medical History and Physical Evaluation I	3
	Total Semester Hours for Sophomore Semester	20

Phase I. Junior Semester

Course #	Course Title	Credit Hours
IPAP 605	Orthopedics	4
IPAP 607	Pulmonary	2
IPAP 610	Cardiology	4
IPAP 611	Endocrinology	2
IPAP 612	Clinical Correlations I	1
IPAP 619	Infectious Diseases	3
IPAP 620	Neurology	2
IPAP 630	Pharmacology II	4
IPAP 632	Patient Evaluation II	2
	Total Semester Hours for Junior Semester	24

Phase I. Senior Semester

Course #	Course Title	Credit Hours
IPAP 600	Hematology/Oncology	1
IPAP 613	Clinical Correlations II	1
IPAP 614	Pediatrics	3
IPAP 615	Surgery	4
IPAP 616	Dermatology	2
IPAP 617	Obstetrics/Gynecology	3
IPAP 618	Emergency Medicine	5
IPAP 622	Genitourinary	2
IPAP 624	PA Professional Issues	1
IPAP 628	Otolaryngology/Ophthalmology	2
IPAP 629	Gerontology/Rheumatology	2
	Total Semester Hours for Senior Semester	26

Phase 2. Academic Year

Course #	Course Title	Credit Hours
IPAP 700	Surgery Rotation	5
IPAP 701	Dermatology Rotation	4
IPAP 702	Obstetrics/Gynecology Rotation	4
IPAP 703	Orthopedics Rotation	6
IPAP 704	Psychiatry Rotation	3
IPAP 705	Internal Medicine Rotation	6
IPAP 706	ENT/Allergy Rotation	4
IPAP 707	Pediatrics Rotation	5
IPAP 708	Ophthalmology Rotation	2
IPAP 709	Emergency Medicine Rotation	3
IPAP 710	Family Practice/Outpatient Medicine Rotation	4
IPAP 711	Clinical Elective Rotation	4
IPAP 712	Directed Study	2
	Total Semester Hours for Academic Year	52

Total Semester Hours for IPAP

152

Note: Students will be registered for Phase II over three terms during the final academic year based on a typical rotation schedule. Final grades for all students will be due at the completion of all coursework.

Appendix C

Academic Honor Code 1. Purpose: To establish an Academic Honor Code (AHC) for the Interservice Physician Fort Sam Houston, Texas. To publish policies, procedures, and guidelines governing its implementation and enforcement. 2. Applicability: This instruction applies to all faculty, staff, and students assigned to the IPAP. 3. Policy: All personnel affiliated with IPAP(to include all Phase 2 sites) are to exhibit honesty and integrity in all aspects of their military and personal lives, and especially in their academic pursuits. Academic integrity is a commitment, even in the face of adversity, to five fundamental values: honesty, trust, fairness, respect, and responsibility. From these values, flow principles of behavior that enable academic communities to translate ideals into action. All students are to acquaint themselves with, and make use of, all procedures established for doing research, writing reports, completing homework assignments, performing laboratory and clinical assignments, and taking examinations. Failure to act in accordance with such procedures is academic dishonesty. Acts of academic dishonesty are legal, moral and intellectual offenses against the academic community and handled as disciplinary problems in accordance with the ISAP. 4. AHC Principles:

a. The AHC is the standard of student conduct while assigned to the IPAP. The AHC exists in conjunction with, and in parallel to, the UCMJ. Therefore, all conduct and performance must be acceptable within the parameters set forth by both of these documents.

b. The AHC uses five fundamental values of honesty, trust, fairness, respect, and responsibility,

(1) An academic community of integrity advances the quest for truth and knowledge by requiring intellectual and personal honesty in learning, teaching, research, and service.

(2) An academic community of integrity fosters a climate of mutual trust, encourages the free exchange of ideas, and enables all to reach their highest potential.

(3) An academic community of integrity establishes clear standards, practices, and procedures and expects fairness in the interactions of student, faculty, and administrators.

(4) An academic community of integrity recognizes the participatory nature of the learning process, and honors and respects a wide range of opinions and ideas.

(5) An academic community of integrity upholds personal accountability and depends upon action in the face of wrongdoing."

c. Integrity is an essential part of any true educational experience. This includes integrity on the part of the faculty members as well as integrity on the part of students. The AHC requires each to student to execute and accept his or her role with self- confidence, determination, hard work, and a desire to excel. Students will not violate nor permit other students to violate the provisions of this AHC.

d. The AHC supports leadership development. It affords the student an opportunity to make conscious decisions regarding its application and to accept the consequences of their decisions.

5. Definitions: For the purpose of the AHC, the following definitions are applicable

a. Academic Activity - Any activity undertaken during the course of instruction to instruct, review, provide practice, or assess performance or knowledge within a given subject area. Academic activity includes, but is not limited to lectures, review sessions, quizzes, examinations, homework, projects, laboratory assignments, tutorials, remediation, simulated or actual clinical performance, oral reports/presentations, and other such assigned activities.

b. Improper Assistance - Help, either given or received, on any academic activity in a manner not otherwise prescribed/authorized by the assigned instructor.

c. Cheating - Knowingly using unauthorized assistance in any academic activity.

d. Plagiarism - The act of stealing and/or passing off the ideas or words of another, whether published or unpublished, as one’s own.

e. Irregular Behavior - Student conduct during any evaluation, to include examinations, quizzes, laboratory assignments and observed physical examination performance that is suspect. Any activity that causes the instructor, evaluator or proctor to suspect that the student’s performance is being (or attempting to be) augmented from any source external to the student's own accumulated fund of knowledge.

6. Prohibited Acts: All forms of cheating, plagiarism, improper giving/receiving ‘ The International Center for Academic Integrity (ICAI). Accessed via http:/Avww.academicintegrity.org on 27 April 2016.

assistance, and irregular behavior are violations under the AHC and may be punishable under the UCMJ. Prohibited acts include but are not limited to the following:

a. The use of notes, texts, issued materials, handouts, or electronic devices (including but not limited to: cellular telephones, calculators, tablets, computers, smartwatches and/or listening devices) during examinations, quizzes or any testing exercises, unless specifically authorized by the instructor.

b. Any visualization of or attempt to visualize another student's test or answer key.

c. Any attempt to enable another student's visualization of any other student's test or answer key during an examination.

d. Knowingly permitting another student to copy any student's answers from an examination paper (or computer screen), writing assignments, speech or briefing materials.

e. The act of providing or accepting (to include the visualization or possession of) unauthorized assistance or materials such as research papers, study guides, prior tests (or parts thereof), review session notes and course information prepared or provided by students outside the current class. This includes any materials possessed by a recycled student (authorized material for that student only) obtained or prepared in a prior class (semester)

f. The act of giving or receiving improper assistance such as, but not limited to, copying answers from another's examination.

g. Using previously written research papers, briefings, or other types of student work normally assigned by the program, provided by former students of the program.

h. Collaboration and/or plagiarism on lab assignments, clinical performance, workbooks, special projects, “take home” quizzes or any other type of graded or mandatory assignments unless specifically authorized by the instructor for that particular assignment.

i. Beginning a “timed” assignment, whether examination, quiz, laboratory assignment or other academic activity, prior to being told to begin the activity.

j. Continuing to work on a “timed” assignment, exam, quiz, lab assignment or other academic activity, after being told that time has expired.

k. Giving or receiving any type of communication during an academic activity unless expressly permitted by the assigned instructor.

|. Submitting previous or subsequent work for a given academic activity under the false premise of having accomplished that work during the designated timeframe for that academic activity.

m. Disclosing or soliciting disclosure of any information regarding examination questions or answers prior to, during, or subsequent to an examination or other graded activity. This specifically includes the prohibition of disclosing any examination content to subsequent class members or solicitation of any examination content from preceding class members.

n. Any behavior that undermines or threatens the integrity of an IPAP assessment processes regardless of whether it occurs before, during, or after a particular academic activity.

7. Enforcement:

a. Responsibility for enforcing the AHC rests with the IPAP faculty, as well as the student community.

b. In the event a student is suspected of violating the AHC, the following procedure will be followed:

(1) Whenever possible, the faculty member will immediately terminate the activity. The faculty member will inform the student(s) involved of the suspected infraction of the AHC. Any supporting evidence will be confiscated and turned over to the Program Director. If a student observes any act in violation of the AHC, he/she will immediately notify the faculty member in the classroom, Class Advisor, Senior Service Representative, and/or Academic Counselor.

(2) All faculty and students are obligated to report suspected violations of the AHC. The faculty member will forward to the Program Director as soon as practical a written statement concerning the occurrence.

(3) The Program Director will evaluate the report and conduct an interview with the reporting party, the student(s) involved, the assigned faculty member, and any other applicable parties. The Program Director may determine the student's disposition as any of the following:

(a) Dismissal of the suspected incident (unfounded/not guilty) (b) Recommendation (to Graduate School Dean) for relief from the program; (c) Placement on program probation;

(d) Referral to that student's Service command for possible disciplinary action.

Appendix D

Phase 1 & 2 Nonacademic Review Process

Step	Disciplinary Action Path	Non-Disciplinary Action Path
1. Action initiated	Action initiated by appropriate authority.
2. Type of action	Disciplinary	Non-Disciplinary
3. Service-specific review	Service-specific review. Program Director notified.	Service-specific review. Program Director notified.
4. Continue training?	If the student is authorized to continue training, the student continues training.	If the issue is non-recyclable, the student is dismissed. If the issue is recyclable, the student may continue training, recycle, or retain, as determined through the review process.
5. Action	Action may result in non-judicial punishment or action under the Uniform Code of Military Justice.	Action may result in dismissal, recycle, retain, or continuation in training.
6. Dismissal decision	If dismissal is directed, training stops. If dismissal is not directed, the student continues training.	If dismissal is directed, training stops. If dismissal is not directed, the student may continue training, recycle, or retain, as appropriate.

Note 1: Phase 1 - Class Advisor, Program Director, or Component Commander. Phase 2 - Phase 2 Site Clinical Coordinator, Phase 2 Site Medical Director, or Phase 2 Component Commander.

Appendix E

Phase 1 & 2 Academic Review Process

Academic Review Process, Page 1

Trigger	Initial Action	Possible Outcome
Test failure of <67% after adjudication, individual course average of <75% after 2 or more tests, 4 test failures total in a single semester, or <80% TPA after 8 weeks.	Probation/remediation. Service notification.	Student continues training unless end-of-course average or semester average falls below the required standard.
Mid-semester program average <80%.	Probation. Service notification.	If end-of-semester program average is <80%, the student is referred to a Performance Review Board. If the student meets the standard, the student continues training.
End-of-course average <75%.	Performance Review Board. Recommend relief/recycle.	Recommendation goes to the Program Director.
End-of-semester program average <80%.	Performance Review Board. Recommend relief/recycle.	Recommendation goes to the Program Director.

Program Director Decision

Program Director Decision	Student Response	Outcome
Retain	Student accepts the decision.	Student returns to class on probation.
Recycle	Student accepts the decision.	Student is removed from class and recycled to the next convening class.
Recycle	Student appeals to Department Director.	Appeal proceeds to Department Director/Graduate School Dean.
Relief	Student accepts the decision.	Student is disenrolled.
Relief	Student appeals to Department Director.	Appeal proceeds to Department Director/Graduate School Dean.

Academic Review Process, Page 2

Department Director/Graduate School Dean Decision	Student Response	Outcome
Retain	Student accepts the decision.	Student returns to class on probation.
Recycle	Student accepts the decision.	Student is removed from class and recycled to the next convening class.
Recycle	Student appeals decision to the Deputy Commandant.	Deputy Commandant reviews the appeal and upholds or overturns the decision.
Relief	Student accepts the decision.	Student is disenrolled.
Relief	Student appeals decision to the Deputy Commandant.	Deputy Commandant reviews the appeal and upholds or overturns the decision.
Deputy Commandant upholds decision	Final appeal outcome.	If upheld, the student is disenrolled. If not upheld, the student is retained or recycled, as appropriate.

Note 1: Specific services CO/OIC will be kept informed at all decision points. Final decision regarding the students will be accomplished with approval of the individual's service CO/OIC.

Academic Review Process, Page 3

Phase 2 Trigger	Review Process	Possible Outcome
Student fails required Phase 2 tests/practical exercises. Forms are initiated for academic relief/recycle.	Notify and counsel student.	Phase 2 Clinical Coordinator interviews student and makes recommendation.
Academic concern remains after counseling.	Performance Review Board held by Phase 2 site and recommendation made.	IPAP Phase 2 Coordinator or IPAP executive staff member may be present on telephone conference.
Program Director receives recommendation.	Program Director determines retain, recycle, or relief.	Student may accept the decision or appeal to the GS Dean/CC/OIC respective service.
Retain	Student accepts the decision.	Student returns to class on probation.
Recycle	Student accepts the decision.	Student is removed from class and returned to company/detachment for recycle into the next class.
Relief	Student accepts the decision.	Student is disenrolled.
Appeal	Student appeals decision to GS Dean/CC/OIC respective service.	If the decision is upheld, the student is disenrolled. If not upheld, the student is retained or recycled.

IPAP Remediation Policy Flowchart

Effective 4MAY2026

Standing/Level	Trigger	Required Action	Outcome
Normal Academic Standing	Start.	Student remains in normal academic standing.	Continue training unless a remediation trigger occurs.
Individual Remediation Event	Single test failure >68% and <75%, or isolated instructor concern.	Individual Remediation Event with course instructor, then counselor.	If there are no further issues, the student continues training. If further issues occur, the student moves to Course Level Remediation.
Course Level Remediation	Single catastrophic test failure <67%, critical instructor concern, less than 75% in a course after 2 exams, second exam failure in the same course, or repeated instructor concerns.	Course Level Remediation. Instructor-led and verified by counselor.	Course grade determines next step.
Course Grade Outcome	>=80% course grade.	Course requirement met.	Continue training.
Course Grade Outcome	>75% and <80% course grade.	Continue with cohort on Program Level Remediation.	Student continues with cohort on PLR.
Course Grade Outcome	<75% course grade.	Comprehensive Exam.	If passed, retain with cohort with option for probation status. If failed, refer to PRB.
Course Level Remediation	Second course failure while in CLR.	Refer to PRB.	PRB determines retain, recycle, or relief.
Program Level Remediation	PLR Criteria: less than 80% total GPA after 8 weeks; required comprehensive exam last semester; >75% total GPA and <80% at end of semester; >75% and <80% individual course grade; or repeated instructor concerns.	Program Level Remediation. Counselor-led and verified by Senior Service Representative.	If the student finishes the semester above PLR criteria, continue training off PLR. If the student finishes the semester still below PLR criteria, refer to PRB.
Program Level Remediation	Second course failure while on PLR.	Refer to PRB.	PRB determines retain, recycle, or relief.
Other Probation	Honor code violation, repeated or egregious professionalism issues, or failure of PLR.	PRB.	Student may be placed on probation status or relieved.
Recycle	Major life event exclusive of academic failure.	Non-Academic Recycle recommended by Senior Service Representative.	Program Director final decision. If approved, student continues training with next cohort.
PRB Outcomes	Referral to PRB.	PRB reviews student record and circumstances.	Possible outcomes: retain, recycle to next cohort, or relief.

Appendix F

Student Acknowledgement of ISAP and AHC Briefing

Memorandum of Understanding

SUBJECT: Acknowledgement of Individual Student Assessment Plan (ISAP) and Academic Honor Code (AHC) for the Interservice Physician Assistant Program

1. I have read and understood this ISAP and the AHC for the Interservice Physician Assistant Program. Course personnel answered all questions I had pertaining to this ISAP and the AHC prior to signing this memorandum. I understand that this ISAP and the AHC remain in effect as written for the duration of my enrollment in the program unless specifically notified otherwise.

2. I have access to course syllabi describing the course structure and examination procedures.

3. I am aware of the counseling requirements in accordance with MEDCoE Reg 351-12, Enrollment, Dismissal, Recycle, Administrative Disposition, and Counseling of Student Personnel, as briefed to me by course personnel.

Signature of Student

Date

Printed Name of Student

IPAP Remediation Policy

4 May 2026

I. Purpose

The purpose of this policy is to outline the Interservice Physician Assistant Program (IPAP) Phase 1 didactic remediation process.

In accordance with accreditation standards, remediation is a defined process for addressing deficiencies in a student’s achievement of program competencies, such that the correction of these deficiencies is measurable and can be documented.

II. Policy Statement

This policy applies to all IPAP Phase 1 students, as well as principal and instructional faculty involved in the delivery, assessment, and remediation of didactic coursework.

It is the shared responsibility of the student, course instructors, and academic counselor to complete individual remediation for any eligible scenario. It is the responsibility of the student’s academic counselor to document completion of remediation. Remediation must be completed prior to the next examination in the course in question. In the event that a student fails the final course exam (written or skills-based), they must request and complete remediation prior to taking the course comprehensive exam, if eligible.
Failure of the student to complete remediation in accordance with this policy will result in the student being ineligible to take the comprehensive examination for that course.
Exceptions to remediation timing may be granted by the IPAP Medical Director in documented extenuating circumstances.
Any exceptions to remediation policy will be determined by the Performance Review Board with concurrence of the IPAP Program Director.

III. Procedures

1. Individual Remediation Event

When a student earns a score >/= 68% and < 75% on any individual examination (written or skills-based), or there is an isolated instructor concern, an Individual Remediation Event (IRE) is required. It is the responsibility of the student to request and complete IRE with the course instructor and the academic counselor to document prior to the next examination in that course.

For any failed written exam, the student must complete the back portion of their examination answer sheet in full, including:

Student name
Date of exam
Course name
Predicted grade and actual grade
Academic counselor’s name
Description of any extenuating circumstances
Documentation of each missed question and rationale for the incorrect response

During IRE, the course instructor will complete the final grade section and document the remediation method (group or one-on-one review), as well as the date of remediation. Both the instructor and student must sign the answer sheet in the designated signature areas, verifying that remediation occurred. A copy of the back portion of the answer sheet ONLY should be provided to the student for his/her records. Completed testing forms will be uploaded in the student’s electronic record.

For any failed skills-based exam, the student must contact the course instructor within 3 duty days and request IRE. The request for IRE should be made through the Canvas messaging system. Failure to submit the request within 3 duty days is considered non-compliance with this policy and will be subject to the PRB process, if applicable.

A. Individual Remediation Event Process

When a student requests an IRE, the course instructor must conduct remediation that, at a minimum, includes a review of all missed written exam questions and an explanation of why the correct answers represent the best choices. For skills-based exams, the course instructor must conduct remediation that at a minimum, reviews deficiencies noted on the grading rubric and the development of skill-specific corrective actions. If the student continues to demonstrate uncertainty or lack of understanding of targeted learning objectives, the instructor must provide additional remediation.

Examples of supplemental remediation may include, but are not limited to:

Targeted one-on-one instruction
Directed readings or literature review
Assigned educational videos or supplemental materials
Written self-reflection exercises.

When the course instructor provides supplemental remediation or skill-specific corrective actions, it must be documented and stored in the student’s electronic academic folder after the remediation activity is completed. Should the student neglect to complete the supplemental remediation or skill-specific corrective actions prior to the next exam or specified deadline set by the course instructor, an annotation indicating non-completion shall be made and included in the student’s electronic academic folder.

2. Course Level Remediation

When a student earns a score considered a catastrophic individual score of < 67% on any individual examination (written or skills-based), student has < 75% in a course after 2 exams, there is a second failure in the same course, there is a critical instructor concern, or there are repeated instructor concerns, the student is placed on Course Level Remediation (CLR). It is the responsibility of the student to complete CLR led by the course instructor and verified by the academic counselor to document.

A. Course Level Remediation Process

During CLR, the course instructor must conduct remediation that, at a minimum, includes the IRE process as outlined above. At this time, the student should be offered additional remediation and resources.

Examples of supplemental remediation in addition to IRE resources may include, but are not limited to:

Medical or behavioral health evaluation
Directed lectures, podcasts, supplemental literature
Army Ready and Resilience program evaluation

When the course instructor provides supplemental remediation or skill-specific corrective actions, it must be documented and stored in the student’s electronic academic folder after the remediation activity is completed. Should the student neglect to complete the supplemental remediation or skill-specific corrective actions prior to the next exam or specified deadline set by the course instructor, an annotation indicating non-completion shall be made and included in the student’s electronic academic folder.

B. CLR Outcomes

A student will continue in the course in question until such time a final course grade is determined.

If student’s final course grade is >/= to 80%; student continues training
Student’s final grade is >/= 75% < 80%; student is referred to Program Level Remediation for the following semester (see below)
Student earns <75% for the final course grade and is referred to the Performance Review Board (PRB)
A second course in the same semester has a total course average of <75% and the student is automatically referred to the PRB

3. Program Level Remediation

When a student earns a total grade point average (GPA) after 8 weeks of <80%, if a student’s total GPA is >/= 75% and <80% at the end of the prior semester, if the student earned >/= 75% but <80% in a course the semester prior, if the student required a comprehensive examination the semester prior, or if there are repeated instructor concerns, the student is placed on Program Level Remediation (PLR). It is the responsibility of the student to complete PLR led by the academic counselor to document and verified by the student’s senior service representative.

A. Program Level Remediation Process

During PLR, the academic counselor must conduct remediation that includes, but is not limited to, elements of the IRE and CLR processes outlined above. The student should be offered additional remediation and resources and discuss progress with the academic counselor at least every 2 weeks. PLR is distinct from CLR in that systemic issues affecting a student’s performance in IPAP should be addressed. CLR typically focuses on deficiencies within an individual course. In contrast, a well-developed PLR plan should address broader factors affecting student success, such as study habits, test-taking skills, external stressors, major life events, use of support services, and professional behavior concerns.

B. PLR Outcomes

The student will continue in the semester in question until such time a final course grade in each course and a total GPA is determined.

If student’s final total GPA grade is >/= to 80%, student continues training
Student’s final grade is >/= 75% < 80%, student is continued on Program Level Remediation for the following semester
Student earns <75% for the final total GPA grade and is reviewed to the PRB
A second course in the new semester has a total course average of <75% and the student is referred to the Performance Review Board (PRB).

4. Probation

When a student has an honor code violation, repeated or egregious professionalism issues, or failure of PRB, the student will be referred to a PRB for determination. Students will be counseled that this may require stating ‘yes’ to questions regarding probation for future credentialing and privileging actions in accordance with MEDCoE Regulation 351-12.

5. Non-Academic Recycle

When a major life event exclusive of an academic failure occurs, the student will discuss with the Senior Service Representative for recommendation and, if determined eligible and approved by the program director, may be recycled into next available training cohort.

6. Performance Review Board

When a student is referred to the PRB for any of the above reasons as outlined above, board will evaluate the student’s entire academic record, to include all remediation efforts, as well as clinical skills, professionalism and attitude, and any non-academic life events.

A. PRB Outcomes

The student will continue in the semester in question until such time a final outcome is determined.

Student is retained
Student is recycled
Student is relieved

B. Comprehensive Exam Eligibility and Completion

If a student is retained by the PRB for an academic failure, a comprehensive examination must be offered to satisfy course completion. The comprehensive course examination is available only to students who fail to meet an individual course average of at least 75% by the end of the course. Students will be allowed to sit for only one comprehensive exam per semester and no more than two throughout the didactic (Phase 1) year. Once a student has exhausted the number of comprehensive exams they are permitted to take, they will be referred directly to the Performance Review Board (PRB) for a course failure.

In the event of a course failure resulting in poor performance on a skills-based assessment only, the comprehensive exam will be skills-based.
In the event of a course failure due to failed written and skills-based exams, the comprehensive exam will consist of both written and skills-based assessments.
Successful completion of IRE/CLR for every failed exam is required for the student to be authorized to take the course comprehensive examination. It is the responsibility of the student to complete IRE. The PRB is responsible for verifying that the student satisfies the necessary requirements to sit for the comprehensive exam. Failure to fulfill the remediation requirements will lead to a failing course grade and will be governed by the policies applicable to the PRB process.
When a student passes the course comprehensive exam, the maximum end-of-course grade they can receive is 75% and will subsequently result in a student being placed on PLR for the next semester.
When a student fails the course comprehensive exam, the student will receive the end-of-course grade earned prior to completing the comprehensive exam and will be governed by the policies applicable to the PRB process.

C. Comprehensive Exam Preparation

All course comprehensive examinations will be completed by the course instructor and reviewed by a second faculty member to ensure accuracy, clarity, and proper content coverage. Prior to administration, the IPAP Medical Director (or designated service medical director) will conduct a final quality assurance review to validate exam structure and confirm alignment with course learning objectives. The intent of a course comprehensive exam is to demonstrate student attainment of the minimum necessary standard of program competency achievement to warrant program progression.

7. Documentation and Oversight

All remediation efforts will be documented, submitted to the students’ academic counselor, and retained in the student’s electronic academic folder. The IPAP Medical Director will ensure consistency and quality of remediation practices across all courses.

IV. Responsibilities

Students are responsible for:
- Completing the testing answer sheet in full for all written exams and requesting IRE with the course instructor as specified in this policy for all exam grades <75%.
- Attending all scheduled remediation sessions.
- Communicating academic concerns or extenuating circumstances to their academic counselor and course instructor.
- Engaging in and completing all required IRE, CLR, PLR elements
Course Instructors are responsible for:
- Conducting IRE/CLR for every student who requests and requires it, documenting remediation activities, and verifying the student’s understanding of relevant learning outcomes and instructional objectives.
- Providing supplemental remediation when necessary and coordination with the academic counselor for at-risk students.
- Completion and administration of comprehensive examinations.
Academic Counselors are responsible for:
- Maintaining accurate remediation records in the student’s electronic academic folder.
- Coordination with course instructors for at-risk students.
- Conducting PLR for eligible students
- Reporting to the PRB on all remediation efforts.
Senior Service Representatives, Academic Coordinator are responsible for:
- Supporting implementation of remediation policies.
- Communicating any extenuating circumstances to PRB members.
- Verifying all students PLR and his/her progress
- Determining eligibility of non-academic recycle events
IPAP Medical Director is responsible for:
- Ensuring consistency, fairness, and quality of remediation practices across all courses.
- Reviewing comprehensive examinations for validity and alignment with course learning objectives prior to administration.
- Approving exceptions to remediation timing under documented extenuating circumstances.
- Overseeing continuous quality improvement related to remediation processes, including review of end-of-course student feedback.
- Approval changes in timing to the remediation process.
- Supporting implementation of remediation policies.
Performance Review Board is responsible for:
- Verifying students referred to them have completed the remediation requirements outlined in this policy before authorizing the completion of a course comprehensive exam.
- Determining outcomes for those referred to board for academic decision
Program Director is responsible for:
- Supporting implementation of remediation policies.
- Communicating any extenuating circumstances to PRB members.
- Final determination from PRB
- Approval of any/all exceptions to policy

IPAP Program Director

MEDCoE Dean of Graduate Education

IPAP Remediation Policy

Effective 4MAY2026

Text Version of Remediation Policy Flowchart

Standing or Process Area	Trigger or Criteria	Required Action or Decision Point	Possible Outcome
Normal Academic Standing	Start	Single test failure >68% & <75% or Isolated instructor concern	Individual Remediation Event w/ course instructor then counselor
Normal Academic Standing	Individual Remediation Event w/ course instructor then counselor	Further issues?	No: Continue Training Yes: Course Level Remediation
Course Level Remediation	Single Catastrophic Test Failure (<67%) or Critical Instructor Concern	Course Level Remediation (Instructor Led Verified by Counselor)	Course Grade?
Course Level Remediation	Less than 75% in a course after 2 exam or Second exam failure in same course or Repeated instructor concerns	Course Level Remediation (Instructor Led Verified by Counselor)	Course Grade?
Course Level Remediation	Course Grade?	>/= 80% course grade	Continue Training
Course Level Remediation	Course Grade?	> 75% & <80% course grade	Continue with cohort on PLR
Course Level Remediation	Course Grade?	< 75% course grade	Comprehensive Exam
Course Level Remediation	Comprehensive Exam	Pass	Retain
Course Level Remediation	Comprehensive Exam	Fail	PRB
Course Level Remediation	2nd course failure while in CLR?	2nd Course Failure	PRB
Program Level Remediation	PLR Criteria: Less than 80% total GPA after 8 wks or Required comp exam last semester or >75% total GPA <80% at end of semester or >75%, <80% individual course grade or Repeated instructor concerns	Program Level Remediation (Counselor Led Verified by SSR)	Finish semester still below PLR Criteria or Finishes semester above PLR Criteria
Program Level Remediation	Finishes semester above PLR Criteria	Continue training off PLR	Continue training off PLR
Program Level Remediation	Finish semester still below PLR Criteria	PRB	Retain with cohort w/ option for probation status, Recycle to next cohort, or Relief
Program Level Remediation	2nd Course Failure	PRB	Relief or Recycle to next cohort
Other Probation	Other Probation Criteria: Honor code violation; Repeated or egregious professionalism issues; Failure of PLR	PRB	Student placed on probation status or Relief
Recycle	Major life event exclusive of academic failure	Non-Academic Recycle Recommended by SSR	PD Final Decision
Recycle	PD Final Decision	Recycle	Continue training with next cohort

Interservice Physician Assistant Program 2020 Student Handbook

Appendices

Physician Assistant Competencies
NCCPA Code of Conduct
NCCPA Exam Content Blueprint
AAPA Guidelines for Ethical Conduct
IPAP Individual Student Assessment Plan
IPAP Academic Honor Code

Student responsibility: All IPAP students are required to read this handbook in its entirety, ensure full understanding of its contents, seek clarification from IPAP faculty and staff as needed, and comply with program policies.

SECTION I

PROGRAM DIRECTOR’S INTRODUCTION

Congratulations on your selection and welcome to the largest PA program in the world. The Interservice Physician Assistant Program (IPAP) is one of only 238 PA programs in the U.S. accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), and represents the only PA program providing direct placement of graduates into the Armed Services. The IPAP is affiliated with the University of Nebraska Medical Center, which confers a bachelor’s degree upon successful completion of the 16-month didactic phase (Phase I), and a master’s degree after completing of the clinical training phase (Phase II). The next 29-months of PA school requires absolute dedication and perseverance in order to navigate the diversity of course requirements. Upon successful completion of the IPAP and the Physician Assistant National Certifying Examination (PANCE), you will join a highly dedicated and respected profession and serve as future military leaders. Most importantly, you will be responsible for the care and medical readiness of our nation’s warfighters. The updated version of the IPAP Student Handbook outlines the program expectations and governing policies while at the same time introducing you to the professional and ethical standards of the PA profession. Take the time to familiarize yourself with this document, as you must follow these guidelines, both academically and professionally.

SECTION II: History

The profession of the Physician Assistant (PA) has only been recognized for about 51 years. In the late 1950’s and early 1960’s, the lack of physicians in both the military and civilian health care systems led to the development of the PA profession. In a 1961 article published in the Journal of the American Medical Association (JAMA), Dr. Hudson first broached the subject of the "extern" in helping to meet the nation’s healthcare provider needs. This "extern" would be responsible for most of the technical procedures and some of the medical responsibilities of the physician under whom they would work. This concept lead to the development of the first PA educational program.

In 1965, Dr. Eugene Stead developed the first PA program at the Department of Medicine at Duke University Medical Center in Durham, North Carolina. Using four ex-Navy corpsmen, the two-year PA program began. The curriculum modeled a fast-tracking medical doctor`s program developed during World War II. In this program, the first 9 months focused on sciences and clinical skills, the next 13 months centered on clerkships in a variety of hospital clinics, and the final two months involved working with a clinical preceptor learning their professional skills. On 06 October 1967, the first PA students graduated from the Duke University, thereby establishing the PA profession.

Other PA programs quickly appeared across the U.S. shortly after Duke University matriculated the first PA student; however, these represented other prototypes for PA education. For example, at the University of Washington, Dr. Richard Smith designed a program called MEDEX (Medicine Extension) to train former military medics to service areas of Washington State that were lacking in medical personnel. This program required three months of concentrated study and 12 months of preceptorship with university medical doctors. Highlighting another prototype, in 1966 the merchant marines began a nine-month training program for purser mates (the people in the merchant marines responsible for overseeing ships documentation and customs declarations, as well as medical care). While the concept of the “physician’s assistant” increased in popularity throughout the late 1960’s, it was the American Medical Association’s endorsement and subsequent efforts to establish a formalized PA education process that led to the modern-day existence of PA profession.

Today, most PA programs are 24-29 months in length, but range from 18-36 months. Despite the differences between the schools, all PA programs must meet the same standards for accreditation set forth by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Only graduates from an ARC-PA accredited program may take the Physician Assistant National Certifying Examination (PANCE), which is the only certifying examination in the United States.

History of the Interservice Physician Assistant Program

In 1996, the military services combined their various PA programs to form Interservice Physician Assistant Program (IPAP), located at the Army Medical Department Center and School (AMEDDC&S), Fort Sam Houston, Texas. At this point, upon completion of this 24-month program, the graduates received a Bachelor of Science in Physician Assistant Studies from the University of Nebraska Medical Center (UNMC). In 2003, the curriculum expanded to meet new industry requirements and, for the first time, IPAP graduates received a Master of Physician Assistant Studies (MPAS) degree from UNMC. Realizing the challenges of adding a master’s curriculum to the already packed 24-month program, the IPAP expanded to 29-months in January 2011. Today, the program remains as redesigned in 2011, a 16-month didactic phase and a 13-month clinical phase.

Even within the Army Medical Department Center and School (AMEDDC&S), the IPAP has undergone significant organizational changes. In 2007, the IPAP joined other AMEDDC&S allied health programs in forming the Graduate School within the Academy of Health Sciences. Later in 2014, the AMEDDC&S received recognition as the Depart of Defenses Health Readiness Center of Excellence. Today, the AMEDDC&S Graduate School consists of 12 different programs from four different universities across the country. From masters programs in Health Administration to doctoral programs in Physical Therapy, the focus of medical education for the Department of Defense centers on excellence based on the highest professional standards.

This ongoing commitment to excellence remains at the forefront of the IPAP’s now 21-year affiliation the University of Nebraska Medical Center (UNMC). From the initial affiliation agreement to this ongoing partnership with UNMC, the IPAP gains national recognition and institutional support. For instance, all IPAP faculty members receive recognition as adjunct faculty ranging from instructors to associate professors. Furthermore, it was the collaborative efforts between the IPAP and UNMC in 2003 that lead to the industry leading transition from a bachelor to master degree program. This affiliation leads to graduates receiving a Masters of Physician Assistant Studies (MPAS) degree. Highlighting the success of this affiliation, in 2015, the IPAP received national recognition when the U.S. News & World Report ranked the IPAP as #11 of 171 ARC-PA accredited PA programs in the United States.

Taking a closer look at the IPAP of today, the efforts by the faculty and staff remain crucial to educating PAs for the uniformed services. Our main campus remains located on Historic Fort Sam Houston, which is now an essential component of Joint Base San Antonio (JBSA). Here all IPAP students complete their 16-month didactic phase. Phase 1 education consists of basic medical science courses intended to develop a PA student`s foundational knowledge of critical medical concepts. After completing this portion of the curriculum, students continue with their medical clerkships at one of 23 Army, Navy, and Air Force Phase 2 sites across the country. These Phase 2 sites are located at military installations with adequate medical facilities to support the rotations required to be a successful military PA. Our Phase 2 Clinical Coordinators are responsible for the administrative support and ensuring that clinical preceptors provide appropriate clinical training. This training allows IPAP students to obtain the skills necessary for becoming a successful PA. However, on top of the educational endeavors, the efforts of the IPAP faculty and staff remain focused on maintaining the highest standards of university education.

As mentioned earlier, all PA students must graduate from an ARC-PA accredited program in order to be eligible to sit for PANCE. The IPAP faculty and staff work tirelessly to ensure the IPAP complies with all civilian standards for PA education established by the ARC-PA. In fact, in 2015, the efforts set forth by the IPAP faculty and staff not only met the ARC-PA standards, but the IPAP received an unprecedented 10-year accreditation. Today, staying in compliance with the ARC-PA standards remains a committed focus of the IPAP faculty.

SECTION III: Mission, Vision, Guiding Principles

Mission Statement

To provide the uniformed services with highly competent, compassionate physician assistants who model integrity, strive for leadership excellence, and are committed to lifelong learning.

Vision Statement

To be recognized as the world-class leader in physician assistant education

Guiding Principles

To provide leadership and education of the highest quality and greatest value to our students, thereby instilling a lifelong desire for growth and learning
To immerse faculty and students in an environment that fosters a sense of academic and professional excellence
To educate the future leaders of military medicine to become the most dynamic and highest quality physician assistants possible
To demonstrate personal integrity and ethical conduct

SECTION IV: Program Objectives And Expectations

Program Objectives

Provide a quality curriculum by teaching basic sciences and a conceptual framework in the applied sciences to enable students to assimilate information and develop problem-solving skills.
Prepare students for primary care practice with an emphasis on the evaluation and treatment of mental and physical disorders.
Prepare students for their uniformed services role as primary care providers in peacetime and in conflict.
Prepare students to successfully complete requirements for certification as physician assistants.
Prepare students to contribute to the physician assistant profession in clinical practice, research, teaching, service, and community activity.
Provide a professional and educational foundation which graduates will use to develop a personal professional development plan while in the military, or as a civilian.
Develop and support academic and clinical faculty as role models, educators, clinicians, and scholars.
Support academic faculty members in their contributions to the PA profession.
Support the development of IPAP graduates as clinicians, leaders, and scholars.
Develop the future officers within the Uniformed Services.
Prepare graduates to provide medical care to patients from diverse populations.
Graduates of the IPAP will possess the knowledge and skills to accomplish the following minimum critical functions in the family practice setting:
1. Given a patient with any disease, disorder, or injury: Accurately assess and record a comprehensive history to include a chief complaint, history of present illness, past medical history, past surgical history, family history, social history, and an appropriate review of systems for any contributing symptoms to the chief complaint.
2. Given a patient with any disease, disorder, or injury: Perform both a comprehensive and problem oriented physical examination, recording both positive and negative findings appropriately, organize written notes in a standard and legible format for presentation to the supervising physician.
3. Given a history and the results of a physical examination: State the most probable diagnoses and describe the pathophysiologic process associated with each diagnosis.
4. Order, interpret, and report appropriate laboratory and radiographic findings that are necessary to present to the supervising physician for possible therapy.
5. Identify pertinent data obtained from the patient and the examination and incorporate into a problem-focused plan.
6. Plan and implement appropriate primary care treatment plans and medical education, such as applicable life style changes, within the time, equipment and supply limitations of the medical facility to which assigned. Discuss and instruct patient on a treatment plan.
7. Given the results of a history, a physical examination, and appropriate laboratory and radiographic findings, for a wide variety of disease processes and injuries, determine which clinical cases may require further medical or surgical specialty consultation for diagnosis and/or treatment.
8. Formulate treatment plans that are relevant to the patient in resolution of his/her medical problem.
9. Perform patient education and counseling for patient compliance, family planning, wellness, and health maintenance.
10. Given either environmental conditions or clinical cases: Identify clinical or social situations, which may have public health significance and ultimately recommend and implement preventive measures.
11. Given a medical or surgical emergency: Perform an appropriate initial evaluation to stabilize and manage the patient until transferred to the care of a physician.
12. Apply clinical knowledge obtained in behavioral concepts related to health care in interpersonal relationships with patients.
13. Given raw medical data (including history and physical examination), communicate this information both orally and in writing to another health care provider, in a clear, concise, and well organized manner.
14. Demonstrate personal conduct, behavior and the professional qualities required of an officer and a health care professional. Continually evaluate one's own performance as a physician assistant.
15. Become involved in the professional organizations that represent physician assistants on the local, state, and national level.
16. Participate in an interdisciplinary, collaborative approach in providing high quality, efficient and effective healthcare to our beneficiaries.

All students will be evaluated on these program-defined learning outcomes (12a-p)

Program Expectations

Expectations are attributes, characteristics or behaviors that are not explicitly part of the profession's core of knowledge and technical skills but are nevertheless required for success in the profession.

COMMITMENT TO LEARNING – The ability to self-correct, and self-direct: to identify needs and sources of learning; and to continually seek new knowledge and understanding.
INTERPERSONAL SKILLS – The ability to interact effectively with patients, families, colleagues, other health care professionals, and the community and to deal effectively with cultural and ethnic diversity issues. The ability to show respect to classmates, faculty, patients and colleagues.
COMMUNICATION SKILLS – The ability to communicate effectively (i.e., speaking, body language, reading, writing, listening) for varied audiences and purposes.
EFFECTIVE USE OF TIME AND RESOURCES – The ability to obtain the maximum benefit from a minimum investment of time and resources.
USE OF CONSTRUCTIVE FEEDBACK –The ability to identify sources of and seek out feedback and to effectively use and provide feedback for improving personal interaction.
PROBLEM SOLVING – The ability to recognize and define problems. Analyze data, develop and implement solutions, and evaluate outcomes.
PROFESSIONALISM – The ability to exhibit appropriate professional conduct and to represent the profession effectively. Treat people as they should be treated.
RESPONSIBILITY – The ability to fulfill commitments and to be accountable for actions and outcomes. Do what is right, legally and morally.
CRITICAL THINKING – The ability to question logically; to identify, generate, and evaluate elements of logical argument; to recognize and differentiate facts, illusions, assumptions, and hidden assumptions; and to distinguish the relevant from the irrelevant.
STRESS MANAGEMENT – The ability to identify sources of stress and to develop effective coping behaviors.

SECTION V: General Program Information

Abbreviated Organizational Chart

SECTION V

GENERAL PROGRAM INFORMATION

Abbreviated Organizational Chart

```

Commanding
General,
AMEDDC&S

|

Vice Provost,
HRCoE

|

Dean, Graduate
School

|

Program Director,
IPAP

IPAP Executive Officer/Deputy Program Director	\|	Medical Director, IPAP
Army, SSR	\|	Air Force, SSR
Navy, SSR	\|	Coast Guard, SSR
Academic Coordinator	\|	Phase 2, Clinical Coordinator

|

Faculty & Staff/
Academic
Counselors

|

Class Advisors

|

Students

```

Academic Schedule

The Academic Coordinator produces the daily and long-term academic schedule after input from primary and adjunct faculty, Senior Service Representatives, and the IPAP Program Director. This involves creating, updating, and posting the academic schedule to the UNMC CANVAS website, as well as forwarding the schedule updates via email to Class Advisors. Please consult your Class Leader and Class Advisor as needed for the latest information.

Changes of the daily academic schedule after the second week of the semester will be limited. If a schedule change is thought to be necessary, the written request (utilizing IPAP Schedule Change Request form) will be properly routed through the class student leader, primary instructor(s), and Class Advisor. Only the Class Advisor or Course Instructor should be contacting the IPAP Academic Coordinator regarding schedule change requests

Academic Transcripts

The IPAP has no role in maintaining or issuing student transcripts. This is accomplished by contacting the affiliate university. Download website form from http://www.unmc.edu/studentservices/academic-records/transcripts/transcript-forms.html and mail requests to:

UNMC Academic Records
984230 Nebraska Medical Center
Omaha, NE 68198-4230

IPAP Curriculum Guidance

The IPAP curricula is developed and implemented in accordance with the:

Army, Navy, Air Force, and Coast Guard educational and credentialing requirements
Accreditation Standards, per the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)
Educational Blueprint, per the National Commission on Certification of Physician Assistants (NCCPA)
Competencies for the PA profession, as approved by AAPA, PAEA, NCCPA, and ARC-PA
Interservice Training Review Organization curriculum management and program resourcing process

Program Accreditation

The IPAP is accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The next scheduled site visit will be in 2025.

Graduate Certification

As an ARC-PA accredited program, all IPAP graduates are eligible to sit for the National Commission on Certification of Physician Assistants National Certification Examination (NCCPA PANCE). Upon successfully passing this initial certification examination, the graduate PA will be able to apply for initial clinical privileges.

Professional Gear

All incoming students should arrive with a personal laptop, netbook, and/or tablet device to use after-hours during Phase I and Phase 2.

All students must acquire their own stethoscope and reflex hammer NLT the senior semester of Phase I.

Students may wish to purchase their own copy of required and/or optional medical references for personal use during or after matriculation. However, be aware that many of these references are available through the AMEDDC&S electronic library and McGoogan Library through the UNMC CANVAS learning platform.

Faculty & Staff

Program Director: LTC(P) Brian E. Burk
XO/Assistant Program Director: MAJ Kerri Van Arnem
Medical Director: Maj Jamie Robey
Clinical Coordinator: LCDR Jeffrey Bateman
Academic Coordinator: Mr. Mike Kroger
IPAP Front Office: Mrs. Maria Charles
Phase 2 Ed Tech: Ms. Stacy Walters
IPAP NCOIC: SFC Sergio Romero
Senior Army Service Representative: LTC James Jones
Senior Navy Representative: LCDR Jeffrey Bateman
Senior Air Force Representative: LtCol Bruce Callahan
Senior Coast Guard Representative: LT Jeremy Fisher
Principal Faculty (subject to change):
- Ms. Holly Booker
- MAJ Robyn L. Chalupa
- Mrs. Denise Fricchione
- Capt Kevin Graham
- Dr. James Jelen
- CPT(P) Ryan McMahan
- COL Edward Michaud
- Maj James Moore
- CPT Torrance Nevels
- LTC Vu Q. Nguyen
- LT Jose Plata
- Maj William (Chad) Roasa
- MAJ Lauris Trimble
- MAJ Kerri Van Arnem
- Mr. Richard Weber
- MAJ James Winstead
Instructional (Adjunct) Faculty (subject to change):
- Dr. Ryan Chandlee
- LTC Jose Chavez
- MAJ Richard Foucault
- LTC Tyrus Hatcher
- CPT Zachary Leftwich
- Dr. James Murray
- LTC Lawrence Petz
- MAJ(P) Teresa Pearce
- MAJ Grant Severson
- LTC Scott Schlofman
- MAJ Jason Unsworth
- Dr. Teresa Walters
- Mr. Nolan Wright

Phase I Plan of Instruction

``` ```

Course #	Course Title	Credit Hrs
Freshman Semester
IPAP 500	Anatomy and Physiology I	7
IPAP 501	Anatomy and Physiology II	7
IPAP 502	Biochemistry	4
IPAP 503	Microbiology	5
IPAP 608	Research Evaluation	2
	TOTAL SEMESTER HOURS for FRESHMAN SEMESTER	25
Sophomore Semester
IPAP 504	Clinical Laboratory	4
IPAP 505	Pathology	3
IPAP 506	Med / Law Ethics	2
IPAP 602	Pharmacology I	3
IPAP 603	Radiology	2
IPAP 604	Psychiatry	3
IPAP 606	EKG	2
IPAP 609	Gastroenterology	2
IPAP 623	Military Public Health / Dental	2
IPAP 631	Medical History and Patient Evaluation I	3
	TOTAL SEMESTER HOURS for SOPHOMORE SEMESTER	26
Junior Semester
IPAP 605	Orthopedics	4
IPAP 607	Pulmonary	2
IPAP 610	Cardiology	4
IPAP 611	Endocrinology	2
IPAP 612	Clinical Correlations I	1
IPAP 614	Pediatrics	3
IPAP 620	Neurology	2
IPAP 630	Pharmacology II	4
IPAP 632	Patient Evaluation II	2
	TOTAL SEMESTER HOURS for JUNIOR SEMESTER	24
Senior Semester
IPAP 600	Hematology/Oncology	1
IPAP 613	Clinical Correlations II	1
IPAP 615	Surgery	4
IPAP 616	Dermatology	3
IPAP 617	Obstetrics/Gynecology	3
IPAP 618	Emergency Medicine	5
IPAP 619	Infectious Diseases	3
IPAP 622	Genitourinary	2
IPAP 624	PA Professional Issues	1
IPAP 628	Otolaryngology/Ophthalmology	2
IPAP 629	Gerontology/Rheumatology	2
	TOTAL SEMESTER HOURS for SENIOR SEMESTER	27

PHASE II Plan of Instruction

IPAP 700	Surgery Rotation	5
IPAP 701	Dermatology Rotation	4
IPAP 702	Obstetrics/Gynecology Rotation	4
IPAP 703	Orthopedics Rotation	6
IPAP 704	Psychiatry Rotation	3
IPAP 705	Internal Medicine Rotation	6
IPAP 706	ENT/Allergy Rotation	4
IPAP 707	Pediatrics Rotation	5
IPAP 708	Ophthalmology Rotation	2
IPAP 709	Emergency Medicine Rotation	3
IPAP 710	Family Practice/Outpatient Medicine Rotation	4
IPAP 711	Clinical Elective Rotation	4
IPAP 712	Directed Study	2
	TOTAL SEMESTER HOURS for PHASE II	52

	TOTAL IPAP CURRICULUM	154

Course Descriptions – Phase 1

IPAP 500. Anatomy and Physiology I (7 cr)
Students will be introduced to the fundamental structural and functional principles of the human body, including aspects of basic development, genetics, cell and tissue organization, and the nervous and musculoskeletal systems. Studies include regional anatomy of the head and neck, back, trunk, pelvis and perineum, and limbs.

IPAP 501. Anatomy and Physiology II (7 cr)
Students will be introduced to the fundamental anatomy and physiology of the cardiovascular, respiratory, renal, gastrointestinal, endocrine, and reproductive systems. Diving and altitude physiology will also be included.

IPAP 502. Biochemistry (4 cr)
This course introduces the fundamental principles of metabolism (carbohydrates, proteins, lipids, and nucleic acids) appropriate for the physician assistant. These concepts will be used to discuss the chemistry of various tissues and organs and their metabolic interactions. Basic concepts of gene expression, protein synthesis and molecular biology are also presented. Clinical applications of the biochemical principles are discussed.

IPAP 503. Microbiology (5 cr)
This course acquaints students with the basic concepts of microbiology and principles of microbial defense as they relate to infection and disease. The basic principles of bacteriology, mycology, parasitology, virology, and microbial genetics are covered. Host parasite relationships and pathogenic properties of medically important species of bacteria, fungi, viruses, protozoa, and helminths are presented.

IPAP 504. Clinical Laboratory (4 cr)
The fundamental biologic principles and concepts of cell biology, cytology, histology, immunology, immuno-hematology, hematology, coagulation and formation and composition of body fluids and wastes are applied to the appropriate utilization and interpretation of laboratory analyses used in diagnostic clinical medicine. Basic laboratory exercises are used to demonstrate and learn the principles presented. Pathophysiology of diseases affecting these systems is introduced in preparation for study of the clinical disorders. Instruction in OSHA standards for laboratory practice are given.

IPAP 505. Pathology (3 cr)
This course presents the basic pathological processes associated with the pathogenesis of disease, cellular response to stress, process of inflammation, and neoplasia. A discussion of the genetic principles of inheritance and normal embryology become the framework for understanding genetic and developmental disorders. Also includes discussion of specific systems and their pathology such as; hemodynamic disorders, pathology of blood vessels, the heart, respiratory system, gastrointestinal tract, liver and biliary system, pancreas, endocrine system, bones and joints, skeletal muscle and nervous system.

IPAP 506. Med / Law Ethics (2 cr)
The course defines the medico-legal aspects of health care to include practice issues, and patient and provider rights and responsibilities. Issues concerning the stages of grief, death, and dying are also included. This course also informs students on the primary ethical theories and the methods in which ethical decisions in health care are made. Terminology, models of biomedical ethics, provider's rights and responsibilities, and steps in resolving ethical dilemmas are provided. The course also covers the basic biological, social, psychological, and counseling aspects of human sexuality.

IPAP 600. Hematology/Oncology (1 cr)
This clinical course builds upon the principles introduced earlier in the semester in the Clinical Laboratory course. The clinical manifestations of hematologic and neoplastic disorders are emphasized, as well as the current principles of diagnosis and management.

IPAP 602. Pharmacology I (3 cr)
This course is designed to provide the principles of basic pharmacology, clinical pharmacology, and pharmacotherapeutics. Key issues include the therapeutic rationale, pharmacokinetics, and pharmacodynamics of drugs. Major areas of concentration include the peripheral nervous system, central nervous system, anti-infective drugs, cardiovascular drugs, drugs of the endocrine system, anti-inflammatory agents, and gastrointestinal agents.

IPAP 603. Radiology (2 cr)
Principles and language of modern radiologic imaging, procedures, and techniques are discussed. Included are development of a systematic approach to radiology, proper preparation of the patient, safety measures, interpretation of normal and abnormal radiological findings, the limitations of radiography, special techniques and equipment and possible adverse effects.

IPAP 604. Psychiatry (3 cr)
Introduction to modern clinical psychiatry and psychiatric interviewing techniques includes recognition and differentiation of the various psychiatric disorders. Primary emphasis is placed on those personality, behavioral and psychiatric problems most likely to be encountered in a primary care setting and or on the battlefield.

IPAP 605. Orthopedics (4 cr)
This course concentrates on the care and treatment of the orthopedic patient. Focus is on the establishment of diagnosis and management of orthopedic conditions commonly encountered in a primary care setting. Orthopedic physical examination and casting skills are included.

IPAP 606. EKG (2 cr)
This course introduces the student to routine and emergent cardiovascular conditions commonly encountered in the primary care setting, with emphasis on clinical manifestations, assessment and appropriate therapeutic measures.

IPAP 607. Pulmonary Medicine (2 cr)
This course is designed to introduce the student to the fundamentals and clinical aspects of pulmonary medicine with emphasis on the clinical features of various pulmonary diseases or conditions such as asthma, COPD, pulmonary embolism, and tuberculosis, etc. and the appropriate diagnostic criteria and management of those conditions.

IPAP 608. Research Evaluation (2 cr)
This course will prepare the student to evaluate current medical literature for use in their clinical practice. Students will be introduced to epidemiology and biostatistics as well as research methodology. Epidemiology and biostatistics will include basic principles of epidemiology, history of public health, familiarization with basic statistical concepts and an overview of inferential statistics. Samples of technical writing and journal articles will be evaluated for use in clinical practice.

IPAP 609. Gastroenterology (2 cr)
This course introduces the student to the fundamentals of gastroenterology with primary focus on the history, physical exam, lab and or radiographic studies, endoscopic studies, diagnosis and treatment of those gastrointestinal disorders most commonly encountered in the primary care setting.

IPAP 610. Cardiology (4 cr)
This course introduces the student to routine and emergent cardiovascular conditions commonly encountered in the primary care setting, with emphasis on clinical manifestations, assessment and appropriate therapeutic measures.

IPAP 611. Endocrinology (2 cr)
This course introduces the student to the common endocrinopathies encountered in disorders of the pancreas, thyroid, parathyroid, pituitary, and adrenal glands. The emphasis in this course is upon clinical manifestations, differential diagnosis, diagnostic criteria and patient management.

IPAP 612. Clinical Correlations I (1 cr)
This course is the practical application of techniques learned in Patient Evaluations culminating in an objective structured clinical examination (OSCE). The focus of the course is to refine the techniques of patient interviewing, history taking, performing a physical examination, ordering diagnostic studies, establishing a treatment plan, and documenting the encounter in patient records in rotations through various outpatient and inpatient settings.

IPAP 613. Clinical Correlations II (1 cr)
This course is the practical application of techniques learned in Patient Evaluations culminating in an objective structured clinical examination (OSCE). The focus of the course is to refine the techniques of patient interviewing, history taking, performing a physical examination, ordering diagnostic studies, establishing a treatment plan, and documenting the encounter in patient records in rotations through various outpatient and inpatient settings.

IPAP 614. Pediatrics (3 cr)
This course reviews the normal growth and development of the child and covers the fundamental aspects of common childhood disorders and diseases. Instruction is also provided in the areas of physical assessment of neonatal, pediatric, and adolescent patients, preventive medicine during childhood, congenital disorders, common psychological disorders relating to pediatrics and adolescent medicine, and pediatric drug therapy.

IPAP 615. Principles of Surgery (4 cr)
This course concentrates on the care and treatment of the surgical patient. Focus is on the establishment of a diagnosis for surgical conditions with the subsequent pre- and postoperative care and management. The student will also learn to properly evaluate the effects of the principle agents of trauma seen in a military environment. Instruction and practice in suturing and starting intravenous access is included.

IPAP 616. Dermatology (3 cr)
This course focuses primarily on the clinical assessment of common dermatologic conditions found in the ambulatory care setting. It includes emphasis on dermatologic terminology, techniques and procedures.

IPAP 617. Obstetrics/Gynecology (3 cr)
This course is designed to introduce the student to the fundamental principles of obstetrics to include pregnancy, labor, and delivery, as well as introduction to normal gynecology with a focus on diagnosis and management of common gynecologic abnormalities.

IPAP 618. Emergency Medicine (5 cr)
This course covers practical aspects of assessment and management of many commonly encountered medical emergencies. Training will include initial assessment of the trauma victim, review of signs and symptoms, accompanying physical findings, and methods for diagnosis and treatment of a spectrum of emergent illnesses. Development of skills used in the clinical year include suturing, gowning, gloving, BCLS, establishing emergency airway, and performing peritoneal lavage, chest tube placement, venous cutdown, and pericardial tap.