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Policy

Attendance and Absence - Clerkship

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Rationale

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 be excluded from final examinations and may be found in breach of the MD Program’s Breach of Professionalism policy.

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 monitor attendance by those students who are in academic or professional difficulty. Such circumstances would be clearly documented and provided in writing to the student.

Mandatory Nature of Learning Experiences in Clerkship

ALL activities in clerkship are considered mandatory unless otherwise expressly indicated by the Course Director or most responsible preceptor. Examples include:
  • 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 he or she has had inadequate experience to perform well on assessments, he or she may be requested to do additional time in the rotation prior to assessments.

Attendance during the CaRMS Application Process

The College understands that the CaRMS process can be a stressful time for students and requires a significant amount of preparation. Time management is extremely important during this process. If time management is an issue, students are strongly encouraged to seek supports and resources through the Office of Student Affairs.

Unapproved absences both before and after the CaRMS match period will be treated seriously and may be considered unprofessional conduct, may be reflected in the final grade of the course, and may constitute grounds for failure of the course.

Clerkship Leave Request Form

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.

Sick Leave

Students who are 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

   a. If a contact is away from the phone, leave a message and/or send an email.
   b. 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).
   c. Notify hospital switchboard.
   d. Notify his or her preceptor or ward attending.
   e. Notify the residents with whom he or she is working.

If a student becomes ill while on duty he or she 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 he or she 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 you are 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:

  a. If a contact is away from the phone, leave a message and/or send an email.
  b. 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).
  c. Notify hospital switchboard.
  d. Notify his or her preceptor or ward attending.
  e. Notify the residents with whom he or she is working.

Note: Non-Urgent medical or dental appointments should be booked during holiday time or via medical leave (see below).

*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).

Medical Leave

For medical leaves of one week or less, permission for medical leave should be sought from the Rotation Coordinator in consultation with the Year Chair and the Assistant Dean of Student Services. The student’s file will be reviewed to determine if he or she 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.
2. A leave request form approved by the departmental Clerkship Administrative Assistant.
3. A letter of support for the leave from the student’s own health care provider. 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.
4. Re-entry to the program may need approval from SAMC depending on the duration of medical leave.

For prolonged medical 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.

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.

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 a leave request 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 Assistant Dean Academic. The decision of the Assistant Dean Academic is final.

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 maximum of 3 week days may be taken as vacation during a 4-week block (Rural Family Medicine, Emergency Medicine), and no vacation time/education time is allowed during a 2-week block (Anesthesia, Selectives).

  • A combined maximum of 5 week days may be taken as vacation and/or education leave during a 6 week block.
  • 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 a leave request 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).

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 electivesshould 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 absenceneeds 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 Director. Flex Days may not be taken on a day that the student is responsible for presenting in the course.
  • Student must complete a “Clerkship Leave Request Form” for the Flex Day absence. In addition, students are required to notify the following contacts about the absence as soon as they are able:
      a. Notify the UGME office administrator at his or her current site.
      b. Notify the administrative assistant in his or her current rotation
      c. Notify hospital switchboard
      d. Notify his or her preceptor or ward attending
      e. Notify the residents with whom he/she is working with.

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.

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.