MD: Phase 2 Attendance Policy

Background

The profession of medicine requires the utmost commitment of time and energy to learning/education, patient care, research, and, when appropriate, other scholarly activities. The development of this commitment begins in Phase 1 of the Gateway Curriculum and extends into Phase 2 as students advance in their training to become physicians.

Students must recognize that teaching, learning, and assessment in both clinical and nonclinical settings are dependent on the student's presence and active participation. Time spent away from educational experiences, in both clinical and nonclinical settings, may decrease learning and impede effective assessment.

The clerkships of Phase 2 of the Gateway Curriculum consist of a foundational week(s) period, a period of clinical assignments divided into individual rotations based on the specific clerkship, and a week of assessment, reflection, coaching, and communities (ARCC).

This document outlines the attendance policies and expectations for Phase 2 of the Gateway Curriculum while also recognizing that students may have legitimate reasons for absences. In keeping with LCME element 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 required learning activities. Please refer to the Access to Healthcare Services Policy for additional details.

Policies/Requirement

Students are expected to attend all required sessions within Phase 2 of the Gateway Curriculum as specified within the learning management system. Required sessions will be noted in the learning management system and should only be missed under extreme, unavoidable circumstances such as a medical illness or family emergency.

In the unusual circumstance in which a student finds that they are unable to attend a required session, the student must complete an absence notification form in the learning management system that will be sent to the faculty lead, with a copy sent to the Office of Medical Student Education (OMSE). This form must be completed prior to the session that the student will miss or as soon as possible after the session if it is missed due to sudden illness or emergency. Students unable to attend a team activity should notify their team members by email with as much advanced notice as can reasonably be expected under the circumstances. This obligation also applies to correspondence with clinical teams for absences that occur during the clinical portion of the clerkship. If the unavoidable absence occurs during the ARCC week and an assessment will be missed, the student must also complete the Request to Delay Assignment/Assessment form.

When students encounter an unavoidable absence for required events within the foundational week(s) of a clerkship or the ARCC week, those students will work with the clerkship directors and/or other stakeholders to develop a remediation plan for the missed session, when possible. All required assignments associated with a missed session must be completed, and clerkship directors may require additional makeup work for missed sessions. 

In keeping with the principles outlined above, students are expected to fully participate in their patient care assignments. If students find that they need to be absent from their responsibilities while rotating on clinical services, they will need to submit an absence notification form with as much advanced notice as can be reasonably expected under the circumstances. Students will still be accountable for meeting all clerkship requirements. Any absences that compromise a student’s ability to meet these requirements and/or other Phase 2 requirements will require a remediation plan at the discretion of the clerkship director.

Attendance data will be tracked longitudinally by the OMSE within the learning management system for all phases of the curriculum. An absence will be recorded even when makeup work for a missed session is completed. Data will be monitored by the Assistant Dean for Assessment (ADA) in collaboration with the OMSE, and it will be reviewed by the Competency Attainment Committee as evidence contributing to the attainment of competency in PROF-2: Exhibit high standards of professional integrity.

Guidelines

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

Students are encouraged to notify clerkship leadership teams about any planned absences so that clinical assignments can be developed to minimize the educational impact of such absences.

Clerkships will also observe a general limit of three days of absences during a student’s clinical assignment. If a student has more than three days of absences during their clinical assignment, the consequences rendered will be at the discretion of the clerkship director, the Associate Dean of Student Affairs (ADSA), the ADA, and the Associate Dean for Medical Student Education.

Central monitoring of absences will reside with the OMSE and the ADA. A concerning trend of absences may be discussed with the ADSA and the Director of Coaching and Student Success to ensure appropriate student support can be offered and provided. Faculty directors of required Phase 2 sessions will include a specific faculty contact in the learning management system associated with all required sessions.

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 maximum flexibility for interviewing and USMLE exams.
  • Discuss planned absences with clerkship directors early and prior to clinical assignment development to better allow placement on a team to optimize the educational experience. We believe this guideline strikes an appropriate balance between increasing flexibility for the MSTP students and ensuring a meaningful educational experience on the core clinical rotations.

The Washington University School of Medicine Phase 2 Attendance Policy was approved by the Committee on the Oversight of Medical Student Education on Dec. 6, 2021. All substantive edits to this policy require approval by the Committee on the Oversight of Medical Student Education.