Clerkship Absence and Attendance Policy


Purpose: The purpose of this policy is to outline a clear process and set of enforceable rules for student attendance and absences during the clerkship year.

This policy will be effective as of January 1, 2020.

Background: Clinical teams expect students to make every effort to attend clinical activities, even when there are competing interests or pressures such as exam preparation. This is consistent with the expectations by patients of physicians. On the other hand, the school acknowledges the legitimate need for student access to important family or personal events, along with any required medical care; the latter must be available in a private and confidential manner. The following rules seek to balance these requirements.

Policy:

General Principles

  • Attendance during clinical rotations is mandatory, except in extenuating circumstances.
  • Attendance will be tracked by the medical school administration, clerkship directors, and clerkship coordinators.
  • Students will be granted time off for certain federal holidays.


Personal Day Excused Absences

  • Students are encouraged to take up to 4 personal days per 12-month clerkship block during the course of the MOD 4 clinical year.
  • Students can use their personal days for events such as weddings, graduations, religious holidays, tournaments, and conferences (where you are not presenting).
  • Students may also use their personal days for planned wellness days.
  • Students can request personal days by submitting the Clerkship Absence Request Form. The form is automatically sent to the Chief Operating Officer (COO) for review. The request will be approved if it meets all of the qualifications listed below.
  • Students must submit the request at least 4 weeks in advance of the scheduled absence and must meet all personal day qualifications listed below in order to receive the personal day.
  • If the student has exceeded 4 personal days for the clerkship year, the request will be flagged by the COO, and will need to be evaluated by the COO and Associate Dean for UME Clinical and Health Systems Sciences Curriculum on a case-by-case basis, before being processed by the clerkship coordinator.
  • Personal day qualifications
    • Students cannot use a personal day on the first day (orientation) of a clerkship.
    • Students cannot use a personal day to extend a school holiday.
    • Students cannot use a personal day on the day of a quiz, test, or other graded assignment where attendance on that day is necessary to receive a grade for that assignment.
    • Students cannot use a personal day during the week of a final clerkship exam.
    • Students cannot use more than 1 personal day during a one or four-week clerkship.
    • Students cannot use more than 2 personal days during a six or eight-week clerkship.
    • Students cannot use 2 or more personal days in a row.
    • Students will be allowed to use 1 of their 4 personal days for a clerkship didactic day, if necessary. However, students must notify their clerkship director in writing, and the student will be responsible for any missed work during the clerkship didactic day.
    • MD/PhD students can take up to 2 personal days during the 6 months prior to entering their MD/PhD degree program and 2 personal days during the 6 months upon returning to the clerkships after their PhD work.
    • Students will be granted the personal days as long as they meet the above criteria.

 

Non-Personal Day Excused Absences

  • Students may also be granted non-personal day excused absences for the following situations: 1) chronic illnesses/ongoing need for medical or mental health care, 2) presentation of research or other scholarly work at a regional or national meeting, 3) acute illnesses, and 4) family illness/emergency/death.
  • Chronic illnesses/Ongoing need for medical or mental health care
    • Students who are scheduled for ongoing, recurring appointments, or who have other ongoing medical or mental health appointments during a clerkship must follow the Documentation/Accommodation Process steps outlined on the Student Disabilities Services webpage.
    • Student Disabilities Services will notify the Office of Student Affairs if the request has been approved, while maintaining the student’s privacy.
    • The Director of Student Affairs will subsequently inform the student, the student’s clerkship coordinators and directors, and help accommodate the student’s needs while maintaining the student’s privacy.
    • Students should contact SDS at least 4 weeks prior to the start of the clerkship.
  • Presentation of research or scholarly work at a national or regional conference
    • Students will be allowed to use up to 2 non-personal days per year to attend a national or regional conference at which they are presenting. The day(s) should be used only for the day of the conference they are presenting (not the entire conference) and travel time.
    • Students must submit documentation that they are presenting at the conference in order to qualify for the non-personal day(s).
    • Students who will be presenting at multiple conferences (requiring more than 2 days absent) can utilize their personal day absences for any additional conference time.
    • Students are discouraged from taking additional personal days during any given clerkship if they have already requested 2 non-personal days to present at a conference. If additional days are needed within any given clerkship, students will need to make up the additional days at the discretion of the clerkship director.
  • Acute illness that occurs during a clerkship
    • Students may become acutely ill during the course of the clerkship year. Students should notify their team and their clerkship director, and complete the excused absence request form.
    • If the student requires more than 1 day off for an acute illness, they may need to submit a note from their primary care provider, and may need to make up additional time before the end of the clerkship, especially if the student has already taken off additional time (via personal days or excused non-personal days). This will be determined at the discretion of the clerkship director, and in accordance with the make-up days policy detailed below.
    • All acute illness absences will be tracked by the clerkship coordinators, clerkship directors, and medical school administration.
  • Family illness/Emergency/Death
    • Students will routinely be granted an excused absence, and the school administration will be available as needed for support. Students should inform their clerkship coordinator, clerkship director, and the Director of Student Affairs.
    • Both the school and individual clerkship will work with the student upon their return to assess any possible need for clinical make-up time, if appropriate.

 

Requesting Excused Absences

  • Students should request an excused absence at least 4 weeks in advance of any personal day, or planned, non-personal day excused absence.
  • For a weekend exception, students should email clerkship coordinators 12 weeks in advance of the start of the clerkship (only necessary for clerkships that require weekend shifts) to ensure the highest likelihood of receiving the weekend off. 
  • Occasionally, students may need to request an unanticipated absence. These are absences that occur less than 4 weeks in advance of the requested absence. Any unanticipated absence requests will need to be evaluated by the COO and Associate Dean for UME Clinical and Health Systems Sciences Curriculum on a case-by-case basis before being processed by the clerkship coordinator.
  • Approval for an unanticipated absence is not guaranteed. If the request is approved, the day will count toward one of the four personal days and the student will be directed to submit the request via the absence request form.
  • Students must submit an absence request form for all other absence requests they are seeking.
    • The information from the form will then be routed to the COO and the clerkship coordinator. Students will subsequently be notified by the COO about approval.

 

Requesting Weekend Absences

  • The following clerkships will require students to work weekend shifts: Internal Medicine, OB/Gyn, Emergency Medicine, and Pediatrics.
  • Email the clerkship coordinator at least 12 weeks before the start of the clerkship.
  • For clerkships in which students are expected to work Friday night, Saturday, and/or Sunday, requests for absences on a weekend (weekend exceptions) may not need to count as a personal day, if the request is made at least 12 weeks before the clerkship begins. Schedules may be able to be organized so that students do not have to take off an extra day.
  • The following requirements pertain to requests for weekend exceptions
    • A student can only request one weekend exception per clerkship. The clerkship director will make every effort to grant the request, but it is not guaranteed.
    • If a weekend exception cannot be granted, then the student will need to request a personal day in order to take a weekend day off.
    • If the relevant clerkship coordinator does not receive a request for a weekend exception at least 12 weeks before the clerkship starts, the weekend exception request will not be honored.

 

Unexcused Absences

  • Any student who does not notify the clerkship directors and/or the Office of Student Affairs as described above, and who does not receive formal approval, may be subject to an unexcused absence.
  • Any student with an unexcused absence may be subject to the following: 1) additional make-up days, 2) lowering of a clinical grade, and/or 3) referral to the student’s Advisory Dean and/or the Associate Dean for Student Affairs. If there have been other professionalism concerns, one unexcused absence could initiate a referral to the Student Standards Committee.
  • Repeated or habitual absences will be brought to the attention of the Associate Dean for UME Clinical and Health Systems Sciences Curriculum, the Associate Dean for Student Affairs, and the Senior Vice Dean for Medical Education. It may also result in the student’s record being presented to the Student Standards Committee for professionalism.
  • Any questions as to whether an absence is appropriate or excusable should be sent to the COO for consideration.

 

Policy for Missing Partial Clinical Days

  • Students are not permitted to miss rounds or mandatory didactic sessions during the clerkship without approval from their clerkship director.
  • Patient care should come before classroom events or extracurricular activities (i.e. non-mandatory student meetings, student interest group meetings, etc.).
  • If a student needs to excuse themselves for a non-mandatory and non-personal health activity, they must discuss the possibility with either their team or their clerkship director.
  • Any non-mandatory or non-personal health activity that requires a student to miss more than one hour of a clerkship day will need to be approved by the clerkship director.
  • Any personal health activity (i.e. doctor’s appointment) that requires a student to miss more than one hour of a clerkship day, or that interferes with performing clinical duties, requires approval from the clerkship director (unless the student has received prior approval through the Weingarten Center or Office of Student Affairs).
  • Students may need to take an excused absence personal day for any activity that requires them to leave clerkship duty for more than one hour, or that interferes with performing clinical duties in any way.

 

Make-up Days

  • The following rules apply for make-up days that occur in excess of the allowable excused/personal day absences. 
  • For any 1-week or 4-week clerkship, students are required to make-up every additional day beyond 1 day of missed clerkship duty.
  • For any 6-week or 8-week clerkship, students are required to make-up every additional day beyond 2 days of missed clerkship duty.
  • The timing and type of make-up work is at the discretion of the course director and may be scheduled during vacation periods. Make-up days which cannot be completed before the course end date will result in a grade of "Incomplete".
  • Students who are absent for a number of days deemed to be disruptive enough to prevent satisfactory completion of the clerkship through make-up days may be required to drop and retake the entire clerkship. This decision will be made in conjunction with the clerkship director(s), the Associate Dean for UME Clinical and Health Systems Sciences Curriculum, and the Office of Student Affairs.

 

Any Additional Issues

 

Policy updated 12/9/19