Years 3 and 4 Coursework and Examination Absence Policy

It is the policy of the University of Arizona College of Medicine – Phoenix that all 3rd and 4th year clinical experiences (clerkships, selectives, and electives) are mandatory. Any absences must be recorded and are not to exceed 0.5 days per week on average for clinical courses. Although some absences are unavoidable, absences impact student experiences, other medical students, the entire clinical team, and patient care on clinical rotations. Exceptions to this may be considered in accordance with the appropriate grading and progression policy. 

Grading and Progression Policies:

• Grading and Progression for Clerkships and Selectives Policy 
• Grading and Progression for Electives Policy

All absences must be remediated. A grade of Incomplete may be assigned until remediation occurs. An Incomplete can be resolved following the procedures outlined in the grading and progression policies linked above. In instances where remediation of absences is not possible, a student’s progression may be delayed. The course* director will establish general guidelines for implementation of remediation plans for clinical absences that are specific for the unique requirements of the course*. The implementation guidelines will apply for students at all sites within that course*. Guidelines will be published to the course* syllabus made available to the students and reviewed by the course* director during course* orientation. Students should refer to the course* syllabus and work with the course* director to determine whether remediation is possible and determine a plan for completion of required activities.  Students should work with their course* director to determine a remediation plan. Direct clinical experiences for absence remediation will be assigned whenever possible in order for students to gain the necessary experience. Students are still responsible for meeting all learning objectives and requirements for each course*.

Clinical rotations include:

• Emergency Medicine
• Family, Community & Preventive Medicine
• Internal Medicine
• Longitudinal Integrated Clerkship (LIC)
• Neurology
• Obstetrics & Gynecology
• Pediatrics
• Psychiatry 
• Surgery
• Ambulatory Selective
• Critical Care Selective
• Sub Internship Selective
• All Patient Care Electives 

For non-clinical courses* (Personal and Professional Development A/3 and B/4 (PPD), Longitudinal Patient Care, Scholarly Project, and Non patient care electives), attendance is critical as well. Therefore, attendance, including tardiness, is part of the behavioral assessment of professionalism and poor performance may result in failure to meet competency expectations (i.e., earning a Level 1). 

Excused Absences 

An excused absence will be approved for one or more of the following reasons, when they do not exceed the 0.5 days per week on average for clinical courses, noted above. Students are expected to notify faculty and plan remediation of an absence as early as possible. The earlier a remediation plan can be developed, the more options that are likely to be available. Students should note that availability and flexibility of schedule options may vary based on clinical rotation, site, etc:

• Presentation at a professional conference or leadership activity (e.g., as an AMSA committee member) on behalf of the College of Medicine – Phoenix the number of days excused will be decided in consideration of the student’s role and duties at the conference and the requirements and experiences of the course* that would need to be remediated.
• Religious observance – Students may request an excused absence for religious observances, in accordance with Arizona and federal laws and the Religious Accommodations Policy.
• Personal circumstances – Personal circumstances may include, but are not limited to, significant family or personal events (e.g., a wedding, car trouble, etc.) that disrupt the student’s ability to attend to mandatory course* requirements. 
• Personal wellness (health care maintenance, illness, injury, or disability) – In the case of a student’s own wellness, it is the student’s responsibility to ensure the appropriate parties (noted in syllabus), including the site and course* directors are informed of the absence in a timely manner. If the student is seriously ill, a family member or friend can inform the appropriate parties. 
• Residency interview and application related activities – It is expected that students use discretionary time, when possible, to schedule interviews and applicant visit days. An interview or visit requiring an absence may be unavoidable, particularly during peak residency interview season. It is the student’s responsibility to notify appropriate parties, including the course* and site director so that appropriate remediation may be determined. 

Extended or Recurrent Absences 

• If a student is unable to participate in a clinical experience because of their own serious illness, injury, or disability, or other personal reasons, they should be apprised of the College of Medicine – Phoenix’s Leave of Absence Policy.
• Students with disabilities who require reasonable accommodation(s) must register with the University of Arizona’s Disability Resource Center in accordance with procedures outlined and work with that office to affect such accommodations.

Unexcused Absences and Consequences 

• Any non-emergency absence that is taken without prior notification by the student, the student’s designee, or permission of the dean, student affairs and/or the course* director (i.e., a “no call/no show” absence) is considered an unexcused absence and will be treated as an act of unprofessional behavior. For clinical courses*, this will be included in the student’s final assessment and result in a grade no higher than Pass. For non-clinical courses, this will negatively impact student professionalism competency rating. Students are responsible for all material missed with the understanding that some material cannot be reproduced by the course* director.

Holidays 

• Students will observe the holiday schedule of the University of Arizona during all required clerkships, PPD A/3, PPD B/4, and LPC. A student may request to work on a day designated as a holiday by the University of Arizona.  All other clinical activities, including students participating in electives and selectives (in either the third or fourth year), will observe the holiday schedule of the institutions of their rotations.
• The student may request to work on a holiday in place of a regular, non-holiday work day, by contacting the course* director in advance.

Requesting an Excused Absence^{^}

• To request an excused absence, students must request the absence through Formsite at least 30 days in advance for scheduled events, or as early as possible in the setting of unanticipated and/or urgent events. The date(s) of the absence must be included in the request. The course* director and site director must be notified by the student requesting the absence and the director will work with the student on an individualized remediation plan as soon as necessary information is available. 
• If a student requests an excused absence due to an unanticipated illness or injury, they will utilize the electronic absence request system immediately and notify their site director unless unable to do so because of such illness or injury. It is expected that the student reports their absence, through Formsite, as soon as physically possible. The course* director and site director must be notified by the student and the director(s) will work with the student directly to develop an individualized remediation plan.
• For absence requests that do not meet the requirements for automatic approval, students shall select the ‘personal’ request type. Students submitting a personal absence request must provide additional information explaining the reason the absence does not meet the standard absence requirements. The dean, student affairs, or respective designee, will notify the student and the course* director of their decision regarding the requested absence via Formsite.

Examination Absence

1. Excused Exam Absence/Date Change Request
   1. Request for excused exam absence and exam date change may be approved for the following reasons:
      1. Reasons that are predictable in advance (religious observance, life event, jury duty, etc.)
         1. The exam absence request must be made in advance of the regularly scheduled exam date and documented using the Student Exam Change Request within the following timeframes:
            1. For pre-approved absence for an end-of-clerkship NBME shelf exam, the request must be made at least 30 days in advance of the regularly scheduled exam date.
            2. For a pre-approved absence from OSCE 4 (both doctoring and simulation portions), please refer to the PPD syllabus.
      2. Reasons that are not predictable in advance (acute illness, family emergency, etc.) where 30 days’ notice cannot be given.
         1. The Student Exam Change Request must be made as soon as possible and no less than within 24 hours before the regularly scheduled exam date. Absences related to emergencies that do not allow 24 hours’ notice or more will require further review by the dean, clinical curriculum, and/or approval of the dean, student affairs.
         2. Must be discussed with the course director and may require approval of the dean, clinical curriculum, or respective designee who will communicate approval with the exam team.
      3. Exam absences are monitored, and recurrent requests to reschedule exams may require documentation and a meeting with the dean, student affairs, or respective designee.
   2. Once the exam absence request and date change for any of the reasons above are approved, a make-up examination date must be arranged by the student with the dean, clinical curriculum, and the relevant exam team at a time not to interfere with other scheduled academic requirements.
      1. For NBME make-up examinations, the make-up date and time must be confirmed at least 72 hours before the desired exam date to allow ordering of the NBME shelf exam.
         1. Appropriate testing resources and personnel (e.g., proctor, proctored venue, technology, etc.) must be available on the alternative test date.
      2. For OSCE make-up examinations, the logistical complexities in administering these exams may limit the make-up options available to students, and this may subsequently limit a student’s ability to participate in away rotations or other off-campus enrichment activities. Students are responsible for understanding the implications of a missed OSCE examination and should meet with the Office of Student Affairs to discuss the potential impact on their progression and completion of graduation requirements.
2. Unexcused Exam Absence and Consequences
   1. A missed examination with no prior communication, no communication within 24 hours of the missed examination, or a denied request from the course director, dean, clinical curriculum, or dean, student affairs, or respective designees constitutes an unexcused exam absence.
   2. A student who does not obtain an excused absence for a missed examination will receive a score of zero. Students should reference the course syllabus to understand the impacts that an exam failure will have on their final grade and/or academic progression.

Exceptions for unexcused absences must be approved by the dean, student affairs, in conjunction with the dean, clinical curriculum, or respective designees. 

^Students do not need to reveal personal nature/aspects of the absence request to the course* or site director.

Course* = Any component of the curriculum where a grade is earned.