Student Attendance Procedure

Rationale

Learners pursuing the MD degree at the Brody School of Medicine (BSOM) are physicians in training who must meet technical standards of professional conduct and responsibility to develop into effective physicians. As a professional school, BSOM requires attendance and active participation in all components of the curriculum. Active participation in the School’s course and clerkship activities indicates the learner’s understanding and mastery of the professional responsibility. The granting of the MD degree attests to the fact that the learner has demonstrated a commitment to their professional responsibilities through participation in all aspects of the curriculum as defined by the faculty. When it is necessary for learners to be absent from a required MD program activity, they must approach such absences with the same standard of professional responsibility required of practicing physicians; professional responsibility extends to one’s patients and members of one’s team.

The Brody School of Medicine (BSOM) Office of Student Affairs has established attendance procedures that support physical and emotional wellness as well as learning and success for all medical learners. These attendance procedures are designed to ensure attendance of critical education activities while providing reasonable and consistent processes when such attendance becomes impossible for reasons which are excusable.

Scope

During the M1 and M2 years, learners must be available for classes from 8:00 AM to 5:00 PM on class days and from 8:00 AM to 8:00 PM on assessment days. They must plan accordingly for those hours – i.e., arrange travel plans and other commitments to allow availability during these hours. During the M3 and M4 years, required learner availability is rotation and elective-specific.

However, there are certain instances in which learners will be excused from classes, clerkship responsibilities, and assessments in accordance with the terms of this policy.

Policy

Every learner is strongly encouraged to regularly and consistently attend classes. Every learner must attend all mandatory learning events, clerkship requirements, and assessments. However, BSOM recognizes that there are instances in which learners should be excused from attendance or should be excused from on-time arrival.

Learners are expected to be on time for all sessions, regardless of whether the session is mandatory. For the purpose of tracking attendance at mandatory sessions, a learner will be considered tardy if they are not present at the designated start time for the session. A learner will be considered absent if they arrive 15 minutes or more after the designated start time.

Some class and assessment activities cannot be made up due to staffing, logistical, or other institutional reasons. Although every reasonable effort will be made to afford learners the opportunity to make up activities missed due to excused absences, each course syllabus addresses how excused absences will be treated when the course’s activities or assessments cannot be made up.

Learners who engage in an excessive pattern of absences from mandatory classes and assessments, whether excused or unexcused, will be required to meet with the Associate Deans for Student Affairs and may be referred to the Professionalism and Community Standards Committee. Learners with three or more absences from mandatory classes or assessments during a block, whether excused or unexcused, will be required to meet with the Associate Deans for Student Affairs and the year-appropriate Review and Promotion Committee. Absences will be tracked and automatically reported to the Office of Student Affairs through an online process.

Process

Overview

This policy is interpreted and enforced by the Office of Student Affairs, which is responsible for determining whether absences are excused or unexcused. This determination may not be appealed.

Absences Excused

An excused absence must fall into one of the following categories: transportation, healthcare appointments, personal illness, serious illness/death of a loved one, religious observances, jury duty, professional travel, and natural disasters. Furthermore, those absences will be excused only if requested in the manner required by this policy. All other absences will be considered unexcused.

Process for Requesting

Requests for an excused absence should be in accordance with this process:

1. Students should communicate openly, clearly, and in a timely manner whenever an absence is required. Email is an acceptable option for notification, followed by completion of the excused absence process.
2. All requests for excused absences must be submitted using the ‘Absence Request Form’ located on the Office of Student Affairs webpage – requests received by other means will not be considered.
   1. Absence request forms must be received prior to the start of any assessment.
   2. When an absence does not involve an assessment or when the category of absence does not require advance notice, an absence request form and supporting documentation may be submitted within forty-eight (48) hours of the mandatory activity, if possible, but no later than within forty-eight (48) hours of return to classes.
3. As soon as a student realizes that they will have either a planned or unplanned absence from a clerkship activity or mandatory learning event, they must notify the appropriate parties. Any advance notice requirement for the specific type of absence must be met. Any request for an excused absence from an assessment must be formally submitted via REDCap prior to the start of the assessment, except in cases of emergency.
   1. For M1 and M2 students, the student must contact the Course Director and/or Course Coordinator and the Office of Student Affairs. If there is an urgent absence involving an assessment, the Testing Coordinator and the Associate Dean for the Office of Medical Education should also be contacted.
   2. For M3 and M4 students, the student must contact the Clerkship Director, Clerkship Coordinator, the Office of Student Affairs, and their clinical team (attending and resident). If there is an urgent absence involving an NBME Shelf exam, the Testing Coordinator and the Associate Dean for the Office of Medical Education should also be contacted.
4. The Office of Student Affairs staff will review all official Absence Request Forms and designate them as ‘excused’ or ‘unexcused’. Whether excused or unexcused, OSA will then notify the Course/Clerkship Director and Coordinator for each affected course. The Office of Student Affairs staff will keep a log of the number of absences per student and report these to the Associate Dean for Student Affairs on a quarterly basis.
5. Course/Clerkship Directors and Coordinators should await notice from the Office of Student Affairs before confirming an absence as ‘excused’. If there is any question about the status of a student absence, the Course/Clerkship Director is encouraged to contact the Office of Student Affairs. It is recommended that Course/Clerkship Directors include guidelines in their syllabi outlining the Course/Clerkship’s approach to absences (if beyond the scope of this procedure). M3 and M4 Clerkships are recommended to publish their ‘black-out’ days in a timely fashion to allow students the opportunity to make informed decisions about the timing of their administrative days.

Consequences

Learners who fail to comply with BSOM’s attendance policy face a number of serious consequences. These include, but are not limited to, the following:

1. Potential impact on grades
2. For M3 learners – Students who accumulate more than 8 absences during an academic year will be required to meet with the Associate Dean for Student Affairs, Clinical Sciences to discuss barriers to attendance. Students accumulating more than 12 days in the M3 year will be reviewed by the M3/4 Promotion and Review Committee for recommendations on repeating the M3 year.
3. Failure to report any absence from any course or clerkship session may result in referral to the Professionalism and Community Standards Committee or the year-specific Review and Promotion Committee.
4. If an absence occurs during an assessment, learner should refer to the Make Up Assessment policy on the Office of Medical Education’s website.

The treatment of unexcused absences and tardies, other than assessments, are addressed by each course’s syllabus.

Scope of Approved Absences

Transportation

Learners experiencing unexpected delays due to transportation problems, such as automobile accidents, flat tires, dead batteries, and road closures, may qualify for an excused absence or an excused late arrival for classes and assessments. Excused absences will not be granted due to excessive traffic or other predictable travel delays.

Required Documentation

Photographic or other evidence of transportation difficulty must be provided as soon as possible, but not later than within twenty-four (24) hours of the absence.

Healthcare Appointments

Learners should make every effort to schedule healthcare appointments at times which do not conflict with required learning events and assessments. The BSOM supports student wellness and will grant excused absences for healthcare appointments and for unplanned absences due to illness. Excused absences for assessments will not be granted for planned healthcare appointments, except in extraordinary circumstances and at the discretion of the Associate Deans for Student Affairs. Planned absences due to healthcare appointments must be requested at least two weeks prior to the planned absence.

Required Documentation

For healthcare appointments, the learner must submit a medical office note to the Office of Student Affairs as proof of the appointment within forty-eight (48) hours of returning to classes.

Personal Illness

If a learner is ill and must miss a mandatory learning event or clinical activities, that absence will be excused if the learnrer informs the appropriate parties (as defined above) of their illness. If the learner must miss an assessment due to personal illness, that absence will be excused so long as a note from the learner’s medical provider is provided within forty-eight hours of the absence and the excused absence is requested prior to the start of the assessment.

Required Documentation

For a personal illness lasting longer than 3 days (or for an absence from an assessment or mandatory activity due to illness), a doctor’s note is required within forty-eight (48) hours of the assessment or mandatory activity, if possible, but no later than within forty-eight (48) hours of return to classes.

Serious Illness/Death of a Loved One

The BSOM understands that learners sometimes have obligations to loved ones and may need to be absent to attend funerals or support loved ones suffering from serious illness.

Required Documentation

The learner must provide a copy of the memorial service program or medical proof of family illness within forty-eight (48) hours of the assessment or mandatory activity, if possible, but no later than within forty-eight (48) hours of return to classes.

Religious Observances

Per the East Carolina Univerisity Policy regarding religious observances, learners are allowed a minimum of two (2) excused absences each academic year for religious observances required by the faith of the student. Requests for excused absences due to religious observances must be submitted using an Absence Request Form fourteen (14) days prior to the start of the affected clerkship or rotation (M3 and M4 years); fourteen (14) days prior to the start of the affected block (M1 year); or fourteen (14) days prior to the start of the affected course in the M2 year. If the exact date of the religious observance is unknown, learners must communicate the expected range of dates directly with their affected course/clerkship/rotation director (using the same timeline as above).

Required Documentation

The learner must provide documentation showing the observance occurs on the date requested. Travel time prior to and following the religious observance is not covered.

Court Appearances/Jury Duty

Medical learners will, at times, be called for jury duty. Learner status, along with the rigor of the curriculum, allows for a deferment of this duty (if desired by the learner). Learners must contact the Office of Student Affairs and provide a copy of the jury duty summons. The Office of Student Affairs will provide the documentation needed for the deferment. Learners who do not desire deferment will be provided an excused absence. Depending upon the length of the time away from school, learners may be required to restart/retake affected courses or clerkships or take a leave of absence, potentially prolonging their time in school.

Required Documentation

Any learner requesting an excused absence due to a court date must present a copy of the jury summons, court notice, or other official documentation of the court date in advance of the absence.

Professional Travel

Excused absences are provided for learners representing the BSOM at conferences by presenting research, holding positions on state or national committees, or presenting in relation to distinction track activities. Absences should be limited to the day of the presentation and reasonable associated travel time, i.e., the absence may not include the entire conference. Professional travel requests must be submitted at least fourteen (14) calendar days prior to the first day of travel for M1 and M2 students and fourteen (14) calendar days prior to the start of the affected clerkship for M3 and M4 students. Learners must be in good academic standing to be approved for professional travel. Conference travel will not be approved if it conflicts with an orientation day, OSCE exam, oral exam, or any mandatory learning event.

Required Documentation

Learners requesting an excused absence for professional travel must provide relevant conference information to establish compliance.

Natural Disaster

All learners are excused from classes and assessments when classes are canceled by East Carolina University due to inclement weather, natural disasters such as hurricanes or tornadoes, or other disaster. In those instances, class, clerkship activities, and assessments will be rescheduled at the discretion of the Course/Clerkship Director and the Foundational or Clinical Curriculum Committee, as appropriate. There may also be other excusable situations where natural weather events preclude learner attendance.

Additional Excused Absence Information Specific to M3 and M4 Learners

M3 Learners

M3 learners are an integral part of the healthcare team with professional obligations and responsibilities. It is BSOM’s expectation that learners will be present for their clinical rotations.

M3 learners are allowed five (5) administrative days to use at their discretion over the course of the M3 year. A learner can use no more than one (1) day per 6-week clerkship or two (2) days per 8-week clerkship, and the maximum number of allowable absences in each clerkship applies to these administrative days (see below). These days can be taken in half-day increments, at the discretion of the clerkship. Requests to use these days must be submitted using an Absence Request Form fourteen (14) days prior to the start of the affected clerkship. Each individual clerkship has ‘black-out’ days when the administrative days cannot be used (due to mandatory activities).

Please see each individual clerkship syllabus for a listing of these days. Administrative days will not be approved if requested on a blackout date, as listed by each clerkship. Learners who exceed administrative days or miss mandatory activities on a black-out date are subject to academic consequence as defined in the grading rubric for each clerkship.

Aside from the categories of excused absences above, there are no other excused absences in the M3 year. Even with an excused absence, each individual Clerkship has the authority to require that missed work or clinical time be ‘made up’. Every leaner is encouraged to communicate clearly and effectively with their course directors and course coordinators.

The following are the maximum amount of total absences (excused and unexcused) allowed given the clerkship length. Please note that any learner exceeding these limits will be required to repeat the clerkship or make up the time in some other fashion at the Clerkship Director’s discretion.

• 8 weeks: 4 days
• 6 weeks: 3 days
• 2 weeks: 1 day

Any M3 learner missing more than eight (8) days in the M3 year will be required to meet with the Associate Dean for Student Affairs, Clinical Sciences to discuss barriers to attendance. Learners missing more than twelve (12) days in the M3 year will be reviewed by the M3/4 Promotion and Review Committee for recommendations on repeating the M3 year.

M4 Learners

M4 learners are an integral part of the healthcare team with professional obligations and responsibilities. It is BSOM’s expectation that learners will be present for their clinical rotations.

Learners should carefully read the syllabus or course description for each M4 course to understand the absence policy for each individual clerkship. Learners must respond to correspondence from Clerkship Directors/Coordinators, course faculty, administrators, and staff within 24 hours while enrolled in online courses.

During the residency application process, M4 learners will communicate directly with their Clerkship Directors/Clerkship Coordinators or Rotation supervisors regarding absences for interviews – an Absence Request Form is not necessary. It is imperative that students communicate clearly regarding leave required for interviews. Learners must make Clerkship Directors/Clerkship Coordinators or Rotation supervisors aware as soon as they know about a planned interview. If a learner plans to be absent for the majority of a clinical rotation, the Clerkship Director or Rotation supervisor may refuse to allow the learner to continue in that clerkship.

M4 learners must complete an ‘Absence Request Form’ for the categories of excused absences described above, as well as for USMLE exam dates. Below are the maximum amount of total absences allowed given the clerkship length. Any learner exceeding these limits will be required to repeat the clerkship or make up the time in some other fashion at the Clerkship Director’s discretion.

• 4 weeks: 3 days
• 2 weeks: 1 day

Even with an excused absence, each individual clerkship has the authority to require that missed work or clinical time be made up.

Procedures for Implementation and Review

This procedure will be reviewed by the Foundational and Clinical Curriculum Committees before approval by the Executive Curriculum Committee every three years.

This procedure will be disseminated by the Office of Student Affairs to learners and teaching faculty/administration during orientation each year.

Related Policies

Assessment System: Assessment Creation and Implementation SOP
Assessment System: Make-up Examinations SOP
Assessment System: Foundational Phase Quiz Grading SOP
Professionalism and Community Standards SOP

Applicable Laws, Regulations & Standards

LCME Standard 3, Element 1