Absences

Overview

We strongly recommend students to be present for ALL educational activities. And as stated above, for many of the educational sessions attendance is required. These required sessions are described above.

The practice of medicine is collaborative and collegial. Excellent patient care requires good communication and trust among and between colleagues. Medical education requires students to work collaboratively with each other, patients, fellow students, staff, and faculty in a regular and predictable manner.

The nature of our work as caregivers requires that we notify appropriate persons when we must be absent so that patient care is not compromised, and both clinical and educational responsibilities are fairly shared. As a supportive community that values wellness and well-being, the School of Medicine faculty, staff, and administration realize that various circumstances--emergent or otherwise--will require that members of our community must occasionally be absent from required events. Furthermore, we must work together to support each other during circumstances that take us away from required events. This policy outlines the process by which students can request absence from required duties. Failure to comply with this policy will be considered unprofessional behavior.

Absence Policy

During Foundations

During Foundations, absences from required duties will be considered for the following reasons:

• Appointments for medical care that cannot reasonably be scheduled outside your MD program responsibilities
• Acute medical illness or family emergency
• To give a scholarly presentation at an academically relevant national meeting
• Running for or holding national office in a relevant professional organization
• Religious observances
• Residency interviews
• Participation in the MD or MD/PhD interview as an invited tour guide related to the admissions process
• Participation in meetings of the EUSOM Executive Curriculum Committee and its subcommittees
• Required student meetings with deans and potential/actual Discovery mentors
• Required MD/PhD meetings, including the annual MD/PhD retreat

During the Foundations Phase, students should contact Dr. Ira Schwartz to be granted an excused absence.

Requests should be made as far in advance as possible, and always before the experience for which the student will be absent For emergent absences, students should phone AND Email the appropriate Dean. All other requests should be made in person or by email.

If the requested absence is approved, Dr. Schwartz will notify the Foundations director and the student’s Small Group Advisor.

Any required sessions or assignments that are missed must be fulfilled to the satisfaction of the course and Foundations director and the appropriate Dean. Within reason, course directors will assist students to complete all work missed during excused absences, as they deem necessary. If an excused absence does not allow for the missed work to be made up before the end of the course or phase, the student may be assigned a grade of "Incomplete" until the work is completed. If the student is unable to complete the missed work in a timely manner, as determined by the course director, the grade may be converted to "Withdrawal". The designation of "Withdrawal" would require the student to repeat the course.

Repeated unexcused absences during the Foundations Phase will be considered a professionalism concern and will be brought to the attention of the Progress and Promotions (P&P) committee. If a student has three or more unexcused absences, referral to the P&P committee could result in a letter of concern, warning, probation, or other ramifications as the committee deems appropriate.

During Clinical Clerkships

During the Application, Discovery, and Translation Phases, students should follow the Absence from Clinical Duties Policy and Process (below).

Clinical training is an essential part of medical education and represents a critical phase of the medical student experience. Given this, any absence from clinical duties (ACD) is considered a serious matter and may require the time to be made up. This includes if the absence is anticipated (for example: attendance/presentation at a national meeting, important personal events, etc.) OR unanticipated (for example: personal illness/injury or family emergency). Clerkship directors understand that circumstances will sometimes require a student to be absent from clinical duties. The following are responsibilities and general guidelines for a medical student considering an ACD:

Terms and Definitions

Absence from Clinical Duties (ACD)

This is an absence that occurs during scheduled duty hours and does not occur during mandatory time off or on additional scheduled days off from clinical service. It does not include wellness half-days. An ACD will decrease the total amount of time that a student is able to invest in clinical service activities. A student who has an ACD may be required to make up the time absent, depending on what activities were missed.

Extended ACD

This is an ACD that is longer than the limit set based on the length of the clerkship, and which will need to be made up. As above, this applies regardless of whether the absence is anticipated or unanticipated. Policies are enforced and make-up experiences are at the discretion of individual clerkship directors. An extended ACD is defined by the total length of a clerkship/rotation:

• 1-week clerkship/rotation: ≥ 1 day
• 4-week clerkship/rotation: ≥ 2 days
• 6-week clerkship: ≥ 3 days
• 8-week clerkship: ≥ 4 days

Duty hours

Duty hours are defined as time spent doing all clinical and academic activities related to the program and include patient care, administrative duties related to patient care, and scheduled educational conferences. Clinical service time may occur outside of business hours but should not exceed 80 hours/week.

Scheduled Days Off/Mandatory Time off/Wellness Half-Days

Each clerkship (except Emergency Medicine) will assign a number of scheduled days off, which includes the minimum mandatory time off from duty hours, as specified by ACGME guidelines. The total number of scheduled days off will be determined by each clerkship according to clinical service needs and schedules. Required wellness half-days are also considered mandatory time off from clinical duties and students are expected to request the allotted amount of wellness half-days for each clerkship.

Student Responsibilities

1. Students should attempt to schedule non-clerkship related activities outside of normal duty hours for that clerkship (e.g., late afternoons/evenings and weekends or scheduled/mandatory time off, or during wellness half-days).
2. Students must communicate all requests with advance notice (as soon as the need is known to the student) to the clerkship director, clerkship coordinator, and Associate Dean for Student Affairs, Clinical Services. Students must recognize that not all requests for ACD will be able to be accommodated and should be willing to prioritize their requests to assist the clerkship leadership team with their planning
3. All communication regarding requests for time off should be done in a professional manner.
4. Students who are ACD are required to collect any didactic materials/notes from lectures that they may have missed during their time away.

Guidelines

1. Advance communication with the clerkship director, clerkship coordinator, and the Associate Dean for Student Affairs, Clinical Services is required for any requested activity that could result in an ACD. Requests should be made as far in advance as possible, and always before the experience for which the student will be absent. For emergent absences, students should phone AND email the Associate Dean for Student Affairs, Clinical Services and clerkship director. Activities considered for an ACD include:
   1. Acute medical illness
   2. Appointments for medical care that cannot reasonably be scheduled outside your MD program responsibilities
   3. Meetings with Discovery Mentors
   4. Meetings or conferences at which the student is presenting (poster or podium)
   5. Important personal events (graduations and weddings of immediate family members)
   6. Residency interviews
   7. Religious observances
   8. Curriculum committee meetings
2. With advance notice, the clerkship directors will work with the student to try and avoid an ACD. This may include arranging rotations or shifts to accommodate the request or helping the student select the best days/times to attend their activity and limit time away from clinical duties. If accommodations can be made to align the student’s scheduled time off with their activity, the absence will not be considered an ACD. However, clerkship directors may not always be able to accommodate these requests. In this case, if the clerkship director permits the student to attend the activity, this will result in an ACD.
3. Emergency requests for ACD such as student illness, personal injury, or injury/illness/death of a family member should be communicated as soon as possible to the Associate Dean for Student Affairs, Clinical Services and the clerkship director and clerkship coordinator.
4. In cases of ACD without prior communication with, or approval by, the Associate Dean for Student Affairs, Clinical Services office and the clerkship director, a Professionalism Report will be filed by the clerkship director. This includes unauthorized extension of a previously authorized ACD..

Further information about common reasons for missing required educational events

Absences from Clinical Duties for Personal Medical Care

Medical students are strongly encouraged to maintain their own physical and mental health and well-being. Whenever possible, students should schedule non-emergent healthcare appointments during times that do not conflict with classroom and clinical activities. In the event an appointment must be scheduled during a required educational activity, students must request permission to be absent from required duties from the appropriate Dean (see above).

Religious Observances

The Emory School of Medicine recognizes and respects the importance of individual religious beliefs and practices. While the School of Medicine calendar includes only religious observances recognized as U.S. federal holidays, the school seeks to accommodate student religious needs reasonably and within the requirements of the academic schedule. There shall be no adverse or prejudicial effect resulting to any student requesting an absence from required duties for religious observances. Students assigned to patient care educational activities may request assignments that allow the student to meet their religious needs; on occasion, students may be asked to attend patient care activities that cannot be reasonably re-scheduled, such as on-call time with a care team. Required academic work missed as part of an absence from required duties must be made up to the satisfaction of the supervising faculty member.

Residency Interviews

During clinical clerkships, students MAY be granted one-day of absence from clinical duties for residency interviews per each two weeks of the clinical rotation. This may vary on rotations that schedule shift clinical duties (e.g., Emergency Medicine). Students should discuss and submit requests for absence from clerkship responsibilities to the Deans Office and Clerkship Director PRIOR to making travel or other interview plans. Regardless of absences for interviews, students must complete the requirements of the rotation by the last day of the rotation. Any deviation from this policy must be approved by the Associate Dean for Student Affairs, Clinical Services.

Participation in the MD or MD/PhD Admissions Process or Tour Guide

Students actively participate in the MD and MD/PhD admissions process, serving as interviewers and tour guides. Students will not be allowed to miss mandatory components of any clerkship to serve as an interviewer and tour guide.

Participation in Meetings of the EUSOM Executive Curriculum Committee and its Subcommittees

Students actively participate in the subcommittees of the EUSOM Executive Curriculum Committee. They play an invaluable role in curricular decisions. Students are allowed to attend

Required Student Meetings with Deans and Potential/Actual Discovery Mentors

During the required clerkships, students are required to meet with the Associate Dean for Student Affairs, Clinical Services or their designee. In addition, students need to meet with faculty members in order to select a mentor for their Discovery phase project. If possible, these meetings should be scheduled during a time that minimizes student disruptions in clinical care activities.