Attendance Standards

A. Introduction and Background

Students at the Medical College are physicians-in-training who are expected to carry out all academic responsibilities in a professional manner. Professional comportment is an essential and required component of becoming effective physicians. Students must handle absences from required Medical College activities in a manner that reflects a standard of professional responsibility for practicing physicians. At the same time the faculty of the Medical College recognize that students learn in different ways that include in-class and clinical experiences, independent study, digital media, scientific investigation and presentations, to name a few --- many of which may compete for a student’s time. A central concept to the attendance policy is that students provide the faculty with a timely and valid request and/or notification for absences from any curricular activities. The faculty considers a student’s honesty in presenting a reason for an absence to be the core principle that underlies all professional communication regarding the absence policy. Likewise, the student can expect that the faculty will apply the attendance policy without preconceived judgment or assumptions in a way that is both fair and consistent, but which also considers a student’s individual situation. When a student does not attend a required session, and has not provided in advance an appropriate request for permission or explanation of the absence, as described below, the student is in violation of the standards of conduct required for students at the Medical College. This policy on student absences sets out the criteria and process for handling absences from academic duties; it also applies to students taking courses at the Medical College who are from other medical schools.

B. Rationale

The integrated curriculum of the Medical College in the foundational years (first year and half) is designed to promote an engaging, collegial interchange of ideas among students and faculty in all sessions including large group formats such as lectures. Students are are required to attend all sessions and to participate. In some formats that involve collaborative work, attendance and participation will be assessed and both comprise an important element in the satisfactory demonstration of competence. The faculty have identified small groups that meet one or more of the following rationales as those learning formats in which attendance and participation will be assessed: 1) sessions that involve collaborative teamwork (e.g., anatomy dissection, case-based formats such as PBL or its equivalent, etc.) 2) sessions that involve interactive discussion (e.g., seminars that depend on student analysis, presentations, or discussion such as PBL, journal club, problem-solving, clinical case or ethics case analysis, etc.) or 3) demonstration of a skill (e.g., microbiology or physiology lab activities, interviewing, patient examination, OSCEs, simulations, first responder training etc.). Because the patient must be the center of all health care activities, attendance will be assessed at all sessions, in large groups or small group formats that involve patients. In addition, students shall attend, on time, all sessions that specifically involve written or oral examinations. A student who arrives late will not ordinarily be allowed additional time on an examination. The faculty leadership of each foundational segment (i.e., Essential Principles of Medicine; Health, Illness, and Disease; and LEAP) will inform students in advance of which sessions meet the above rationale and involve the assessment of student attendance and participation.

The clinical phase of the curriculum mandates the full time commitment of the student in all patient-care and didactic activities. The student’s presence on the clinical floors of the hospital, clinics and physician offices is critical to the learning experience because it provides opportunities to observe and to participate in acute medical management decisions. Students are required to attend all lectures, rounds, case presentations, conferences, clinics, on-call periods, and other experiences as designated by the clerkship director.

The time period devoted to independent scholarly study, i.e. an Area of Concentration (AOC), offers students a more flexible time window to engage in a wide range of learning and enrichment activities both on and off campus. Nonetheless, the faculty expect that students will use the time wisely in scholarly pursuits and students shall participate in all learning activities (conferences, lab meetings, etc.) as directed by their research mentor, and will attend all required AOC sessions as specifically set forth by the leadership of the AOC.

C. Operational Issues

Students have the right to speak with the Associate Dean for Academic Affairs at any time about questions they may have about the attendance policy itself, their personal circumstances, or the concerns about the fairness in the application of the attendance policy to themselves or in a learning unit or clerkship.

Responsibilities of Students Regarding the Attendance Policy
Students are expected to have read the attendance policy, to abide by it, inquire in advance of the course leaders if they are uncertain how it might apply in their situation, handle all inquiries and evaluations by the faculty in a timely and honest manner, and follow through with counseling and/or satisfactory completion of missed course work. Attendance is expected unless excused.

Responsibilities of the Faculty Regarding the Attendance Policy
Faculty course and clerkship leaders are expected to implement the attendance policy as described above in way that is fair, transparent, consistent and measured in consequences for any violations. Faculty are expected, a priori, to indicate to students enrolled in their units how the policy will be implemented in their units. This should be done by a clear statement in the learning segment, clerkship or AOC website and supplemented, if necessary, through class orientations, email clarifications, or other means.

Faculty leaders responsible for implementing the policy are expected to respond to student inquiries about the policy in a timely manner, consult with education deans as needed for advice, and evaluate student absences fairly and without preconceived assumptions or judgments.

D. Types of Absences

Generally, the Medical College recognizes that emergent absences due to illness, personal emergency, or family emergency are not under the control of students and that it may be impossible for students to consult with course leaders prior to being absent for these reasons. Nevertheless, it is incumbent upon the student to notify the designated faculty or course leader or the Associate Dean (Student Affairs) as soon as possible when these events occur so that the Medical College may be assured of the student’s well being and may make plans with the student regarding the resumption of regular activities. Such events are not to be confused with other absences that can be anticipated and planned for in advance (e.g., major family events or celebrations, professional off-campus events, residency interviews); these are not emergencies. Only through proper notification and/or permission (see below) will these types of absences be considered "excused" absences by the Medical College.

Absences without proper notification, including planned absences without prior request for permission, are considered "unexcused absences." Such absences may result in sanctions that may include, but are not limited to, receiving a zero grade for the activity missed, receiving a marginal grade in the learning segment, or if serious, such as affecting or interfering with patient care, receiving a failing grade.

Some voluntary absences are not considered reasonable by the Medical College. Actions such as purchasing tickets for travel to leave early or return later, or solely to obtain discounted fares or engaging in other elective activities on course instruction days are not acceptable practice. Students who engage in such conduct must assume full responsibility for whatever ramifications in their performance assessment result from their actions, as described above, since these actions result in unexcused absences. Course leaders are not required to administer make-up examinations, equivalent or extra sessions to accommodate these voluntary unexcused absences.

The faculty recognizes that a medical education curriculum is demanding and that students may oversleep, resulting in their absence from a class session. The designated faculty and course leadership appreciates a student’s honest admission of this type of absence and generally will excuse such an incident. However, a repeated pattern of oversleeping through class sessions will likely result in a further evaluation by the designated faculty and course leaders about the student’s ability to manage time and handle academic stresses and/or a referral to the Associate Dean (Student Affairs) for additional evaluation or counseling.

Students with a recurrent pattern of excused absences that seems excessive, whether for illness or personal emergencies, will be referred to the Associate Dean (Student Affairs) by the designated faculty or course leaders for evaluation or counseling.

E. Duration

Generally, the time frame for an absence is expected to be no more than two consecutive days (including a Friday-Monday sequence). Emergent absences expected to last more than two days require that the student notify the Associate Dean (Student Affairs). Planned absences of more than two days require that the student first obtain the permission of the Associate Dean (Academic Affairs), or if unavailable, the Associate Dean (Curricular Affairs), before requesting permission of the designated faculty or course leader. When a student is uncertain about whether an absence will be considered potentially excusable, he or she should consult one of the associate education deans (student affairs, academic affairs, curricular affairs) for advice.

F. Request and Notification

Permission to be excused from a scheduled activity is to be sought by the student in writing (e-mail is acceptable). Students must ask for permission individually for themselves; they may not request permission for absences on behalf of other students. Emergent absences require notification and planned absences require both permission and notification in order to be considered excused. To ensure that the attendance policy is implemented fairly and consistently, students must notify and request permission of the designated faculty or course leader. Students may not negotiate an absence with the teaching faculty (e.g., a small group facilitator, office preceptor, ward attending etc.), nor are the teaching faculty permitted by the policy to negotiate or arrange such absences (see "Faculty Observation and Reporting of Absences" below).

Students who will be absent emergently (or are absent for reasons beyond the student’s control) are expected to notify the designated faculty or course leader, or, in the case of planned or voluntary absences, are expected in advance to request permission of the designated faculty or course leader in order to have the absence up for consideration as an excused absence. In the notification or permission discussion with the student, the learning unit or course leader will determine how the appropriate faculty or administrators are to be notified and the role of the student in this process. In any discussion of a requested absence, the student must include an explicit discussion of:

  • the reason for the absence;

  • the student’s plan to acquire the information missed;

  • the arrangement by the student for coverage of all clinical or course responsibilities;

  • the student’s arrangements to identify and notify all teaching and clinical faculty, house staff, and students affected by the absence (typically those involved in a team effort or presentation); and

  • the duration of the absence.

If the designated faculty or course leaders to be notified are not available in a timely fashion, are on vacation, or are away from the Medical College for other professional duties, the student should notify the Office of Academic Affairs in writing (e-mail).

Once a student has received an excused absence from the designated course leaders, he or she should inform all teaching and clinical faculty, housestaff, and students affected by the absence (typically students involved in a joint presentation). In the case of unplanned, emergent absences, notification of all affected faculty and students may not be possible in advance.

G. Categories of Absences

1. Illness
In the case of an individual’s illness, the student must notify the designated faculty or course leader(s) as soon as the student feels the illness will interfere with attendance and must discuss the points included under Request and Notification. If the student is unable to reach the course director or designated faculty member, the student must notify the Associate Dean (Student Affairs). If the student is too ill to attend scheduled educational activities, the faculty member may recommend that the student consult with the Associate Dean (Student Affairs), or be seen in student health. This is to ensure proper diagnosis and treatment and to avoid cases of undertreatment for serious illness. Making up the missed work to the satisfaction of the learning unit or course leadership is mandatory.

2. Personal/family emergency
In the case of personal or family emergency, the student must notify the designated faculty or course leader(s)as soon as the student is aware of the emergency. The student must discuss the anticipated length of the absence as fully as possible with the designated faculty or course leader, and must arrange for a way to be in communication with the Medical College to monitor the course of events. As noted above, if the absence exceeds or is expected to exceed two days the student must notify the Associate Dean (Student Affairs). In cases where the time frame is not clear, the student must discuss a plan to provide periodic updates on the situation. Making up the missed work to the satisfaction of the designated faculty or course leadership is mandatory.

3. Major family events
Absences from class to attend major family events (which are scheduled by others without consideration of the student’s schedule) require permission of the designated faculty or course leader(s) as soon as the student is aware of the date. If the activity extends for two or more days, the student must consult with the Associate Dean (Academic Affairs). Making up the missed work to the satisfaction of the course leadership is mandatory and the course director’s decision is final.

4. Professional off-campus events
Academic activities (professional meetings, paper/research presentations) that interfere with course instruction days must be discussed with the designated faculty or course leader(s) as soon as the date of the activity is known. The discussion, which is a request for permission to attend the academic activity, must include a statement of the student’s exact role in the academic activity, the mechanism for making up missed course content, the student’s plan for covering all responsibilities, and notifications as discussed above. With timely notification and permission a student will ordinarily be excused if he or she is presenting a poster or oral session. Students are not excused to allow attendance at the conference. In the case of professional conferences, the student should describe how the conference would provide added value above that of the required curriculum to the student’s learning and/or career plans. After discussion with the designated faculty or course leader(s), the student must also obtain permission from any learning unit leaders or small group leaders that will be impacted by the absence. The course leadership may take into account the student’s academic standing in the course in the decision to grant permission for these types of absences. If the activity extends for two or more days, the student must consult with the Associate Dean (Academic Affairs). Making up the missed work to the satisfaction of the course leadership is mandatory and the course leadership decision is final.

5. Other off-campus events
The College recognizes that students may wish to participate in many off campus events such as charity fundraisers, political campaigns, athletic competitions, etc. The faculty understands that these activities may be rewarding and valuable, but considers that a student’s first priority is his or her immediate scholarly preparation to become a competent physician. Accordingly, attendance at events such as these on instructional days in which attendance and participation is assessed (e.g., specified small groups, clinical work, exams etc.) will not be considered excused absences.

6. Residency interviews
It is not recommended that students schedule required course work during the time that they will be interviewing for residency programs. Any absences attributed to interviews for residency programs must be discussed with and approved by the course/clerkship director prior to their occurrence. Absences due to residency interviews that constitute more than ten percent of the days in the course or rotation are considered a significant loss of course/rotation time. The course/clerkship director will determine the scope of any work that needs to be addressed or completed as a result of absences related to travel for interviews for residency programs.

7. Sub-internships
Because of the high level of responsibility on sub-internships, sub-interns are expected to work each day for the entire rotation. They are not excused on Medical College holidays. If the student must miss clinical responsibilities for any reason, the student must help in making covering arrangements. The sub-internship director has full discretion to determine if the work performed by the student satisfies the course requirements.

8. Religious Holidays
The Medical College recognizes that the members of its community, including students, observe a variety of religious faiths and practices. Few of the various religious days of observance are part of the Medical College’s holiday calendar. However, the Medical College recognizes and respects the religious beliefs and practices of its students and will accommodate them reasonably within the requirements of the academic schedule. As a result, the Medical College will not penalize a student who must be absent from a class, examination, study, or work requirement for religious observance. Students who anticipate being absent because of religious observance must, as early as possible and in advance of an anticipated absence of a day, days or portion of a day, request permission for the absence from the designated faculty or course leader(s).

Whenever feasible, faculty should avoid scheduling examinations and assignment deadlines on religious holidays. A student absent from a class because of religious observance shall not be penalized for any class, examination, or assignment deadline missed on that day or days.

In the event an examination or assignment deadline is scheduled on a day of religious observance, a student unable to attend class shall be permitted the opportunity to make up an examination or to extend any assignment deadline missed. No fees of any kind shall be charged by the Medical College for making available an opportunity to make up an examination or assignment.

No adverse or prejudicial effect shall result to any student who takes advantage of the provisions of this policy. If a student believes that he or she is not being granted the full benefits of the policy, and has not been successful resolving the matter with the course director, the student may confer with the Associate Dean (Academic Affairs). In the event a student continues to believe that he or she is not receiving the benefits of this policy, the student may file an appeal under the appeal provision of the policy on Promotion and Graduation.

9. Jury Duty
New York State has rigorous regulations regarding service on juries and does not allow students to be excused from jury duty.

A student who receives a jury duty notice from New York County should contact the Medical College Registrar as soon as they receive the jury notice. If the student cannot make the dates assigned because he or she is scheduled for a class, clerkship, or elective, should call the number provided on the jury notice, explain that he or she is a medical student, and offer another two-week period to serve. The student may be asked to go to the court clerk to discuss the situation in person. There is no guarantee that students will be allowed to postpone jury service, but one’s willingness to make oneself available during the next break or vacation may aid the request. Students who repeatedly postpone jury service eventually will be required to serve, regardless of their academic schedule. Students should complete their jury service if they are not scheduled for class during the dates on their original jury summons.

Students who receive a notice for Grand Jury service or from a jurisdiction other than New York County should contact the Medical College Registrar as soon as they receive the jury notice.

10. Time Conflicts Between Classroom and Clinical Activities
In the foundational years (first 1.5 years of the curriculum) classroom sessions and clinical activities are usually not scheduled simultaneously. In the longitudinal patient program known as LEAP in which students in teams follow a panel of patients over time, but do not have primary patient care responsibilities, some patient activities may conflict with classroom activities, including examinations. The leadership of the LEAP program sets forth a hierarchy of specific clinical scenarios in which students may be asked to weigh these competing demands. In all cases in which attendance at a patient activity conflicts with attendance at an in-class session in which attendance is part of the academic assessment, students are expected to a provide timely request and notification to the designated course leaders. Students who have questions about the attendance policy as it pertains to LEAP should contact the LEAP faculty leadership.

In the clinical years (clerkships and sub-internships) when students are part of a patient care team, as a general rule, the care of one’s patient takes precedence over attendance at in-class didactic sessions or conferences. However, because these conflicts can never be totally free of ambiguity, students are advised to follow the directives of the clerkship directors and their faculty supervisors.

H. Faculty Observation and Reporting of Student Absences

To ensure that the attendance policy is fairly and consistently implemented, the teaching faculty in learning units and clerkships are not allowed to excuse students from class or clinical sessions. All requests for an absence should be referred to the designated faculty or course leader(s) for evaluation. Faculty members who note that a student is absent from a session in which attendance is being assessed and is not known to have the permission of the designated course leader should notify either the designated course leader directly or the curriculum office in the foundational years or the clerkship director in the clinical years. These course leader(s), in turn, should notify the Office of Academic Affairs of any unexcused absences of more than one day’s duration.

I. Making Up Absences and Reporting

The work or activities that are missed from academic programs, regardless of the reason for the absence, must be made up. The learning unit or course leadership has full discretion to guide the content and the nature of the work that needs to be addressed or completed. If there is an issue with resolving an absence or with the process for making up missed course work that is not resolved with the learning unit or course leadership, the student may confer with the Associate Dean (Academic Affairs).

Consequences of Unexcused Absences
In the foundational years, students who incur an unexcused absence in a learning segment (i.e., Essential Principles of Medicine or Health, Illness and Disease, and LEAP) will receive an email message from the designated faculty leaders advising them of their violation of the attendance standards. In addition, the absence will be noted in the student performance profile on record in the Office of Curriculum and Educational Development. A second unexcused absence in that learning segment will result in a written or email warning from the Associate Dean for Academic Affairs or other designated education dean, and a notation in the student’s official academic record in Academic Affairs. A third unexcused absence in the same learning segment will result in the student’s receiving a grade of "Marginal" for that segment which will remain in the student’s official academic record, but which will not be recorded on the student’s transcript. The student will be required to meet with the Associate Dean for Academic Affairs or other designated education dean for further evaluation of the reasons for persistent absences. Upon a satisfactory completion of the meeting and/or any other additional recommended meetings or counseling sessions, the grade of "Marginal" will be converted to a grade of "Pass" for the purposes of the transcript but a notation will remain in the student’s record of the absences. Students who incur an additional unexcused absence may be required to participate in additional evaluation and investigation as deemed appropriate by the Senior Associate Dean (Education). Students who accrue three grades of "Marginal" on the official academic record may be subject to review by the Promotion and Graduation Committee (See "Promotion and Graduation Standards and Procedures")

In the clinical years, where patient care responsibilities are the primary focus of the student, any unexcused absence will result in immediate evaluation and investigation by the clerkship director. Depending on the individual circumstances of the student and the number or type of didactic sessions and clinical activities missed, the student may receive a grade of "Marginal" or "Fail" that requires remediation through meetings and/or counseling by the Senior Associate Dean (Education) or the Associate Deans of Academic or Student Affairs, and/or a make-up of missed activities, including a possibility of repeating the clerkship satisfactorily in part or in entirety.

In the period devoted to Areas of Concentration, the student’s research mentor will notify the faculty leadership of the AOC program, typically a pathway director or the AOC director, of any persistent unexcused student absences. The faculty leadership of the AOC will evaluate the reasons for the absences and, if warranted, depending on the pattern and types of missed activities, record such absences in the student’s official academic record and/or require that missed sessions be made up. For continued persistent absences, the AOC director will consult with the Associate Dean for Academic Affairs about additional evaluations, stipulations or sanctions.

The faculty leaders of electives that students take as part of the required course for the completion of the MD degree program, after appropriate determination that an absence is unexcused, should report such absences to the Associate Dean for Academic Affairs for further evaluation and/or measures.

Students who take electives or pursue degree programs at institutions other than WCMC are expected to comply fully with the absence policy as set forth by that institution and to incur consequences of its violation as determined by that institution. Evaluations/grades received from the institution will become part of the student’s official academic record at WCMC.

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