Medical Student Handbook

Medical Student Education

Attendance: Clerkship Level

Policy 510.30

Policy Statement

Students are expected to be in attendance on all working days during the Clerkship Level, including scheduled weekends and nights. They are required to satisfy the objectives of each Clerkship Level course. Medical students enrolled in clinical clerkship rotations are an important part of the medical community with responsibilities to patients, clinical team members, and self. Absences have a significant impact on all parties. When requesting an excused absence, students are expected to behave with integrity, to demonstrate accountability and social responsibility in accordance with the LCOM Professionalism Statement and the Student Honor Code, and to consider the impact of the absence on the clinical course stakeholders –including clerkship/course coordinators and directors, the faculty/residents who teach in the clerkship/course, and most importantly, the patients.

Policy Elaboration

It is understood that medical students may need to be absent for various reasons (e.g., unexpected illness, personal events of significance, presenting at an academic conferences). This policy statement is intended to clarify the Larner College of Medicine’s (LCOM) Office of Medical Education (OME) rules regarding planned and unplanned absences and make-up days/work. While Clerkship Directors are asked to follow these guidelines in most circumstances, certain situations may arise where the discretion of a Clerkship Director supersedes these guidelines and a student may be required to make up a day or work, even when the thresholds listed above are not met.

This policy applies to all Clerkship Level courses.

All Absences

1. All excused absences will be monitored and must be approved through the OME by the Associate Dean for Students or their designee to ensure the student is maintaining satisfactory progress toward fulfilling program and course objectives.
2. Students must submit an excused absence request for a planned absence through their “Excused Absences” academic history tab in OASIS. Upon submission, the request will be reviewed, possibly modified, and approved or not approved by the Associate Dean for Students or their designee.
3. If an excused absence request falls on the day of an exam, including a clinical skills exam, the student must also submit an Exam Delay Request.
4. The student is required to work closely with the Associate Dean for Students or their designee and Clerkship Directors to coordinate time away/absences, and to adhere to the make-up time and/or work provisions listed below.
5. For the purposes of this policy, a full day is equivalent to eight hours. Students must estimate the amount of time they will be away in their request (e.g., a specified limited number of hours, a half-day, or a full day).

Planned Absences

1. Students must submit an excused absence request at least 30 days in advance of a planned absence through their “Excused Absences” academic history tab in OASIS.
2. Students may not be absent until the request is reviewed and approved by the Associate Dean for Students or their designee.
3. The student and the OME, in collaboration, are responsible for notifying clerkship directors, coordinators, and direct supervisors (i.e., attendings and residents) of an approved excused absence.
4. Privacy will be maintained by all parties.
1. The OME will not disclose the reason for a student’s absence.
2. Students are not required to disclose the reason for their absence beyond OME.
5. Planned absences during essential activities such as clerkship orientations, overnight or weekend calls, clinical-skills exams, mid-rotation feedback meetings, and end of clerkship shelf exams are not allowed for non-medical reasons and are discouraged for healthcare appointments. Students should make a good faith effort to avoid scheduling healthcare appointments during these essential activities. If this is unavoidable, the student should explain why in their excused absence request. The Associate Dean for Students or their designee may consider exceptions if the following conditions are met:
1. The student has met with and discussed the situation with the Associate Dean for Students.
2. There are extenuating circumstances as assessed by the Associate Dean for Students.
3. The Associate Dean for Students approves the absence.
4. The student has developed a plan with the clerkship director to make-up missed time and activities.

Non-Medical Reasons

Planned absences for non-medical reasons may be requested in half-day or full-day increments for personal, professional, or academic events (e.g., weddings, cultural/religious observances, an academic conference presentations, etc.).

Medical Reasons

Students are expected to seek necessary healthcare to maintain their physical, mental, and dental well-being. Examples of necessary healthcare include stand-alone or recurring appointments for preventive health services and screening (e.g., annual check-ups, routine dental cleaning, and vaccinations), new and follow-up visits for acute illness, ongoing care for chronic illnesses, physical therapy, and counseling and psychological services. Consistent with University policies and the law, students have a right to privacy when seeking care. A student’s decision to seek healthcare during a clerkship will have no impact on their performance assessment.

1. Students requiring more than five consecutive excused absence days for a planned health-related reason, must contact the Director of Student Wellbeing or the Associate Dean for Students.
2. If a student has recurring medical appointments, the students is required to meet with the Director of Student Wellbeing prior to submitting an excused absence request through OASIS to facilitate a plan to minimize time away from clerkship rotations and maximize their clinical educational opportunities. The Director of Student Wellbeing will work with the student to identify the best time to be absent for each Clerkship Level course.
   
   For recurring healthcare appointments, the cumulative hours missed will be added up and counted towards the student’s total days missed. Eight hours of time away for healthcare appointments will equate to one missed day.

Unplanned Absences

Unplanned absences are those that are due to unexpected illness (physical or mental) or personal or family emergencies.

Unplanned absences during essential activities such as clerkship orientations, overnight or weekend calls, clinical-skills exams, mid-rotation feedback meetings, and end of clerkship shelf exams should be rare and only for significant illness or emergency. The student must develop a plan with the clerkship director to make-up missed time and activities.

Privacy will be maintained by all parties.

1. To maintain student privacy with unplanned absences, when submitting an excused absence request the student may state they have an "illness," “personal emergency,” or "family emergency" (which includes serious illness or death of a close family member). Students are not required to disclose the reason for an unplanned absence beyond this.
2. The OME will not disclose the reason for a student’s absence.

Making Up Missed Clerkship Level Days/Work

1. For any reason, planned or unplanned, students are allowed a maximum of ten days away from the Clerkship curriculum.
1. For any six- or seven-week rotation, students are allowed a maximum of two days of excused absence, anything over this will require make-up days/work.
2. For three and a half-week rotations, students are allowed a maximum of one day of excused absence, anything over this will require make-up days/work.
3. For one-week bridge rotations, students are allowed a maximum of four hours of excused absence, anything over this will require make-up days/work.
4. For any two- to three-week block within a clerkship, i.e., a two-week inpatient block in Pediatrics or a two-week block on labor and delivery, students are allowed a maximum of one day of excused absence, anything over this will require make-up days/work.
2. Any student missing more than ten days throughout their clerkship year will be referred to the Associate Dean for Students for further discussion to assess the student’s need for extra support, and the student will be required to make up days/work.
3. Make-up days may fall on weekends, holidays, vacation time, or night shifts and be done when it works best for the clerkship and does not interfere with the education of other learners.
4. The student must work with the clerkship director to determine the appropriate make up time and activities.

Applicability of the Policy

Clerkship Level Students

Related Larner College of Medicine Policies

• 540.24 Examination Delays
• 560.00 Satisfactory Academic Progress

• 620.00 Student Honor Code

Related University of Vermont Policies

Not Applicable

Related Liaison Committee on Medical Education (LCME) Standard(s)

8.8 Monitoring Student Time

History

• 05/20/2014 Policy Adopted [Medical Curriculum Committee]
• 08/26/2014 Policy Revised [Medical Curriculum Committee]
• 07/21/2015 Policy Revised [Medical Curriculum Committee]
• 06/19/2018 Policy Revised [Medical Curriculum Committee]
• 09/18/2018 Policy Revised [Medical Curriculum Committee]
• 03/17/2020 Reformatted [Medical Curriculum Committee]
• 09/30/2020 Policy Revised [Medical Curriculum Committee]
• 12/7/2020 Policy Revised [Medical Curriculum Committee]
• 12/15/2020 Policy Edited [Medical Curriculum Committee]
• 02/16/2021 Policy Edited [Medical Curriculum Committee]
• 02/15/2022 Policy Revised [Medical Curriculum Committee]
• 03/21/2023 Policy Revised [Medical Curriculum Committee]

Policy Oversight

Assistant Dean, Clerkship Curriculum

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