Policy Abstract

The Attendance Policy for Clinical Rotations details expectations for attendance and time off service during clinical rotations.

Reason for Policy

This policy sets the expectation for medical student attendance during clinical rotations. UAB Heersink School of Medicine follows existing Accreditation Council for Graduate Medical Education (ACGME) guidelines for work hours.

ACGME Common Program Requirements Section VI.F.2.D Clinical Experience and Education
“Residents must be scheduled for a minimum of one day in seven free of clinical work and required education (when averaged over four weeks)”

Scope

This policy applies to all UAB Heersink School of Medicine students and visiting students participating in clinical rotations and details medical student attendance expectations during clinical rotations.

Policy

Clinical training is an essential part of medical education and represents a critical phase of the medical student experience. Clinical training involves building a fund of knowledge as well as developing the professional skills to serve patients and support the healthcare team. Given this, any absence from clinical duties can negatively impact both the educational experiences and patient care.

The Heersink School of Medicine follows existing ACGME guidelines for work hours. Based on the ACGME policy, students should expect to receive at least 1 day off per week averaged over a one-month period. Weekends and UAB designated holidays (e.g. Martin Luther King, Jr. Day; Independence Day; Thanksgiving Day; other government-designated holidays occurring during scheduled courses) are considered workdays in this policy. Ultimately, days off will be determined by each clerkship and clinical course according to service needs and schedules.

Procedure

Required Core Clerkships

• Students are expected to be present for all required clerkship activities unless otherwise specified by the clerkship’s director(s). This includes activities on weekends (on-call or post-call activities), at night (night float), and on holidays (on-call or post-call activities). Weekend days when students are not required to participate in clerkship activities are off days to invest in self-care activities or preparation for the Clerkship shelf exam.
• MS3 clerkship students will be dismissed at noon on the day prior to a shelf exam on a 4-week Clerkship and will have the day prior to a shelf exam off on an 8-week clerkship.

Clinical Rotations Other Than Clerkships

• To preclude the possibility of a student being on-call two consecutive days across two rotations, students should not be required to take night call or overnight shifts on Sundays prior to the start of a new rotation on a Monday. 

UAB Designated Holidays

• Clinical students are expected to report to work, if they are on call or post-call on a holiday.

Absence from Clinical Duties

The Heersink School of Medicine recognizes that circumstances may arise necessitating absences from clinical rotations. An absence from clinical duties will reduce the amount of time the student can participate in clinical training. Any absences (unexcused or excused) over the allotted amount (see Rotation length and time allotted for excused absences table below), will trigger review by the Associate Dean for Undergraduate Medical Education (UME) and the Assistant Dean for Clinical Education.

Students participating in longitudinal teaching activities such as Clinical Teaching Assistantships, Anatomy Teaching Assistantships or Simulation Teaching Assistantship are to schedule their involvement in these activities to reduce time away from clinical duties.  Clinical and patient needs should always be prioritized.  Students are to obtain permission from the resident and attending providing student oversight to leave clinical duties to participate in these teaching activities.  Students are expected to return to clinical duties when the teaching activity ends.  Excessive time away will trigger review by the Associate Dean for Undergraduate Medical Education (UME) and the Assistant Dean for Clinical Education

A student with an absence from clinical duties may be required to make up the time missed, regardless of whether the absence was excused or not. Absences requiring make-up time are based on rotation duration and enforced at the discretion of the clinical course director. Days off are not considered absences. 

Rotation length and time allotted for excused absences:

• 2-week clinical rotation: ≤ 1 day
• 4-week clinical rotation: ≤ 2 days
• 8-week clinical rotation: ≤ 4 days

Criteria for Excused Absence from Clinical Duties
Students may be excused from mandatory activities or examinations with proper documentation and approval, only in the case of an incapacitating medical issue or hospitalization, or if there is a death or serious illness of a loved one. Requests for excused absences associated with giving a presentation at a professional conference may be considered. Specifics are further detailed below.  In general, students should notify the course director, their medical team, and the respective campus Medical Student Services office of their absence.

Students may also be excused if they have an approved accommodation related to absences. Students who may need reasonable accommodations based on disability under Section 504 of the Rehabilitation Act and/or the ADA must register with UAB Disability Support Services to determine eligibility for accommodations. While disability approved accommodations for absences will be respected, students must ultimately complete the required time on a Clerkship to be eligible for credit.

Make-up Policy for Excused Absences from Clinical Duties
During clerkships and clinical rotations, students will make up missed days after coordinating with the rotation’s leadership and within 12 weeks from the end date of the rotation. If make-up time cannot be scheduled within 12 weeks, the matter must be brought by the student and the clinical rotation's leadership to the Associate Dean for Undergraduate Medical Education and the Assistant Dean of Clinical Education for consideration of an extension. A grade of Incomplete may be required in cases where students are unable to complete coursework by the time grades are due.

Reasons and Procedure for Excused Absences from Clinical Duties

Personal Illness, Medical Issue, or Hospitalization
In such cases, the students should notify their clinical team, the leadership of the rotation, and their corresponding Medical Student Services representative. Students must report their absence through the Heersink SOM Absence Notification System. Students should upload a letter/excuse from a healthcare professional to the Absence Notification System as soon as feasible. The letter/excuse content should only validate the date(s) of the missed activity and the date that the student may return to school or work. Medical Student Services representatives will communicate the interval that the student’s absence is approved to Undergraduate Medical Education and/or the rotation’s leadership. Approval is required prior to scheduling any make-up time with the rotation’s leadership.

Bereavement
In cases of serious illness, bereavement, and/or funeral attendance for loved ones, students should notify their clinical team, the leadership of the rotation and their corresponding Medical Student Services representative. Students must report their absence through the Heersink SOM Absence Notification System. The student and the rotation’s leadership will work on a plan to make up needed dates. The Office of Undergraduate Medical Education may be called in as needed.

Conference Presentation/Medical Training Opportunities
Students invited to present at a medical or professional conference may request consideration for an excused absence with the rotation’s leadership and the Office of Undergraduate Medical Education prior to committing to attend. Students should submit requests as soon as possible, but no later than 2 weeks prior to the initiation of the clinical rotation. Students should alert the leadership of the rotation as far in advance as possible (preferably before the initiation of the rotation) so that scheduling adjustments can be made. If approved, the excused absence is generally granted for the date of the presentation only. Timeliness of request, Student Academic Standing (academic probation, etc.), and relevance to the student’s training will be considered prior to approval.

Request submission form and instructions to submit can be found in the Heersink SOM Absence Notification System

All forms are subject to review by the Office of Undergraduate Medical Education.

Personal/Wellness days
Students can access 4 personal/wellness days throughout their third year of medical school. Personal/wellness requests must be formally reported through the Heersink SOM Absence Notification System and must comply with these limitations:

1. No more than 1 personal/wellness day may be taken during a specific Clerkship.
2. A student may not take a personal/wellness day on the day(s) when orientation is scheduled during a Clerkship.
3. A student may not take a personal/wellness day on the day(s) when assessments (shelf, oral exam, MS3 OSCE, etc.) are scheduled during a Clerkship.
4. A student may not take a personal/wellness day to extend their stay at a conference beyond the time required for presentation of their scholarly work.
5. Specific clerkships may have further limitations related to when personal/wellness days can be used.

When a student is approved to take off a day for personal/wellness, they are expected to communicate their upcoming absence to the clinical team to which they are assigned and Clerkship leadership. The student is not required to share the nature of/reason for the absence, just report the planned date. Violating the parameters above or taking a personal/wellness day without receiving formal approval through the Heersink SOM Absence Notification System represents a breach of professionalism and may result in consequences up to and including failure in a rotation.

All Other Requests
Students may require absences for reasons not otherwise covered in this document. Approval of excused absence requires that appropriate explanation and documentation be submitted to and approved by the rotation’s leadership, and Medical Student Services campus leadership in coordination with the Office of Undergraduate Medical Education. All requests will receive due consideration. The formal request must be made through the Absence Notification System at least 2 weeks prior to the scheduled activity. If such a request for an excused absence is approved, the exact time, date, and assigned location of the make-up activity will be arranged between the rotation’s leadership and the student. Make-up and extensions for absences deemed reasonable will be coordinated between the Associate Dean for Undergraduate Medical Education, the Assistant Dean for Clinical Education, the rotation's leadership, and the student.

Time away for parental responsibilities is discussed in the Parental Leave Guidelines.

History

Created: 07/18/2012
Approved: 1/1/2024 by UA System Office
Revised: 12/15/2023

University of Alabama at Birmingham Marnix E. Heersink School of Medicine policies shall be reviewed periodically to determine whether revisions are appropriate to address the needs of the medical school community.