Attendance and Absence - Clerkship

Application for Absence

The purpose of this policy is to provide clear and consistent expectations for students, staff and faculty related to student attendance in the clerkship portion of the MD program.

Other related documents are the Student Leadership Absence Policy and the Procedure for Session Attendance Across Sites/Campuses.

Active participation by medical students in learning opportunities is critical to their formation, education, and training. Sustained and deep engagement, which requires regular and punctual attendance, is expected of all students in all of their classes (lectures, laboratories, seminars, tutorials, small groups and clinical sessions). Students who neglect their academic responsibilities may have academic consequences and this behaviour will also be addressed through the Procedures for Concerns with Medical Student Professional Behaviour.

The College of Medicine recognizes that students have varied learning needs and can make choices about their approaches to learning. That being said, for many components of the program, the College of Medicine relies heavily upon faculty with clinical obligations, their patients and other patient volunteers. Absenteeism and lack of punctuality by students place an unwelcome strain on the goodwill of all concerned. Often a significant degree of accommodation by physicians and their patients has occurred to make these educational experiences possible. Replicating these experiences to accommodate student absences is extremely difficult. Acceptance of responsibility for attendance and participation in patient care is part of the student’s professional education and responsibility. Appropriate attendance and punctuality are indicative of the student’s understanding of, and adherence to, expectations of professional behavior.

All absences will be tracked by the relevant UGME Administrative staff. Processing absence requests requires significant administrative resources and reasonable limits are required in order to allow administrative staff to attend to other important responsibilities.

It has been the College’s experience that, for some students, chronic non-attendance often results in academic and/or professional difficulty. Students also end up feeling disengaged and separated from their class cohort, which can further affect academic success because of a lack of peer support. The College reserves the right to mandate attendance by those students who are in academic or professional difficulty. Such circumstances would be clearly documented and provided in writing to the student.

Significant absences may impact a student’s learning, and the program reserves the right to limit absences in order to best support learning.

Exceptions may be made to the maximum number of days absent per rotation due to leadership activities for students in good academic standing, if the Rotation Coordinator is confident that adequate clinical exposure can still be achieved on the rotation. Please see  Student Leadership  Absence Policy.

Students in academic difficulty may have their application for approved absences declined if there is concern that additional absences may put the student at further academic risk, regardless of number of approved absences used to date. This limitation would be only applied in consultation with the student and the Year Chair.

Students who have unplanned absences due to sickness or personal circumstances and who subsequently apply for Planned or Flex Day absences which would result in an excess of the maximum number of days absent per rotation should anticipate that further absences requests will be declined. Exceptions may be considered depending on academic performance, the relative importance of the activity for which the student is requesting an absence, and potential impact of the individual and cumulative absences on learning and assessment. The Year Chair will be consulted on this decision.

Clerkship: The third to fifth years of the University of Saskatchewan Undergraduate Medical Education Program (UGME) are termed “Clerkship”. During this program phase, medical students participate in large and small group learning activities, with a focus on clinical learning activities in health care settings.

Mandatory Sessions: ALL activities in clerkship are considered mandatory unless otherwise expressly indicated by the Course Director or most responsible preceptor.

This policy applies to all undergraduate students registered in Years 3-5 of the Doctor of Medicine (MD) program at the University of Saskatchewan irrespective of the geographically distributed site/campus to which they are currently assigned.

1. Session Types

• Orientation
• Clinical activities
• Site-specific didactic teaching
• Rotation-specific didactic teaching
• Selected Topics in Medicine and Preparation for Residency courses
• Scheduled assessments (i.e. written and oral exams, presentations, OSCEs and any other session where assessment of performance is expected)

NOTE: Regardless of the nature of the session, students are responsible for knowing the content as listed in the curricular/course objectives. The College of Medicine reserves the right to require students to make up missed time, regardless of the nature of the session, reason for the absence, or whether the absence was approved appropriately, to ensure the academic success.

Failure to abide by these regulations without appropriate prior approval, or notice after the fact for emergent absences, may be deemed as unprofessional conduct as outlined in MD Program, Procedures for Concerns with Medical Student Professional Behaviour. If a student disregards the decision of the College of Medicine or other authority in relation to the absences, this may also be considered unprofessional conduct.

Unexplained absences may be reflected in the final grade and may constitute grounds for failure of the rotation or course, even if the composite grade for other aspects of the assessment exceeds the passing grade. The UGME office must be notified of any prolonged or unexpected absences – please see the  Leave of Absence Policy.

If a student misses less than the maximum time permitted but there is concern that they had inadequate experience to perform well on assessments, they may be requested to do additional time in the rotation prior to assessments.

2. Total Absences

2.1. Year 3 Total Absences

1. The maximum amount of time away from a core rotation for any reason is 5 days on a 6-week rotation, 3 days 4-week core rotation, and 2 days on a 2-week core rotation.
2. The maximum amount of time away from Year 3 due to illness is 8 days over the course of the year. For illnesses that exceed 5 consecutive days please see the Leave of Absence Policy for the specific procedure.

• The maximum amount of time away from Year 3 for any reason other than vacation is 12 days over the course of the year.

Timeframe	Absence Type	Maximum
6-week core rotation	Any*	5 days
4-week core rotation	Any*	3 days
2- week core rotation	Any*	2 days
Year 3 (total academic year)	Any (except vacation)	12 days
Year 3 (total academic year)	Illness	8 days

*Please see the Core Clinical Rotation Syllabus for details regarding allowable absence types for each core rotation.

Exceeding the maximum of any of these will prompt a meeting with the Year Chair or designate as well as another rotation director/coordinator and the Office of Student Affairs. This may necessitate extending the duration of a course, or courses, to complete required components.

2.2. Year 4/5 Total Absences

1. The maximum amount of time away from a 2-week elective or selective rotation is 3 days. No absences are allowed on a 1-week elective rotation.
2. The maximum amount of time away from Year 4/5 due to illness is 5 days over the course of the year. For illnesses or other types of leave that exceed 5 consecutive days please see Leave of Absence Policy for the specific procedure.

• The maximum amount of time away from Year 4/5 for any reason other than vacation is 8 days for over the course of the year.

Timeframe	Absence Type	Maximum
1-week elective rotation	Any	No absences allowable
2-week elective or selective* rotation	Any	3 days
Year 4/5 (total academic year)	Any (except vacation)	8 days
Year 4/5 (total academic year)	Illness	5 days

*Please see the Selective Clinical Rotations and Electives Clinical Rotations syllabus and Clerkship Electives Policy for details regarding allowable absence types.

Exceeding the maximum of any of these will prompt a meeting with the Year Chair or designate as well as another rotation director/coordinator and the Office of Student Affairs. This may necessitate extending the duration of a course, or courses, to complete required components.

3. Types of Absences

Please note: It is important when taking time off a rotation that the clerkship leave request be filled out on SharePoint  as all time away from the program is monitored.

3.1. Sick Time

Students who are acutely ill may be required to miss clinical learning activities, both for their own wellbeing and the well-being of patients. Illness can include both physical illness and mental health issues. Caregivers with ill dependents may also request Sick Time to provide primary care.

If the student is ill for Selected Topics in Medicine or Preparation for Residency then they must advise the course director and the course administrative assistant for their site via email prior to the session.

If a student is ill and unable to fulfill their clinical duties, as identified by the student or supervising resident or preceptor, the student must:

1. Notify the rotation administrative assistant.
2. Notify hospital switchboard as applicable.
3. Notify their preceptor or ward attending.
4. Notify the residents with whom the student is working.
5. Complete a leave request in SharePoint.

If a student becomes ill while on duty, it is important that the student:

1. Notify their preceptor and resident as soon as possible to ensure all of their duties are transferred to others.
2. Notify the rotation administrative assistant.
3. Notify hospital switchboard as applicable.
4. Complete a leave request in SharePoint.

*If students are absent due to COVID-19 they must notify the UGME for tracking purposes. Please refer to the Clerkship COVID-19 Guidelines.

The student must make this notification as soon as possible after attending to the emergent needs/issues. The student should make every effort to advise the rotation administrative staff in advance of the absence if possible, for both classroom sessions as well as clinical activities.

Note: Non-urgent health care appointments should be booked during holiday time, outside of normal work hours. If a student has a brief appointment that needs to be attended during the day it can be discussed with their preceptor.

*If a student has already taken the maximum from a core rotation, and subsequently requires additional time away for the rotation due to illness, the student may be required to make up learning time after the scheduled rotation end date. This will be determined by the Rotation Coordinator. If a student disagrees with a Rotation Coordinator decision related to additional time on rotation, the student may appeal the decision to the Year Chair, whose decision is final.

Extended illness may require a formal medical leave request, with documentation. Please see  Leave of Absence Policy for more information.

3.2. Education Time

The following policy should be used to allow students to attend educational activities (e.g. conferences):

A maximum of 4 days in Year 3 is allotted for Education Time. A maximum of 3 days in Year 4 is allotted for Education Time. A maximum of 5 days in Year 5 is allotted for Education Time.

• Year 3 Education Time may be carried over to Year 4, and Year 4 Education Time may be carried over to Year 5, however students should be aware that if completing an external elective the hosting institution may decline the request for Education Time. Year 4 Education Time may also be used during Year 5 with permission of the relevant Rotation Coordinator and Year Chair.
• It is expected that students presenting at a conference will use their Education Time to attend. However, in the exceptional circumstance that a student is invited to present at a conference after using their Education Time, additional time may be granted by the Rotation Coordinator and Year or Site Chair to attend.
• Education Time will not be granted during either of the Consolidation Weeks in Year 3 or Preparation for Residency in Year 4.
• Students should submit a Clerkship Leave Request through SharePoint that will be reviewed by the Rotation Coordinator.

Apart from these timing considerations, standards for successful completion of rotations will not be amended.

• If a student disagrees with the decision of a Rotation Coordinator to decline an Education Time request, the student may appeal that decision to the Year Chair. The decision of the Year Chair is final.

3.3. Vacation Time

3.3.1. Year 3 Vacation Time

Students in Year 3 have a total of 4 weeks of vacation – 1 week of their choosing, and 3 weeks mandatory for the December break (may vary). Students may carry over a maximum of one week of vacation from Year 3 to Year 4. Note that the December vacation will be scheduled for clerks, and other personal holidays will be scheduled at the individual clerk’s request (see parameters below).

• A maximum of 5 weekdays may be taken as vacation leave during a 6-week core rotation. A maximum of 3 weekdays may be taken as vacation during a 4-week core rotation (Rural Family Medicine, Emergency Medicine)
• No vacation time is allowed during a 2-week core rotation (Anesthesia)
• No vacation time is allowed during the Surgery core rotation.
• Vacation leave is not allowed during the Consolidation Weeks
• Vacation leave is not allowed during final exams.
• Some core rotations will not allow students to take time off the first week of the rotation as that is when departmental orientations are scheduled or the last week due to exit interviews and final rotation exams.
• “Off call” days do not count as vacation days and are subject to approval by the department.
• If vacation time is arranged for 5 regular working days consecutively, the student will be taken off call the weekend before OR after the requested weekdays.
• Students shall request vacation time by completing a clerkship leave request through SharePoint at least 6 weeks in advance of starting service on that core rotation. If a student applies for vacation less than 6 weeks in advance of the start of a rotation, the request may be denied

Students may use a portion of their Year 3 holiday time for electives– see Electives Policy.

3.3.2. Year 4 Vacation Time

• Students in Year 4 and Year 5 have a total of three (3) weeks of vacation – 1 week of their choosing and 2 weeks for the December break. In addition, there are two (2) weeks of bookable independent learning time.
• Maximum 3 days allowed for a 2-week elective rotation.
• No vacation time is allowed during a 1-week elective rotation.
• No vacation time is allowed during Preparation for Residency.
• No vacation time is allowed on Selectives.
• Students shall request vacation time by completing a Clerkship Leave Request through SharePoint at least 4 weeks in advance of starting an elective.

Appeals of Vacation Request Decisions:

Relevant rotation administrative staff will approve or deny vacation requests based on this policy. If a student disagrees with the Administrative decision, the student may appeal that decision to the appropriate Year Chair or designate, by providing, in writing (email acceptable) the reasons why the student is appealing the decision. The decision of the Year Chair shall be final for appeals of vacation decisions. The student may seek guidance from the Office of Student Affairs in requesting such an appeal.

3.4. Flex Days

Flex Days are intended to allow students the option of taking an absence without the need to provide a reason or documentation in support of that absence. Students may take Flex Days to proactively support their mental and physical heath, if they recognize they are experiencing symptoms of burn-out, and/or to address circumstances that may arise on short notice (such as appointments or family issues) such that scheduling vacation is not an option. Flex Days are consistent with the definition of “personal days” as defined by the Canadian Federation of Medical Students (CFMS 2017. Personal Day Policies at Canadian Medical Schools position paper).

• No rationale for the absence needs to be provided for a Flex Day absence.
• Students will be able to use a maximum of three Flex Days in Year 3 and one Flex Day in Year 4, per academic year.
• A minimum of 3 business days’ notice is required in advance of the requested Flex Day, to allow notification of preceptors and schedule adjustments if required.
• Absences due to Flex Days will count towards the maximum amount of time away from a core rotation/elective/selective (Varies by rotation please see the Core Clinical Rotation Syllabus, Selective Clinical Rotation Syllabus, and Elective Clinical Rotation Syllabus for details), but do not count towards the number of vacation days.
• Year 3 students will be able to use a maximum of 1 Flex Day per 6-week core rotation (including ERA), or 1 Flex Day per 6 week interval in the SLIC program.
• Flex Days cannot be taken during a one-week elective.
• Flex Days cannot be taken during the Preparation for Residency Course.
• Flex Days are meant to assist in promotion of student wellness and are not simply a way to increase vacation time, therefore they should not be combined with vacation time. Requests that are added onto vacation time will be denied.
• A Flex Day counts as a full day (i.e. Cannot be requested as a half day).
• Flex Days are not to be used during Orientation sessions, the Consolidation Weeks, the day of an examination/presentation, nor on a day when a midpoint or end of rotation interview is scheduled.
• Flex Days are not to be used when a student is on call unless arrangements have been made ahead of time to ensure coverage, or the call is changed to a different day. Appropriate staff/faculty must be consulted and advised of the call change. If arrangements have not been made for the call change ahead of time, the request will be denied.
• Flex Days may be taken during the Selected Topics in Medicine course and must be requested via email to the Course Director. The student is still responsible for material taught during the session, and any assessments missed will must either be made up or the assessments re-weighted, as determined by the Course Director. Flex Days should not be taken on a day that the student is responsible for presenting in the course or on the day of a monthly quiz.
• Flex days do not come out of vacation time (see below).
• Flex days are not transferable between years.
• Student must complete a clerkship SharePoint leave request for a Flex Day absence.

Appeals of Flex Day Request Decisions:

• Relevant Administrative staff (Rotation Administrative Assistant and Rotation Coordinator) will approve or deny the Flex Day absence requests based on this policy.
• If a student disagrees with the Administrative decision, the student may appeal that decision to the appropriate Year Chair or designate, by providing, in writing (email acceptable) the reasons why the student is appealing the decision. The decision of the Year Chair shall be final for appeals of Flex Day decisions. The Student may seek guidance from the Office of Student Affairs in requesting such an appeal.

3.5. Compassionate Leave

Compassionate leave can be taken for reasons of death of a person close to the student and a clerkship leave request should be submitted through SharePoint. Under regular circumstances compassionate leave will not exceed 3 days. Extended leaves for compassionate reasons may be accommodated. Students are encouraged to work with the Office of Student Affairs if considering a leave request. See Leave of Absence Policy.  

If a student has already taken the maximum from a core or elective rotation for vacation, education leave and/or sick leave, and subsequently requires additional time away for the rotation for compassionate leave, the student may be required to make up learning time after the scheduled rotation end date. This will be determined by the Rotation/Elective Coordinator. If a student disagrees with a Rotation/Elective Coordinator decision related to additional time on rotation, the student may appeal the decision to the Year Chair, whose decision is final.

3.6. Other Leave

For extenuating circumstances that fall outside the parameters listed in the above sections permission must be sought from the Year Chair or Site Director via email with cc to the rotation Department Administrative Staff and relevant UGME Year Administrative Staff. The student's file will be reviewed to determine if the student is in academic difficulty. If approved, the student must then submit their SharePoint application with a brief explanation in the comments section of the form. A maximum of 5 days per academic year are allowed for this leave type. The student may be required to make up learning time after the scheduled rotation end date. For prolonged leaves, please refer to the MD Program Leave of Absence Policy.

3.7. Statutory Holidays

Students are entitled to all statutory holidays. Clerks who are on duty on a statutory holiday between 0800 and 2300 shall be given time off in lieu of that day. Time off in lieu can be booked on SharePoint through the leave requests, but must be taken on the rotation in which the time was earned.

Statutory holidays for clerks include:

• New Year’s Day
• Family Day
• Good Friday
• *Easter Monday
• Victoria Day
• Canada Day
• Saskatchewan Day
• Labour Day
• National Day for Truth and Reconciliation
• Thanksgiving Day
• Remembrance Day
• Christmas Day
• Boxing Day

*Please note that even though Easter Monday is not considered a statutory holiday by the University of Saskatchewan, clerks are still entitled to a day in lieu if they work this day.

If the statutory holiday falls over a weekend, the day in lieu will be for the day observed by the University of Saskatchewan only.

 

Clerkship administrative staff and Year Chairs/ Year Site Coordinators are responsible for operationalizing the procedures outlined, with oversight by the Program Manager, and consultation as required with the Academic Director, UGME and Associate Dean, UGME.

Instances or concerns of UGME non-compliance with the Clerkship Attendance and Absence Policy should be brought to the attention of the Vice-Dean, Education or the Associate Dean, Undergraduate Medical Education, within the College of Medicine.

This policy will be housed on the College of Medicine SharePoint, in the UGME Admin common folder. It will also be housed in SAMC SharePoint folder. This policy will be posted on College of Medicine website, under the Policies tab of the Students dropdown menu, as well as the policies tab of the Faculty Dropdown menu. Any updates approved by SAMC will be distributed to the Year 3 and Year 4 Chairs and all admin coordinators/support staff responsible for Clerkship across the province, who will distribute it to all clerkship faculty leads and the Clerkship Sub-committee.

Academic Director, UGME
Phone: 306-966-2750
Email: medicine.ugme@usask.ca