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Attendance, Time Off, and Personal Days

University Policy

BU Chobanian & Avedisian School of Medicine Policy

Policy Statement

This policy addresses the expectations for student attendance and the procedures for requesting time off, and it defines the procedures and expectations of students taking personal days during their required clerkship experiences.

Purpose

Developing competency to practice medicine within four years requires reliable attendance. This policy formalizes the process for requesting time off for both planned and unexpected absences during the four years of medical school. The clear communication of expectations between students and course and clerkship directors will permit flexibility within reasonable limits in a way that does not either impact education or reflect on a student’s professionalism.

As part of becoming a professional, medical students should have the flexibility to address personal and professional needs at their discretion. In the clerkship year, as students transition to more of a professional work environment, they gain the responsibility of a working professional yet do not have the agency to attend to their personal needs. As such, the policies around personal days for the core clerkship year have been developed by the Student Affairs (SAO) and Medical Education (MEO) offices in conjunction with the clerkship directors.

In addition to addressing issues of wellness and professional development, this policy will teach students the importance of time management and managing days off.

Definitions

Excused Absences

  • Across ALL years, excused absences include:
    • Acute illness (physical or mental health)
    • Diagnostic, preventative, and therapeutic health services (including sick days)
    • Religious observances
    • Jury duty
    • Unanticipated family/personal emergencies
    • Conferences (only if the student is presenting, is an officer in a national organization, or in other situations by special permission from the course/clerkship director)
  • In the third and fourth years, excused absences also include:

Personal Days: Days during a required clerkship in the third year when a medical student will be excused from the rotation and is not required to state why they are taking the day.

Restricted Days: Days within a clerkship where taking a personal day is not permitted across all clerkships, as missing these activities will be detrimental to the student’s learning experience. Also referred to as “blackout dates” or “restricted period.”

Notification Expectations

For all planned time off, the student must notify the course, module, or clerkship director as far in advance as possible:

  • Religious holiday notifications should occur before the start of the academic year.
  • Conference requests must be made at least 8 weeks before the start of the module or course.
  • For all excused absences, the student must contact the module or course director and coordinator to report the absence and its expected length as soon as possible and should, unless an emergency, be before the required experience starts.
  • If a student will be absent for more than 3 days in a row, discuss with the Associate Dean of Medical Education (ADME).
  • For personal days, see the “Personal Days in the Core Clerkship Year” section below.

Extended Absences

If a student is absent from the required preclerkship curriculum for 3 or greater consecutive days, the student is required to contact the course director(s) to discuss making up the academic time lost. The registrar, an SAO Assistant Dean or Associate Dean, and ADME must also be informed of all absences in the preclerkship or clerkship curriculum with 3 or greater consecutive days of absence. Every attempt will be made by the course/clerkship directors to help the student make up sessions, if possible. If the time cannot be made up, the student may be required to repeat the course or clerkship.

Medical Student Time Off During the Preclerkship Curriculum

Students in the first and second years are encouraged to attend all class sessions to fully benefit from the preclerkship curriculum.

Attendance of the following sessions is MANDATORY:

  • All sessions in which patients are present
  • All sessions that are designated as Core Integrated Cases
  • All sessions in the Doctoring 1 and Doctoring 2 courses
  • All start-of-year Orientation sessions
  • Any large-group discussion or small-group discussion designated and approved by the Medical Education Committee as mandatory (this will be designated approximately 2 months in advance)

Non-mandatory sessions may have assessment value linked to quizzes and/or participation.

The maximum number of missed mandatory sessions in each preclerkship course may be found in the specific Course Policies.

Medical Student Time Off During the Clerkship and Fourth-Year Curriculum

Professionalism in patient care requires reliable attendance. Any third- or fourth-year student with more than 3 absent days in a 4-week block, 4 days in a 6-week block, or 5 days in an 8-week block may be asked by the clerkship director to make up days if there is a concern that there is not enough information to assess or lack of exposure to the core components of the clerkship.

Responsibilities

Clerkship directors will not penalize students or make assumptions regarding interest when students take a personal day.

Students must understand that there are a minimum number of experiences required for valid assessment of their performance on a clinical clerkship. Students must meet all required experiences for a clerkship and as such, students will not be able to meet expectations of a third-year clerkship if too many days are missed. Total absences of more than 3 days in a 4-week third-year clerkship, 4 days in a 6-week third-year clerkship, or 5 days in an 8-week third-year clerkship will require notification to the Associate Dean of Medical Education, who, in collaboration with the clerkship director, determines if the clerkship needs to be repeated or if the missed time can be remediated. If there are concerns with multiple absences, the clerkship director will notify the Associate Deans of Student Affairs and Medical Education.

Making Up Time in Clinical Experiences

For clinical experiences in the clerkships, the student must be available to make up any time off at the discretion of the clerkship director if the minimum number of experiences is not met or the student cannot be evaluated.

Personal Days in the Core Clerkship Year

Procedure

Third-year students are allowed 3 personal days for each half of the clerkship year. Unused personal days from the first half of the clerkship year will not roll over into the second half of the year. This does not apply to fourth-year students.

No more than 1 personal day can be taken on any individual clerkship. Personal days should be requested as early as possible but not less than 2 days before the requested date. Requests made after 12:00 pm must be made at least 3 days before the requested date. Requests made after that time will likely be denied. Students must complete the procedures below to take a personal day.

Personal days are restricted as follows:

  • Clerkship orientation day
  • End of clerkship exam or OSCE/OCRA
  • Assignment in which a student has responsibilities that would impact the clerkship, e.g., overnight or weekend call (unless the student can make arrangements for coverage)
  • Clerkship specific restricted dates that will be clearly outlined on the MEO website
Steps that must be completed before personal day is granted:
  • Student completes the online Core Clerkship Personal Day request Form, indicating the clerkship and date requested.
  • Student attests that the personal day request does not fall on a clerkship restricted day.
  • The clerkship director or coordinator receives an email notification of the request via an email generated by the Registrar’s personal day system.
  • The Registrar reviews the student’s personal day log and, if the student has not previously used all personal days, notifies the clerkship director and clerkship coordinator via email.
  • The clerkship coordinator is responsible for confirming that the requested date does not fall in a restricted period and notifies both the student and the service attending or preceptor that the absence request is approved.
  • Student is responsible for notifying their team/preceptor of the personal day absence and confirming patient coverage at least two (2) business days prior to the personal day. Notification must be sent via email to the team, copying the clerkship director and clerkship coordinator.
    • Students should send a reminder 24 hours prior to the personal day reminding their team/preceptor and clerkship of the upcoming personal day, copying the clerkship director and clerkship coordinator to provide additional support and verification if needed
Standard notification template to use with teams/supervisors 24 hours prior to personal day:

To: Team (resident and attending), supervisor, clerkship director, clerkship coordinator

This is a reminder that tomorrow is my approved day away from the clerkship. I will return the following day. I have obtained coverage for my patients, where relevant. If there are any concerns, please contact my clerkship director, who is CC’d here.

Thank you,

[Student Name]

Specific Requirements for Residency Interviews

Students who need time away from their clerkships for residency interviews are permitted to request up to 12 days off during interview season, which runs from October 1 through February 15 of each academic year. In addition:

  • All requests for time off must provide the rotation director with written confirmation of the interview date and location.
  • Students may request no more than 4 days off for interviewing during any 4-week rotation, and no more than 2 days over any 2-week rotation. This includes partial day absences of greater than four hours. Students will be required to make up time off at the rotation director’s discretion.
  • Students who require more days off than permitted under this policy must arrange with the rotation director to make up the missed days. Missed days cannot be made up by taking time from other rotations.
  • Students are not permitted to take more than 2 days off in any core clerkship for residency interviews.

Relevant LCME Element(s): 8.8 Monitoring Student Time; 12.4 Student Access to Healthcare Services

Approved by the Medical Education Committee (MEC) on March 19, 2018.
Revised by the Medical Education Committee (MEC) on October 24, 2023.

Related Bulletin Pages

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