Absence Policy for Medical Students on Clinical Rotations

—This policy applies to Legacy Curriculum students.—

Background

The profession of medicine requires the utmost commitment of time and energy to patient care and research activities. While the development of this commitment begins in the preclinical years, it is further practiced and developed during clinical training.

The clinical year at Washington University School of Medicine (WUSM) comprises 48 weeks of required core clinical experiences. The fourth year encompasses a 44-week time block and requires MD students take a minimum of 36 weeks of credit (32 weeks of electives plus four weeks of Capstone). MSTP students are required to take a minimum of 12 weeks of credit (eight weeks of electives plus four weeks of Capstone).

All students on clinical rotations have a scheduled two-week winter recess break and a three-day spring break. All clinical students have a two-week break between the end of the third-year clinical rotations and the start of the fourth-year elective rotations. During every clinical rotation, each student is expected to participate fully in all activities of the clinical rotation until the designated end time of the clinical rotation or the start time of a holiday break. This regularly requires participation beyond formal weekday hours to include evening and nighttime call and clinical responsibilities on weekends. In keeping with LCME standard 12.4, all students requiring access to necessary diagnostic, preventive, and therapeutic care for both acute and chronic health concerns are to be excused from clinical training per the Washington University School of Medicine Access to Healthcare Services Policy.

Students must recognize that clinical teaching, learning and evaluation are dependent on the student's presence and participation in every aspect of the clinical rotation. While students will not be graded down only because of an excused absence, time spent away from the rotation may decrease learning and impede effective evaluation.

Policies

In the event that a student finds that an absence from a clinical rotation is unavoidable, they must complete an absence notification form that will be sent to the clinical course director and the Director of Medical Student Education and Student Affairs. Students must also notify their clinical supervisors by email.

If a student is ill or has a personal emergency, they are responsible for completing an absence notification form as soon as possible. If the absence extends beyond two consecutive days, the Director of Medical Student Education and the Office of Student Affairs will be notified.

It is recognized that a student may, on a rare basis, desire to be excused from clinical activities for professional or significant personal events. Travel prior to or following observed university holidays and breaks that occurs outside of the officially designated times/dates on the MD Program Academic Calendar does not constitute a significant personal event or unavoidable absence.

For all students on clinical rotations, the Clinical Curriculum Committee has agreed upon the following limitations on the maximum number of days of absences (both planned and unplanned) from clinical rotations.

Type of Course MD Students MSTP Students and Interviewing Fourth-Year MD Students*
2-week elective 1 day 1 day
3-week clerkship 1 day 1 day
4-week elective 3 days 5 days
4-week clerkship 3 days 3 days
5-week clerkship 3 days 3 days
8-week clerkship 4 days 4 days
9-week clerkship 4 days 4 days
*

Residency interviewing season is typically from mid-October through January. Any additional days off would require approval by the Associate Dean for Medical Student Education and the elective course director.

If a student misses more than the maximum number of allowable days of absences for a given clinical rotation, the consequence rendered will be at the discretion of the clinical course director and the Associate Dean of Student Affairs or the Associate Dean of the Office of Medical Student Education.

Failure of the student to notify the clinical course director of their absence after consideration of the particular circumstances of the absence will result in the filing of a professionalism concern form (PCF).

Guidelines

All non-clinical electives and the Capstone course may have separate attendance requirements and absence procedures. Please refer to the course syllabus for details.

Students are encouraged to make up missed work on rotations in which this can result in meaningful learning and should discuss this option with the clinical course director.

At the discretion of the clinical course director, any student who misses portions of the clinical experiences due to planned and/or unplanned absences that exceed the maximum time may be required to utilize winter recess, spring break or free time at the end of the third-year clinical rotations to complete the 48 weeks of mandatory clinical rotations.

A concerning trend of absences may result in a review of professional integrity by the Committee on the Academic and Professional Evaluation of Students (CAPES), at the discretion of the Dean of Student Affairs.

MSTP students are encouraged to do the following:

  • Meet with the Assistant Dean for Career Development early for assistance in residency planning.
  • Consider returning to the MD program to allow for 18 to 24 months to complete MD training to allow flexibility for interviewing and USMLE exams.
  • Discuss planned absences with clinical course directors early, prior to a clinical rotation, to better allow placement on a team to optimize the educational experience. We believe this guideline strikes an appropriate balance between increased flexibility for the MSTP students and assuring a meaningful educational experience on the core clinical rotations.

The Washington University School of Medicine Absence Policy for Medical Students on Clinical Rotations was last approved by the Oversight Committee on Medical Student Education on May 3, 2021. All substantive edits to this policy require approval by the Oversight Committee on Medical Student Education.