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Policy

Attendance and Absence - Clerkship

Categories: absence application form attendance faculty policy procedure ugme clerkship

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Purpose

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, Pre-Clerkship Attendance and Absence Policy, and Procedure for Procedure for Session Attendance Across Sites/ Campuses.

Principles

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 medical students are adult learners and entitled to the privileges and responsibilities that come with such status. 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 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 behaviour.

It has been the College’s experience that, for some students, chronic non-attendance often ends up 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.

Definitions

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 setting. 

 

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

Scope of This Policy

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.

Responsibilities

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 Assistant Dean Academic, and Associate Dean UGME.

Procedures

  1. SESSION TYPES
  • Orientation
  • Clinical activities
  • Site-specific didactic teaching
  • Rotation-specific didactic teaching
  • Selected Topics in Medicine and Preparation for Residency courses (except during rural rotations without videoconferencing capacity)
  • 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 or not the absence was approved appropriately, to ensure the academic success of students. 

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.

 


 

  1. Types of Absences:

 

Please note: The maximum amount of time away from a rotation for any reason is 5 days.*  This may even be less depending on the rotation.  Please see the Core Clinical Rotation Syllabus for details.

2.1 Sick Leave

Students who are acutely ill may be required to miss clinical learning activities, both for their own well-being and the well-being of patients.  Illness can include both physical illness and mental health issues.  If a student is ill and unable to fulfill his or her clinical duties, as identified by the student or supervising resident or preceptor, the student must do ALL of the following:

  1. Notify the UGME office administrator at his or her site (See Appendix A for current list), and:
    1. If a contact is away from the phone, leave a message and/or send an email.
    2. Notify the administrative assistant in the department of his or her current rotation (See Clerkship Student Information Guide or College of Medicine website for contacts).
    3. Notify hospital switchboard.
    4. Notify his or her preceptor or ward attending.
    5. Notify the residents with whom the student is working.

If a student becomes ill while on duty the student must:

  1. Notify his or her preceptor and resident as soon as possible to ensure all of his or her duties are transferred to others.
  2. Notify everyone listed above.

If a student becomes ill while on call the student must:

  1. Notify everyone listed above.
  2. Try to find a replacement for call (ideally by switching with another student if possible. If switching call with another student is not possible, the student will be scheduled to make-up the call )

Notify the attending for the case room if on Labour and Delivery.

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 office in advance of the absence if possible, for both classroom sessions as well as clinical activities.   

If a student must be absent due to an urgent medical or dental appointment, the student must notify the UGME office administrator at his or her site (see Appendix A for current list), and:   

    1.  If a contact is away from the phone, leave a message and/or send an email.
    2. Notify the administrative assistant in the department of his or her current rotation (See Clerkship Student Information Guide or College of Medicine website for contacts).
    3. Notify hospital switchboard.
    4. Notify his or her preceptor or ward attending.
    5. Notify the residents with whom the student is working.

Note: Non-Urgent health care appointments should be booked during holiday time, outside of normal work hours.  When these cannot be booked outside of normal work hours, please utilize Medical Leave process below (2.2). An application for absence form should be submitted for tracking purposes.   

*If a student has already taken the 5 day maximum from a rotation for holidays and/or education leave, 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 (see below). Documentation will typically be requested for health-related absences of more than 3 days.

* Please note: Although the maximum time away from a rotation  may be 3-5 days (depending on the rotation), if a student is absent due to illness more than 8 days over the course of Year 3, this 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 result in courses being considered incomplete. For Year 4, if a student is absent due to illness more than 5 days over the course of the year, the same process will be followed.

2.2 Medical/Personal/Parental Leave

Leaves may be requested for significant health or personal issues.  For medical/personal/parental leaves of one week or less, or for absence for a scheduled health care appointment which cannot be scheduled outside of normal work hours, permission for medical leave should be sought from the Rotation Coordinator in consultation with the Year Chair, and an application for absence form submitted for tracking purposes. Students are encouraged to also seek support from the Office of Student Affairs. The student’s file will be reviewed to determine if the student is in academic difficulty.  A decision to deny brief medical leave by a Rotation Coordinator/ Year Chair may be appealed to the Assistant Dean Academic, whose decision is final.

Action/Documentation required for brief leaves of one week or less:

  1. The student should contact Student Affairs at his or her site to discuss the reason for the leave request.
  1. A leave request form Application for Absence form should be submitted.  
  1. A letter of support for the leave from the student’s own health care provider should be provided. The UGME office will work with the student to determine if any other documentation is required.  If the supporting documentation is confidential in nature documentation can be submitted to the Student Affairs Office at the student’s educational site, who will confirm its receipt to the UGME office.
  2. Re-entry to the program may need approval from SAMC depending on the duration of medical leave.

For prolonged medical/personal/parental leaves (greater than one week), please refer to the MD Program Leave of Absence Policy. Permission for prolonged medical leave should be sought from the Assistant Dean Academic, who will consider the leave request in consultation with the Rotation Coordinator(s), Year Chair and the Office of Student Affairs. 

2.3 Compassionate Leave

Compassionate leave can be taken for reasons of death of a person close to the student or for significant family emergencies requiring the student’s attention.   Permission for compassionate leave must be sought from the Rotation Coordinator affected by the absence. The Coordinator will consult with the UGME office regarding the leave and documentation may be required. These requests will be dealt with on a case by case basis. Under regular circumstances compassionate leave will not exceed 3 days. 

 *If a student has already taken the 5 day maximum from a rotation for holidays and/or education leave and/or illness, 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 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 leaves for personal or 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.

2.4 Educational Leave

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 Educational Leave. A maximum of 3 days in Year 4 is allotted for Educational Leave.  Year 3 Education Leave may be carried over to Year 4, however students should be aware that the hosting institution may decline the request for educational Leave during an approved elective. Year 4 Education Leave may also be used during Year 3 with permission of the relevant Rotation Coordinator and Year Chair.
             
  • It is expected that students presenting at a conference will use their Educational Leave to attend. However, in the exceptional circumstance that a student is invited to present at a conference after using maximum Educational Leave,  additional time may be granted by the Rotation Coordinator and Year Chair to attend.       
  • Education leave will not be granted during the week of an OSCE.

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

  • To avoid confusion or misunderstanding, students should make their arrangements directly with the relevant Rotation Coordinators.
  • A request for Educational Leave must be documented on an Application for Absence form and approved by the Rotation coordinator and forwarded to the UGME Administrator. This will be tracked in the UGME office and the leave request will be declined if the 7 day maximum is exceeded.
  • If a student disagrees with the decision of a Rotation Coordinator to decline an Education Leave request, the student may appeal that decision to the Year Chair.  The decision of the Year Chair is final. 

2.5 Vacation

Vacation allocation is 8 weeks (40 days), excluding weekends, throughout clerkship: 5 weeks in Year 3 (of which 2 will be scheduled in December) and 3 weeks in Year 4 (of which 2 will be scheduled in December). A maximum of one week from Year3 may be carried over to Year 4.  Students may use a portion of their holiday time for electives (typically in Year 3) – usually students who are interested in highly competitive programs where additional elective time would be of benefit – see Elective policy. 

Note that the December holidays will be scheduled for Clerks, and other holidays will be scheduled at the individual Clerk’s request (see parameters below)..

  • A combined maximum of 5 week days may be taken as vacation and/or education leave during a 6 week block.
  • A maximum of 3 week days may be taken as vacation during a 4-week block (Rural Family Medicine, Emergency Medicine)
  • No vacation time/education time is allowed during a 2-week block (Anesthesia, Selectives)
  • Vacation leave will be arranged such that any instance in which 5 regular working days are taken consecutively, the student will be taken off call the weekend before OR after the requested weekdays.
  • Vacation leave is not allowed during the week of the OSCEs and the last week of a rotation when an NBME is to be written.
  • “Off call” days do not count as vacation days and are subject to approval by the department.
  • Students shall request vacation time from the Clerkship Administrative Assistant of the department in which the student intends to take that time at least 6 weeks in advance of starting service in that department.
  • Additionally, some rotations will not allow students to take time off the first week of the rotation as that is when departmental orientations are scheduled.
  • A request for Educational Leave must be documented on an Application for Absence form, submitted to the Departmental Clerkship Administrative Assistant and approved by the Rotation Coordinator then forwarded to the UGME Administrator. This will be tracked in the UGME office and the leave request will be declined if the vacation and/or education day maximum is exceeded.
  • Please note that vacation time must be approved first prior to arranging extra electives, which must also be approved (see electives policy).

2.6 Flex Days

Flex days are intended to allow Year 3 students the option of taking a planned absence without the need to provide a reason or documentation in support of that absence.  Students may take Flex Days to pro-actively 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).

Flex Days do not apply to Year 4 students, due to challenges applying this policy during electives including out-of-province electives.  Students requiring urgent time off during electives should request this directly of their electives supervisor, and should notify the University of Saskatchewan UGME office. In addition, the student may request support from their Year 4 Chair and Office of Student Affairs as needed.

 

  • Undergraduate year 3 clerkship medical students shall be allowed to convert a maximum of 2 days during the academic year of their vacation time to Flex Days.
  • No rationale for the absence needs to be provided for a Flex Day absence.
  • 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 rotation (Varies by rotation please see the Core Clinical Rotation Syllabus for details). If absences exceed the maximum amount of time away for the rotation students will be required to make up extra time under the discretion of the rotation director. 
  • Students will be able to use a maximum of 1 Flex Day per 6-week rotation up to the maximum of 2 per academic year. There is no scheduled holiday time during the selective clinical rotation and students will not be allowed to use Flex Days during this rotation.
  • A Flex day counts as a full day (ie. Cannot be requested as a half day).
  • Flex days are not to be used during orientation sessions, the week of an OSCE, the day of an oral examination/presentation, or the last week of a rotation when an NBME/final rotation examination is to be written.
  • Flex days are not to be used when a student is on call unless arrangements have been made ahead of time to ensure coverage and appropriate staff/faculty have been advised of the call change.
  • Flex days may be taken during the Selected Topics Course. 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 may not be taken on a day that the student is responsible for presenting in the course.
  • Student must complete an Application for Absence for the Flex Day absence.  In addition, students are required to notify the following contacts about the absence as soon as they are able:
    1. Notify the UGME office administrator at his or her current site.
    2. Notify the administrative assistant in his or her current rotation
    3. Notify hospital switchboard
    4. Notify his or her preceptor or ward attending
    5. Notify the residents with whom the student is working with.

2.7 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 must be arranged with and approved by the departmental Clerkship Administrative Assistant of 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
  • 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.

 

  1. TOTAL ABSENCES

3.1. Guiding Principles:

  • Significant absences may impact a student’s learning, and the program reserves the right to limit absences in order to best support learning.
  • Processing absence requests requires significant administrative resources and reasonable limits are required in order to allow Administrative Coordinators to attend to other important responsibilities.

3.2. Process:

  • All absences will be tracked by the relevant UGME Administrative staff.
  • Absences are limited by the parameters outlined in the previous sections of this policy. As noted, the maximum amount of time away from a rotation for any reason is 5 days.*  This may even be less depending on the rotation.  Please see the Core Clinical Rotation Syllabus for details.
  • 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 teh maximum number of days absent per rotation should anticipate that further absences requests will be declined. Exceptions may be considered depending on 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.

Contact

Assistant Dean Academic, UGME

Appendix A - Contacts for Notification of Absences

UGME Office Clerkship Administrators:

Saskatoon:      
Clerkship Administrative Assistant -
Shannon Bay
306-966-8828

Clerkship Administrative Coordinator –
Carolyn Blushke
966-7693

Regina:
Clerkship Administrative Coordinator -
Holly Doell /Anne-Marie Ethier
306-766-4890

Prince Albert:
Clerkship Administrative Coordinator -
Nicole Toutant
306-765-6787

Departmental Clerkship Administrative Assistants:
See the list in your Student Guide to Clerkship, or the Contact List.

Appendix A – Contacts for Notification of Absences

UGME Office Clerkship Administrators:

Saskatoon:
Clerkship Administrative Assistant -
Shannon Bay
306-966-8828

Clerkship Administrative Coordinator -
Carolyn Blushke
966-7693

Regina:
Clerkship Administrative Coordinator -
Anne-Marie Ethier
306-766-4890

Prince Albert:
Clerkship Administrative Coordinator -
Nicole Toutant
306-765-6787

Departmental Clerkship Administrative Assistants:
See the list in your Student Guide to Clerkship, or the Contact List.