Absence Policy

The T.H. Chan School of Medicine policy regarding absences from both required preclinical and clinical experiences is intended to maximize the learning experience for each student and is aligned with the expectations of practicing physicians. Medical students are part of a community of learners with responsibilities to self, peers and patients in the learning environment. For required curricular elements, absences may have a significant impact on all learners; team- and problem-based learning is optimal when all participants are present and engaged. Additionally, assessments of student competency and performance are arranged within the context of our integrated and sequential curriculum; inability to complete assessments in a timely manner may have a negative impact on the learner’s subsequent educational experience.

This absence policy addresses each of the following:

1. Timing of requests for an excused, planned absence
2. Timing of makeup work when assigned
3. Frequency and number of absences in the preclinical and clinical years
4. Planned vs unplanned absences

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Unplanned (Vital Needs) Absence Policy
(all curriculum years)

Unplanned absences must be brought to the attention of the course/clerkship director as well as the direct supervisors in the clinical years, as soon as possible, to obtain approval for the absence. Unplanned absences are those that are due to unexpected illness, personal or family emergency. Students will be excused from course or clinical responsibilities upon notifying the course director. Unplanned absences will be recorded, in line with established policies and expectations of a work environment, to ensure that students remain on track with reaching educational goals and expectations, and that the number of absences does not cause an undue burden for students or courses.

To maintain student privacy, students may state they have an "illness", "family emergency" (which includes serious illness or death of a close family member), or a "medical appointment"; the student is not required to disclose details. However, students may be asked to provide documentation (e.g. a doctor’s note vouching for illness lasting more than 2 days). 

• While non-critical illnesses of a child or dependent family member or unexpected dependent school/program closures are not considered emergencies; we understand that these may pose a challenge for students. Accordingly, students should proactively anticipate that these challenges can occur, and should make back-up arrangements in advance for these unexpected circumstances. Additionally, students are encouraged to reach out to Student Affairs early to determine whether resources are available to support students with these unexpected events.
• Students are expected to report to school/work in inclement weather, unless otherwise directed through the school’s Inclement Weather Policy.
• For anticipated recurring absences related to chronic illness or physical/medical concerns, or any illness expected to impact full participation in coursework for a period of more than 1 week, students will be referred to the Americans with Disabilities Act/

Student ADA policy (https://www.umassmed.edu/ada/) to obtain accommodations for the possibility of recurrent absences.

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Planned Absence Policy –
Discovery Phase Curriculum

The Discovery Phase curriculum offers a great deal of flexibility, as learners have the option to participate in many classes in person or remotely through lecture capture. However, some sessions do have required attendance. Required sessions will be noted on the curriculum calendar at the beginning of the semester. These requirements are in place due to the specific content or nature of the material being taught, such as laboratories, or clinical experiences with patient interviews.

Process to request a Planned Absence from a required preclinical curricular activity: 

• Requests must be submitted at least 30 days in advance. Requests made with less than 30 days’ notice may be denied other than for unusual circumstances or medical need.
• Requests must be submitted using the Planned Absence Request Form.
• Requests will be reviewed and approved by the Office of Student Affairs, in conjunction with course leadership.
• Student Affairs will notify the student if the request is approved or denied.
• A TOTAL of 3 days of planned absence time may be used in the discovery phase curriculum.

Approval for planned absences may not be granted if they impact key, required course components or if they create undue hardship for the course, at the discretion of the course director.

Examples: teaching sessions with patients, laboratory teaching sessions, other structured teaching experiences, end of block exams or major assessments

Some sessions cannot be rescheduled and an equivalent makeup assignment may not be feasible due to the nature of the educational experience. Accordingly, in some cases, absence may be granted with loss of points for the session, at the discretion of the course director.

Students with an Approved Absence from a required teaching session may be required to submit makeup assignments for the session and should discuss this with the course director. The grade for the preclinical course will be recorded as Incomplete until the required make-up is completed.

Depending on the nature of the session, options for rescheduling some examinations may only be offered during vacations/breaks.

Examples: required small group/laboratory examinations.

Options for the timing of rescheduled exams (choice is at the discretion of the course director)

• During a designated WIN week
• On the first date/time close to the scheduled exam on which the student has no formal curriculum sessions/events scheduled
• During another courses retest period (WIN week), during the Step 1 study period, or in the summer break.
• At an alternate site with a proctor approved by the course directors (note: this option will be limited to unusual circumstances) 

Absence for Religious Observation, Preclinical Years

Preclinical students will be excused from exams or required sessions on days of religious observance and must follow the process above for rescheduling missed exams/sessions.

Planned Absence Policy – Preclinical Years (FOM2) – only to be applicable for FOM2 in the 2022-2023 academic year

The preclinical curriculum offers a great deal of flexibility, as learners have the option to participate in many classes in person or remotely through lecture capture. However, some sessions do have required attendance. Required sessions will be noted on the curriculum calendar at the beginning of the semester. These requirements are in place due to the specific content or nature of the material being taught, such as laboratories, or clinical experiences with patient interviews.

Process to request a Planned Absence from a required preclinical curricular activity: 

• Requests must be submitted at least 30 days in advance. Requests made with less than 30 days’ notice may be denied other than for unusual circumstances or medical need.
• Requests must be submitted using the Planned Absence Request Form.
• Requests will be reviewed and approved by the Office of Student Affairs, in conjunction with course leadership.
• Student Affairs will notify the student if the request is approved.
• 5 full days or 10 half days of planned absence time is allotted in FOM2.

Approval for planned absences may not be granted if they impact key, required course components or if they create undue hardship for the course, at the discretion of the course director.

Examples: teaching sessions with patients, laboratory teaching sessions, other structured teaching experiences, major exams or assessments, specific course or clerkship orientation/transition events

Some sessions cannot be rescheduled and an equivalent makeup assignment may not be feasible due to the nature of the educational experience. Accordingly, in some cases, absence may be granted with loss of points for the session, at the discretion of the course director.

Students with an Approved Absence from a required teaching session may be required to submit makeup assignments for the session and should discuss this with the course director.

The grade for the preclinical course will be recorded as Incomplete until the required make-up is completed.

Depending on the nature of the session, options for rescheduling some examinations may only be offered during vacations/breaks.

Examples: laboratory examinations. 

Options for the timing of rescheduled exams (choice is at the discretion of the course director) 

• During a designated study time in advance of the scheduled exam
• On the first date/time close to the scheduled exam on which the student has no formal curriculum sessions/events scheduled
• During the course’s retest period, which may occur during winter or spring break, during the Step 1 study period. Retest periods will be noted on the academic calendar at the start of the academic year and in the course handbook/syllabus.
• At an alternate site with a proctor approved by the course directors (note: this option will be limited to unusual circumstances) 

Absence for Religious Observation, Preclinical Years 

Preclinical students will be excused from exams or required sessions on days of religious observance and must follow the process above for rescheduling missed exams/sessions. 

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Planned Absence Policy – Clinical Years
(CCE and AS) 

Students in their clinical years of training serve an important role as part of the team and are expected to fulfill the expectations of the clinical experience to the best of their abilities. The Clinical Years Planned Absence Policy applies to all clinical rotations, including Core Clinical Experiences, Flexible Clinical Experiences, the Interstitial Curriculum and all Advanced Studies (AS) required and elective rotations. Students should follow the policies of the host institution during AS year Away electives. 

Students in the clinical years have a minimum of 4 weeks of vacation each year, as listed on the official academic calendar on the Student Affairs website. In addition to scheduled vacation days, a maximum of three planned absence days are allowed during the entire, collective course of the Core Clinical Experiences and Interstitial Curriculum. Planned absences may be requested for personal, professional or academic events. Planned absences may be requested in half-day or full-day increments and will be tracked and approved through the Office of Student Affairs. 

During the Family Medicine, Internal Medicine, OB/Gyn, Pediatrics, Psychiatry, and Surgery clerkships, students may use up to two planned absence days during a single clerkship. During the Neurology clerkship, students are only allowed to use one of their planned absence days, given the shorter duration of the clerkship.

Process to request a Planned Absence from a required CCE or AS curricular activity 

• Requests must be submitted at least 30 days in advance. Requests made with less than 30 days’ notice may be denied other than for unusual circumstances or medical need.
• Requests must be submitted using the Planned Absence Request Form.
• Requests will be reviewed and approved by the Office of Student Affairs in conjunction with course leadership.
• Student Affairs will notify the student if the request is approved. 

Approval for planned absences will not be granted if they impact key, required course components or if they create undue hardship for the course, at the discretion of the course director. 

Planned absences are not permitted during the Required Advanced Studies Sub-Internships, due to the unique structure and expectations of these experiences, and for the following reasons: 

• The Advanced Studies year has extensive flexibility and time off between rotations.
• Student sub-interns are essential members of the team and sometimes are assigned to teams in place of an intern, to allow the student to develop advanced clinical skills.
• Absence from the care team has a significant impact not only on the student experience but also on patient care and the function of the team. 

Accordingly, students should not enroll in a Required Advanced Studies Sub-Internship during times when planned absences may be anticipated, such as absences for residency interviews or personal/family events. 

Absence for Religious Observation, Clinical Years 

Clinical students are permitted to request planned absence days for observance of religious holidays, provided the request is made at least 30 days in advance of the planned absence. Students may use their 3 personal days for religious observation, or they may choose to make up the time on a weekend, if this can be arranged with the clerkship/course director. If time away for religious observance is made up, the student will still have 3 personal days available during the CCE year. 

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Making Up Missed Days During the Clinical Years (CCE and AS) 

Each clinical course in the Core Clinical Experiences and Advanced Studies years has an internal policy regarding make-up for missed days, regardless of the reason for the absence (planned or unplanned). Make-up will be required in any of the following circumstances, regardless of the reason for the absence, in order to ensure a consistent and complete educational experience for each student: 

• missing more than two days of the Surgery, Medicine, OB/Gyn, Pediatrics, Family Medicine, or Psychiatry clerkship
• missing more than one day of the Neurology clerkship (given the condensed nature of this particular clerkship, 3 weeks in duration)
• missing more than one day of any single Advanced Studies Elective or Required Advanced Studies Rotation
• missing key, required components of the course, regardless of the amount of missed time 

The grade for the clinical course will be recorded as Incomplete until the required make-up is completed. The make-up plans may vary based on course length, activities missed, and availability of additional supervision. The course director will assign make up activities, which may include additional written or clinical work. Rotations may impose a grading penalty for time missed that is not made up, as outlined in the course syllabus/handbook. 

Frequent absences beyond those scheduled as noted above may impact a student’s personal educational experience. If time off is needed beyond that provided through vacations and that allowed by this policy, students are encouraged to speak with their Learning Communities Mentor regarding a short leave of absence or interruption of clinical duties. 

All absences in the preclinical and clinical years, whether planned or unplanned, will be processed through the Office of Student Affairs for tracking purposes. 

Applicability: All T.H. Chan School of Medicine Students 

Responsibility: FOM1 Curriculum Committee, FOM2 Curriculum Committee, Clerkship Directors Committee, Advanced Studies Curriculum Committee 

Date Revised: April 24, 2022 

EPC Approved: July 11, 2022