Students pursuing the MD degree at HMS are required to comply with the School’s attendance policy in all phases of their education and training. As a professional school, HMS expects attendance and active participation in all components of the curriculum, including lectures, tutorials, laboratories, patient clinics, and other course and clerkship activities. Participation in the School’s course and clerkship activities demonstrates the student’s understanding and mastery of professional responsibilities. The granting of the MD degree attests to the fact that the student has demonstrated a commitment to his/her professional responsibilities through participation in all aspects of the curriculum as defined by the faculty.
The attendance policy recognizes two types of official absences: “approved” and “unapproved.” Approved Absences will be granted based on the criteria below (see Approved Absences). Absences not meeting these criteria are considered Unapproved Absences. In all cases, students must submit an absence request in anticipation of an absence from any required course, clerkship, or PCE activity, or as soon as possible when this is not feasible, to the course, clerkship, or PCE director. Unapproved Absences are not permitted during final exams.
Failure to request and confirm an absence from any required course or clerkship session will be considered an unreported absence constituting a failure of professional responsibility subject to review by the HMS Promotion and Review Board (PRB). Students who accumulate more than three Unapproved Absences during a single academic year will be referred to the PRB. Students who accumulate an inordinate number of Approved Absences will be subject to review by the student’s academic society.
As a general guideline, during Years I and II in the HMS curriculum, students are expected to be present for all classes Monday through Friday as shown on the Academic Calendar. Travel arrangements should not be made that conflict with the class schedule as shown on the Academic Calendar.
Absences are categorized as approved or unapproved based on the criteria outlined below. Whether an absence is an Approved Absence or an Unapproved Absence, the student must notify the course/clerkship director and, if applicable, PCE Director whenever he/she will be absent from any required course or clerkship activity. The course/clerkship director and the PCE Director will determine if the reason for the absence meets the criteria for an Approved Absence. For purposes of this policy, the unit of measure for an absence is a day.
I. Unexpected events outside a student’s control may justify an Approved Absence. These include medical emergencies, family emergencies, and sudden changes in life circumstances. After receiving notice from the course/clerkship director that the absence meets the criteria for an Approved Absence, the student is required to report the absence to the following course and school officials (in this general order depending on the circumstance):
1. The tutor/preceptor and, if during PDII, the PDII site director
2. The Academic Society Master or Associate Master (for absences of more than one day)
3. The Registrar’s Office (for absences of more than two days)
1. The PCE director (if during the PCE year)
2. The clerkship director
3. The relevant clinical care team (for clerkships and clinical electives)
4. The Academic Society Master or Associate Master (for absences of more than one day)
5. The Registrar’s Office (for absences of more than two days)
Failure to notify the appropriate individuals involved will be considered a breach of professional responsibility and will be subject to review by the PRB.
II. Religious obligations are a valid reason for an Approved Absence from a class or clerkship activity. Massachusetts state law provides that a student in an educational institution who is unable, because of his/her religious obligation, to attend a class, participate in an examination, or meet a study or work requirement shall be provided with the opportunity to make up this work (see Section 7.01, Harvard University Policy Regarding Religious Holidays). Students should use careful discretion in judging the importance of a particular holiday and in requesting travel days around such holidays. The student must inform his/her course or clerkship director (as well as other relevant individuals as outlined above for unexpected events) in advance when he/she must be absent for a religious obligation. Extended time off beyond the timeframe of the official religious holiday will not be eligible for an Approved Absence. See also Section 2.03, Grading and Examinations.
III. Scheduled Conferences. Leadership in medicine is founded upon a solid knowledge of the science of medicine. To that end, building the foundation of medical knowledge is the first priority of medical students. While leadership in extracurricular and extramural activities is encouraged, such opportunities must not occur at the expense of a student’s required coursework and attendance responsibilities.
a. Individual students may request permission to attend a scientific conference or meeting for the purposes of presentation of a paper or other academic work or poster as first author. An Approved Absence is ordinarily limited to the day of the presentation.
b. Student Associations: Many student organizations host national meetings of interest to HMS students; these organizations include the following:
• Organization of Student Representatives of the Association of American Medical Colleges (AAMC)
• American Medical Student Association (AMSA)
• American Medical Women's Association (AMWA)
• Student National Medical Association (SNMA)
• American Student Dental Association (ASDA)
When a group of students expresses an interest in attending a national or regional meeting of a professional society or association, a representative of that group must first notify the Dean for Students. The individual students who wish to attend must follow the policy below:
- Ordinarily, only elected officers, students seeking or holding leadership positions in the organization hosting the conference, or presenters may receive an Approved Absence from a course in order to attend a conference.
- In general, only one student in a tutorial group may receive an Approved Absence for the same conference.
- The ultimate decision about an Approved Absence for scheduled conferences rests with the course/clerkship director and the Academic Society and is based on the student’s academic record to date, attendance record to date, and the course/clerkship director’s estimation of the importance of the specific course session(s) that would be missed.
Students may not receive an Approved Absence from a final examination in order to attend a professional conference (see Final Examination Policy, Section 2.03).
c. Procedure for students who have met policy preconditions (above):
- Request approval in writing to miss class/clerkship time from the course/clerkship director(s), Academic Society Master or Associate Master and the PCE Director, if applicable. Approval, which must be granted by all parties, will be granted only for students who are performing well academically and who have an exemplary attendance record. If approval is granted, students must inform relevant faculty (e.g., tutors, attending physicians, preceptors) of the planned absence. Dental students must inform personnel at the Dental School as well. Arrangements to cover any missed course work must be made with the course/clerkship director before approval will be granted. In the event that the educational content in a core course/clerkship cannot be made up prior to the course end-date, the student will receive a grade of Incomplete until the coursework is made up, and the course/clerkship director will determine whether the amount of material to be remediated must be completed by repeating the course.
- A student must make certain he/she has financial resources for all anticipated conference and travel expenses before committing to any travel.
- After completing Steps 1 and 2 above, students may make arrangements for their absence (purchase tickets, secure accommodations, pay conference registration fees, etc.). No student should make any purchases until he/she has received permission from the parties listed above to miss class to attend the conference.
- An Approved Absence to attend a scientific conference or meeting for the purposes of presentation of a paper is usually limited to the day of the presentation.
Unapproved absences: Absences for reasons other than those enumerated above will be considered Unapproved Absences. These ordinarily include absences for special events (e.g., weddings, graduations, family gatherings). Students who accumulate more than three Unapproved Absences during an academic year or fail to report an absence from any required course or clerkship session will be referred to the Promotion and Review Board. Because of the high importance placed on attendance at all required course and clerkship sessions, Unapproved Absence requests should be submitted judiciously. Under no circumstances will an Unapproved Absence relieve a student of meeting all of the academic requirements of the course or clerkship; if the Unapproved Absence request conflicts with a session or sessions that cannot be otherwise remediated, the student will be advised that the absence may or will affect the grade received in the course or clerkship.
Vacation periods are published in the course and clerkship calendars. Students are not allowed to begin vacations before the published course start date or extend vacations beyond the published course end date.
Attendance Requirements for Preclinical and Clinical Courses
Fundamentals of Medicine: Attendance at all tutorial sessions and patient clinics is required. At the discretion of the course director, attendance may be required for any or all other class sessions held within the official course meeting times shown on the Academic Calendar. Attendance will be taken at all tutorial sessions and may be taken during any other required course session at the discretion of the course director. Absences from required course activities will be reported to the student’s Academic Society. If a final exam is missed because of an unreported absence, the student will be given a failing grade for the course, a make-up exam will be required, and a final grade no higher than ‘marginal satisfactory’ will be awarded.
Health Sciences and Technology (HST): During the HST preclinical curriculum, all course activities are generally required.
Principal Clinical Experience and Advanced Experiences in Clinical Medicine: Students doing clinical training are an integral part of a patient care team, and, if a student is not present, his/her responsibilities will need to be done by another member of the team, to ensure that essential patient care does not suffer. Additionally, all core clerkship activities and all PCE activities are mandatory. Accordingly, students need to maintain a very high threshold for requesting an absence during a clinical rotation. A zero tolerance policy exists for unreported absences during clinical clerkships and clinical electives. Failure to request and confirm an absence from any required clerkship or PCE session – didactic or clinical - will be considered an unreported absence constituting a failure of professional responsibility subject to review by the HMS Promotion and Review Board (PRB). Students must contact the clinical care team, the clerkship director and, if during the PCE, the PCE director to discuss any potential absences. This should be done as far in advance of the absence as possible. Students who miss clerkship/class time during this period because of an absence will be required to make up the work. The course/clerkship director and the PCE director, when applicable, will determine whether the absence is approved or unapproved, and if approved, whether the amount of work missed can be made up during the course/clerkship or must be completed by repeating the course/clerkship.
In the core (required) subinternship in Medicine or Pediatrics senior medical students function as an "intern equivalent" under the supervision of a senior resident. Given the level of responsibility students assume in this clinical setting, no Unapproved Absences are allowed during this clerkship. If a student anticipates a need for time off during the final year of medical school, the subinternship should be scheduled during a different block, pending availability.
Consequences of Noncompliance with Attendance Policy
Students who fail to comply with the School’s attendance policy face a number of serious consequences. These include the following:
- Grades may be lowered.
- An unreported absence from a clerkship will result in a failure and require that the clerkship be repeated.
- Students who accumulate more than three Unapproved Absence days during an academic year or fail to report an absence from any required course or clerkship session will be referred to the Promotion and Review Board.
- The Promotion and Review Board will review attendance noncompliance to determine whether such unprofessional behavior warrants official censure in the student’s academic record and Dean’s Letter.
- Summative comments in the evaluations of both preclinical and clinical courses may include descriptions of Unapproved Absences and/or unreported absences or tardiness. Such comments will be included in the Dean’s Letter.
Any student who does not attend classes or clerkships for a period of 30 days and has not been placed on an official leave of absence (LOA), absent extenuating circumstances, will be considered absent without leave, and will be considered withdrawn from Harvard Medical School.
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