Attendance, Absence, & Duty Hours Policy

Student Participation in Curricular Events

All Phases of Curriculum:

Absences from required academic activities:

Students may miss required academic activities for health-related reasons (see “Absences due to Illness” below).   For other non-health related reasons (such as compelling personal or family issues, required public duty or invited presenter at professional meetings), a student should contact their college dean for consideration of an excused absence.  In all instances, a student’s college dean must be contacted for approval of an absence as soon as the potential need for absence arises.

Absences due to Illness:

Students need to notify their college dean for any absence due to illness. If a student misses more than two consecutive days due to illness, in addition to notifying their college, they need to seek medical evaluation from the Department of Student Health and Wellness in Charlottesville, student health services at Inova or other licensed healthcare provider. It is anticipated that this will be done in person, but students with a flu-like illness or symptoms consistent with COVID infection first should call the appropriate student health service or provider to determine whether or not to report or perhaps schedule a virtual appointment. Students with contagious diseases may be furloughed by Student Health and Wellness, UVA Health System, or student health at Inova to prevent infections from spreading to patients, healthcare workers and fellow students. Clearance from the respective student health service is required before the student can resume educational activities.

Excessive Absences:

If in the view of any SOM faculty a student’s absences have affected adversely their education or the education of others in an affiliated group, the faculty may submit a Professionalism Concern Card regarding that student to the Office of Student Affairs. The student must meet with their college dean to address the issue(s). If the issue(s) cannot be resolved or recurs, the student will be referred to the Academic Standards and Achievement Committee (ASAC) for review and action.

Phase 1 of Curriculum:

Attendance:

The Cells to Society Curriculum provides many diverse learning opportunities for our medical students and attendance at all activities is encouraged. However, students are responsible for their own learning and are not required to attend all activities. Attendance is mandatory for all activities in which team accountability is required, including but not limited to, Team-Based Learning activities, Anatomy Dissection Teams, and Foundations of Clinical Medicine groups. Attendance also is mandatory for all patient presentations, interviews or panel discussions out of professional respect for the patient(s) and/or invited panelists. Failure to attend a mandatory activity is considered a breach of professionalism and will result in a Professionalism Concern Card being submitted to the student’s college dean, unless the college dean has excused the absence in advance (see below). Additionally, students must inform the system leader(s) or the appropriate instructor about their absence from mandatory activities and copy their college dean. By the nature of their short course status, attendance is required in all sessions for Orientation, Cells to Society and Classrooms to Clinics.

Work Hour Expectations:

The Phase 1 learning activities will be scheduled from 8:10 am to 12:00 noon, Monday through Friday. Students will have their Foundations of Clinical Medicine (FCM) small groups once a week from 1-5pm, Monday through Thursday.   In addition, students have both Patient Student Partnership responsibilities and/or certain community service responsibilities as part of the Social Issues in Medicine course.   The total amount of in-person scheduled course work is therefore 24 hours per week.  The Curriculum Committee has further established that 30 hours of preparation/study time is the expectation for medical students in the Phase 1 curriculum.

Delay of Summative Examinations:

Summative examinations may be delayed only for reasons of illness, or under unusual circumstances for compelling personal reasons. In all instances, approval to delay a summative examination must be obtained from the student’s college dean in advance of the examination unless there is an emergency that precludes it. Students who seek to delay these examinations for medical reasons also must be seen by the Department of Student Health and Wellness or their PCP unless the student has flu-like or COVID symptoms, in which case they should call Student Health and Wellness (924-5362) to see if a visit is warranted. After approval is given to delay a summative examination, it is the student’s responsibility to inform the appropriate system leader or course director and to arrange a time for examination make-up. The exam may not be taken prior to the scheduled date and time and a student forfeits the right to challenge examination items to avoid delaying the post exam review process.  There is no make-up for other scored interim activities.

Phase 2 and Phase 3 of Curriculum:

Attendance

It is the expectation that students will be present in person for their clinical duties and attend all required academic activities in Phase 2 and 3 according to the schedules outlined by their course and clerkship directors.

Orientations for all clerkships are required and an absence shall preclude a student from being able to participate in that clerkship.

Absences and Reporting of Absences

Students whose absence has been excused by their college dean must notify the director of the clerkship, Phase 3 required course or elective as well as the immediate faculty instructor by e-mail and copy their college dean. The course director will determine how and when the student can make up the time and activities that have been missed.  More than two days of excused absences must be made up.

Duty Hour Expectations

Medical students rotating on clinical services (clerkships, required Phase 3 courses and electives) will be subject to the same principles that govern the 80-hour work week for mid-level residents (a maximum of 80 hours of required clinical duties per week averaged over a four-week period, no more than 24 consecutive on-duty hours with at least eight hours off between shifts, and on average one day in seven free from all required clinical duties). Four additional hours for the handover of patients (no new patients) after 24 hours is allowed for feedback on clinical decisions and for continuity. Directors of clerkships, required Phase 3 courses and electives are responsible for monitoring and ensuring that duty hours are adjusted as necessary. Student duty hours were established by the Curriculum Committee considering the effects of fatigue and sleep deprivation on learning and patient care and mirroring the duty hour limits for mid-level residents per the ACGME Common Program Requirements.

Delay of Shelf Examinations

NBME Subject Examinations (“shelf exams”) may be delayed only for reasons of illness, or under unusual circumstances for compelling personal reasons. In all instances, approval to delay a shelf examination must be obtained from the student’s college dean in advance of the scheduled examination. Students seeking to delay a shelf examination for medical reasons also must be seen by a the Department of Student Health and Wellness in Charlottesville, student health services at Inova or other licensed healthcare provider unless the student has flu-like or COVID symptoms in which case they should call the appropriate student health service to see if a visit is warranted. When approval is given to delay a shelf examination, it is the student’s responsibility to inform the appropriate clerkship or course director, the clerkship or course coordinator and copy their college dean. After making up any necessary clinical time and fulfilling the other requirements of the clerkship, it is also the student’s responsibility to contact the clerkship coordinator to arrange a time to take the shelf examination in the next academic cycle at a time when clerkship students are taking a shelf exam. The student will receive an “Incomplete” until all clerkship requirements are completed.

If a student is absent less than 20% of the time within a given clerkship or required course, the clerkship or course director, in discussion with the student, will determine whether the student has had sufficient clinical experience to take the shelf exam at the end of the rotation.  The student’s college dean will be consulted to determine if they have information of extenuating circumstances that could influence this decision. Although students who have missed less than 20% of the time within a given clerkship may be permitted to complete the shelf exam during their current academic cycle, completion of the clerkship is dependent upon completion of all required activities, assignments, and missed clinical time, at the discretion of the course director. If the student is absent more than 20% of the time within a given clerkship, the student shall take the shelf exam in the next academic cycle after making up any necessary clinical time and fulfilling the other requirements of that clerkship. In all cases the student will receive an “Incomplete” until all course requirements are completed.

Other

Attendance is required for all sessions in the Transitions Course of Phase 2 as it provides necessary training and prepares students for expectations in the clinical environment.  No excused absences are allowed during the following required Phase 3 courses:  Bedside to Community, Advanced Clinical Elective, and Intern Readiness.  Anyone who is ill or has a personal or family emergency during these times must contact their college dean, course director and the attending faculty on the service immediately.

For all other Phase 3 electives, students are allowed to take up to one day per week off (or four days during a four-week rotation) between October 1 and February 1 for residency interviews. Some electives do not allow time off to interview, and it is the student’s responsibility to check the elective course description or make inquiry of the course director. Specific days missed must be pre-approved by the course director and the attending on the service. If greater than two days are missed for interviewing, or another excused absence, during an elective, the course director will work with the student to determine how and when make-up time will occur.  If missed time is not made up, adjustment to credit earned may occur.

Students may schedule time off for USMLE exams during electives that do not prohibit absence during the rotation in the elective course description.  The time off must be pre-approved by the course director and the attending on the service.  The course director will determine if days missed must be made up and, if so, how that will be scheduled.  Students are responsible for reviewing the Phase 3 handbook and course catalog for full details regarding Phase 3 attendance.

Questions

Students with questions related to the attendance or absences policies should contact the Office of Student Affairs or their college dean.

The Curriculum Committee has oversight and approval for this policy.

• Next scheduled review June 2026
• Revised May 2023
• Revised August 2022
• Revised & Reaffirmed February 2022
• Revised & reaffirmed June 2021
• Administrative revision April 2021
• Revised & reaffirmed June 2019