Attendance, Time Off, and Personal Days Policy

Attendance Time off Personal Days Policy

Jump to: Clerkship-Specific Restricted Days

Policy Statement

This policy addresses the expectations for student attendance and the procedures for requesting time off and defines the procedures and expectations of students taking excused absences during their medical school.

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 impact either 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, additional policies around personal days for the core clerkship year have been developed by the school.

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

Definitions

Students must participate in the curriculum as designed and scheduled to receive university credit. The curriculum cannot be redesigned to meet the individual needs of students, but the school will be flexible to help students through unanticipated absences and other reasons listed below.

In general, students should not miss more than 5 total days in any academic year.  Any students with greater than 5 absences within an academic year will need to make up any time missed (timing will depend on when it can be accommodated by the clerkship or course).  Any student requesting an absence for an unexcused reason for more than 5 days will be asked to provide a petition to the SEPC.

A student can be placed on an emergency short term leave for up to 14 days. This absence reasons must fall within the excused absences listed below and be an unanticipated event. If the matter is confidential or related to health matter, the student should meet with a Student Affairs Dean.

Excused absence:

  • across ALL years includes:
    • 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 other situations by special permission from the course/clerkship director)
  • in the third and fourth year, excused absences also include:

Personal Days: a day 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: LPA, OSCE/OCRA, End of Year Assessment and Shelf Exam days are generally restricted but will be excused for unanticipated or unavoidable emergencies. 

  • The make-up date for LPAs will be within 3-4 days of the original date and will generally not be given after the second business day of a new module’s start date due to risk of missing required content. LPAs can also be made up during reexamination and remediation dates listed on the calendar.    
  • Shelf exams can only be made up on a date when shelf exams are being regularly administered AND the student cannot make up a shelf exam when they have another shelf exam scheduled or are on a rotation that has a shelf exam at the end of the block for risk of jeopardizing performance on both exams. Shelf exam can also be made up on the remediation dates listed on the academic calendar.
  • OSCEs and OCRA exams take a significant amount of administration and will be scheduled only on course determined remediation dates and at the discretion of the course/clerkship director.
  • 3rd year restricted days – personal day is not permitted across all clerkships, as missing these activities will be detrimental to the student’s learning experience are listed on the clerkship site. Please see “restricted dates.”

Notification Expectations

Students must use the online absence forms to report their absences in all four years.

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 8 weeks before the start of the module or course given that the dates are known well in advance. A change to religious needs will be accommodated later but should be the notification exception.
  • Conference requests must be made at least 8 weeks before the required attendance. It is recommended that students notify faculty as soon as the dates are known.
  • 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 through the absence form unless it is a restricted date.
  • If a student will be absent for more than 3 days in a row, notify course directors in an email and it will be discussed with the ADME.
  • For personal days, see “Personal Days in the Core Clerkship Year” section below

Extended Absences

If a student is absent from the required pre-clerkship curriculum for 5 or greater consecutive days, the student is required to contact the course director(s) to discuss making up the academic time lost and cc the ADME. 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 make the time up in another academic year.

A student can be placed on an emergency short term leave for up to 14 days. This absence reason must fall within the definition above. Students with absences that exceed 14 business days will be asked to meet with the Associate Deans of Medical Education and Student Affairs to discuss a potential leave of absence. Any exception to policy will need to be submitted as a petition to the Student Evaluation and Promotions Committee.

Medical Student Time Off During the Clerkship and 4th Year Curriculum

Professionalism in patient care requires reliable attendance.

Responsibilities

Clerkship directors will not penalize students or make assumptions regarding interest when students take a personal day or excused absence 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 (including unexcused, excused and personal days) 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. Clerkship and rotation directors have a limited number of days and sites for make-up activities. Therefore, the student will be expected to be available during and attend the dates offered, with the exception of the reasons listed in the excused absence policy

Personal Days in the Core Clerkship Year

Procedure

Third-year students are allowed three (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 one personal day can be taken on any individual clerkship. Personal Days should be requested as early as possible but not less than 24 hours before the requested date. Requests made after that time will likely be denied. Students must complete the following procedures 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 dates 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

In addition:

  • All requests for time off must be submitted through the online absence form as soon as the interview is scheduled.
  • 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.
  • Students may request no more than 3 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.
  • 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.
  • Students needing more than 3 days off in a 4-week rotation do not meet the credit requirements unless the time can be made up within the 4 week rotation and documented before the final grade is submitted.

 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.

Clerkship-Specific Restricted Days

All Clerkships
  • Clerkship orientation day
  • Site orientation day (second day of clerkship)
  • End of clerkship exam or OSCE
  • Assignment in which a student has responsibilities that would impact the clerkship, i.e. overnight or weekend shift or call. (Unless the student can make arrangements for coverage)
Emergency Medicine
  • Didactic days – Mondays (9am-12pm)
  • Residency Conference days – Wednesdays (8am-1pm)
Family Medicine
  • Didactic days – Monday and Tuesday of week 1; Monday of Weeks 2, 4, and 5 (Days of the week may be adjusted if falling on a holiday week)
Medicine
  • The first day on a new team or at a new site (this includes 1st and 2nd day of rotation due to clerkship and site orientation and the 1st day of Week 5)
  • Any day of the 8th week. This is a really limited time frame when students will be 1) Completing final assessments including OCRAs and Directly Observed H and P assessments, and 2) Reading days are assigned during these times. Due to these other obligations, the students will already have limited facetime with their teams. Additional scheduled absences, such as personal days, will significantly limit preceptors’ abilities to complete student CSEF assessments.
Neurology
  • Didactic Days-Every Tuesday
  • Clerkship orientation days
  • Last Wednesday of clerkship
  • End of clerkship exam or OSCE
  • Weekend days
Ob/Gyn
  • Clinical Application Days-Every Wednesday
  • BMC/Lahey Students: Days assigned to student-run urgent (PACES) clinic
Pediatrics
  • BMC/BCH
    • Ambulatory Clinic Rotation: cannot miss primary care clinic sessions, can miss a subspecialty clinic if that is all that is scheduled that day.
    • Last week of the clerkship (Monday-Wednesday) if at BMC except under specific circumstances (please discuss with clerkship director/coordinator)
  • South Shore Hospital: no PD during the Ward /Nursery Week
  • All students:
    • Nursery rotation: cannot miss any days if your rotation week is ≤ 3 days long (unless your site can make up that time at a later date)
    • Didactics – must be available for any scheduled teaching sessions each day
    • Orientation
Psychiatry
  • Clerkship orientation – day 1 of week 1
  • Didactic days – Thursdays, weeks 2-5
  • MFA visit
  • OSCE
Radiology
  • Quiz days
Surgery
  • First day at any site or new service
  • Last week of clerkship: Monday, Tuesday, Wednesday