Clerkship Attendance, Participation and Absence Policy

PURPOSE
To outline the attendance, participation, and absence policy for the required core clerkships, the intersession course, and related educational activities of the clerkship curriculum phase. Students presence and participation in the clinical environment is paramount in clerkship learning. This policy does not apply to (s)electives taken during the clerkship phase; (s)electives attendance policy is included in the Post-Clerkship Attendance, Participation, and Absence Policy.

AUDIENCE
Clerkship phase medical students, clerkship course directors, faculty and staff

LCME STANDARD
8.8 Monitoring Student Time
12.4 Student Access to Health Care Services

POLICY

DEFINITIONS

Core Clerkship (Rotation) Definitions

• Absence: not being at the clerkship or related educational activities (including but not limited to academic obligations such as Clinical Performance Exam (CPX)) for a continuous amount of time equal to or greater than 4 hours. Time that cannot be made-up clinically, except at the discretion of a Clerkship Director, is included in this definition. The ability to make up clinical time will vary by clerkship rotational capacity.
• Core Clerkship: the Family and Community Medicine (FAP), Internal Medicine (IM), Pediatrics (PED), Psychiatry (PSY), Obstetrics and Gynecology (OBGYN) and Surgery (SUR) courses.
• Day: time equal to, or greater than, 4 hours of any day or night a student is assigned to clinical work.
• Time Away: not being at clerkship or related educational activities for an amount of time less than 4 hours.

Clerkship Intersession Course Definitions

• Expected Attendance: learning events that students are expected to attend and are responsible for the content therein, but attendance is not tracked.
• Required Attendance: learning events that require students' attendance and attendance is tracked. 

1. Students are expected to arrive on time, fully engage in the clerkship/course, remain present, and act professionally
2. Students must get prior approval for an absence unless it is emergent, and send a notification for time away. (See Procedure)
3. Clerkship Intersessions Course: Students must not miss more than 2 days of assigned activities.
   1. To meet the learning objectives of the course, any absence may have make up work assigned at the discretion.
   2.  The course syllabus and LMS will have full details regarding required versus expected attendance activities including anticipated in-class assessments.
4. Core Clerkship Rotations: Students must not miss more than 2 days of assigned clerkship activity in a 6-week block; missing more than 2 clinical days will require clinical make up time specific to the clerkship.
   1. This clinical make up time may range from 1:1 clinical time replacement to completing a multi-week block of service time that may be more than the clinical time missed.
   2. The ability to make up clinical time will vary by clerkship rotational capacity and may occur during school holidays, school breaks, or in the following academic year.
   3. Making up clinical time does not remove absences from the student record.
   4. For students with educational accommodations:
      1. Accommodation for occasional absences allows students to exceed the permitted number of absences; however, it does not exempt them from the responsibility of making up missed clinical hours. 
      2. Students are required to complete their clinical hours in addition to any other required activities.
5. If a student misses an exam, assignment deadline, clinical hours, or a graded class activity because of an acute disability flare or approved accommodation, they should contact the Clerkship Directors as soon as their symptoms improve to arrange for rescheduling and completion. 
   1. Students who are unable to complete clinical time before the end of the clerkship must work with the Clerkship Director to determine a plan for when clinical time can be made up and a date for completion.
      1. Students will receive an ‘I’ grade until clinical time is completed.
      2. If a student does not engage with the Clerkship Director to develop a plan and establish a deadline for completion, they will receive a ‘Y’ mark with a comment on the MSP narrative.
6. Time away or an absence that results in a student being unable to meet the learning objectives of the clerkship will require the student to complete additional work to achieve all objectives or repeat the clerkship.
7. An absence from clerkship activities may include personal, illness, or professional activities provided it does not exceed 2 days within the 6-week block.
8. A student who is absent more than 2 days of assigned clerkship activity in a 6-week block will be referred to the Associate Dean for Students for consultation and next steps.
9. Students are excused from all scheduled clerkship activities on university holidays, regardless of site, unless clinical make up time is required.
10. Students are expected to use an absence when they plan to be away from a core clerkship, intersession course, or related educational activities for any observed religious holidays that do not coincide with university holidays.
11. Any student absent more than 7 days of assigned clerkship activity during the academic year will be required to meet with the Senior Associate Dean for Undergraduate Medical Education.
12. Students are required to attend clerkship orientation, site orientations, and scheduled exams. 
    1. Students may not request anticipated (non-emergent) absences during orientations or exams.
    2. Non-emergent rescheduling of an examination will not be permitted, as outlined in the Required Course Exam policy.
13. Each clerkship may have further attendance and participation details beyond this policy outlined in the clerkship's syllabus; see each syllabus for details.
14. Exceptions to this policy may be made for students needing leave from the curriculum or a modified curriculum due to medical or other reasons.
    • Educational leave and modified curricula will require an educational plan developed jointly with the Associate Dean for Students, the Associate Dean for Curriculum, and the relevant course/course/course/course/clerkship directors, faculty and staff stakeholders for the period of the leave or modified curriculum. (See the Student Leave Policy)

PROCEDURE

1. Notification of Emergent Issues
   1. Students must notify (e.g., email or phone) their clinical teams, the Clerkship Directors, and the Clerkship Coordinator of their emergency as soon as possible.
   2. Students must complete the Absence Request Form as soon as possible, no later than 24-hours after the emergent issue.
2. Notification of Time Away (less than 4 hours) or an Absence (4 or more hours)
   1. Students must complete the Absence Request Form at least six weeks in advance of the absence request date, or as soon as an absence is anticipated.
   2. Students must notify their teams of all time away or absences as soon as they are known.
      • If any objection is encountered, students should inform the Clerkship Director.
   3. Clerkship Directors will be notified of all time away and absences and will follow up with students regarding any questions or concerns.
      1. Absences that occur without appropriate notification will be considered unapproved.
      2. Unapproved absences will be referred to the Associate Dean for Students.
   4. Emergent absences will be considered if a student experiences an illness or an emergency affecting the day(s) of concern.
      • The Clerkship Director and the Curriculum Manager should be notified as soon as the emergent issue becomes apparent.

RESPONSIBILITY
Clerkship Directors and Curriculum Manager(s) 

REFERENCE
UC Davis School of Medicine Bylaws and Regulations, Regulation 60: Requirements for the Degree Doctor of Medicine

RELATED POLICIES
Disability Accommodation Policy
Post-Clerkship Attendance, Participation, and Absence Policy
Professionalism Policy
Required Course Exam Policy
Student Leave Policy
Technical Standards Policy