Attendance and Absence Policies

Following are our policies on attendance and absence for the Fundamentals Curriculum and the Clinical Curriculum.

VP&S Fundamentals Phase Attendance Policy 

Overview/Rationale 

VP&S is committed to providing learners with an outstanding education in the art and science of becoming a physician, as reflected in our Medical Education Program Objectives. Adherence to ethical behavior in all realms of professional life, and commitment to integrity, advocacy and leadership are crucial behaviors to excel during medical school and beyond. We expect our students to learn about and adhere to the highest standards of leadership, advocacy, and integrity, consistent with the VP&S Honor Code, VP&S values, clinical site policies and procedures, and those of the profession. The Fundamentals phase attendance policy reflects this objective by defining expectations for our students around demonstrating initiative, responsiveness, reliability, and accountability through attendance to, and timely recording of attendance at, all mandatory curricular activities. 

Students are exposed to a large volume of new information in medical school, some of which is delivered in large group sessions and some as on-line modules for students to work through individually over time. Interactive sessions, where learners work together to problem-solve, explore hypotheses, or practice new skills, require student attendance so that they and their peers share in their learning. 

Due to the possibility of both predictable and unpredictable events impacting attendance, the attendance policy should incorporate provisions and procedures to address these situations. Students are accountable for monitoring their attendance and participation, communicating professionally about absences, and seeking help from the school if personal circumstances affect their attendance and participation. 

Accreditation Standards 

• LCME 12.4 Student Access to Health Care Services 

Stakeholders 

Medical students and Faculty in the Fundamentals Phase of the Curriculum 

Policy 

During the Fundamentals phase of the curriculum, students are required to attend and record attendance at all small group and clinical activities and unrecorded teaching sessions featuring patients. Specifically, these include: 

• All small group and clinical activities (classroom, labs, Sim Center, bedside sessions, FCM (Foundations of Clinical Medicine) Seminars clerkships) 
• All non-recorded large group sessions (ex: Patient as Professor, Psychiatric Medicine patient interviews and presentations) 
• Scheduled sessions in the Simulation Center (individual or group) 
• Summative Assessments 
• OSCE (Objective Skills Clinical Examination) and Assessment Week exam review sessions 
• Additional activities to be determined and posted on the calendar well in advance 

Other lectures are recorded and may be viewed asynchronously. Attendance at recorded lectures is not mandatory but is highly recommended.

Expectations from students: 

• Students are expected to be aware of and abide by the attendance policy. It is their responsibility to meet the attendance requirements for each course and curricular activity to which they are assigned.  
• All required curricular events will be identified on OASIS as “Mandatory.” Students are responsible for making sure that their OASIS calendar updates regularly. 
• Students are expected to be present at all mandatory events and to record attendance using the aPlus+ system at the time of the event. The Office of Curricular Affairs will monitor the aPlus+ system.  
• Falsely recording attendance (recording while off-site or recording on behalf of another student) is a serious violation of the Honor Code and may lead to a performance review by the Fundamentals Faculty Committee. 

Expectations from Faculty and Staff: 

• Students will receive the academic calendar in advance of the start of the semester so that they are aware of expectations and plan vacations accordingly. 
• Course directors in Fundamentals must describe the attendance policy in the syllabus and make clear that repeated absences may lead to a course failure. 
• The attendance policy will be communicated to students in person during Orientation and the beginning of each semester, and the policy will be posted on the VP&S website. 
• Curricular Affairs is responsible for ensuring that mandatory curricular activities are identified as such on OASIS, and that the OASIS calendar is accurate and up to date. 
• Curricular affairs will ensure that students are provided with an opportunity to log in to aPlus+ at each mandatory curricular activity. 
• Course administrators will be responsible for tracking student attendance and for notifying students when they fail to record. 

Procedures 

How to request an approved absence from a mandatory curricular activity 

Students should not schedule personal events that would result in an absence from a mandatory curricular activity or assessment. We recognize that students may experience planned or unplanned life events that may impact learning, however, and have designated the following circumstances as acceptable reasons for being absent from a mandatory curricular activity: 

1. Acute illness 
2. Urgent health care needs 
3. Personal crisis (for example, death in the family) 
4. Religious holiday observances (as described in the Columbia University Regulation on Religious Holidays) 
5. Participation in a scientific conference where the student is the lead author/presenter and directly participating in the conference presentation 
6. Significant life event not otherwise specified 

If a student anticipates missing a mandatory session or assessment, they must request an approved absence at least 4 weeks in advance of the event via this request form through a Qualtrics form. The student will be notified that the absence is approved within 1-2 weeks of the request. 

In cases of unanticipated absences involving illness and unexpected emergencies, students must notify the Office of Medical Education through a Qualtrics form as soon as is feasible and must also notify their course directors by email of their absence. 

Students wishing to discuss additional reasons for absences may contact the Associate Dean for Student Affairs, Support and Services. 

Course directors will be notified of approved absences and will provide opportunities for make-up examinations as appropriate, but in most cases missed curricular activities cannot be rescheduled. Students may be required to make up any missed required material.  

Procedure when student misses or fails to record attendance to a mandatory curricular activity without an approved absence 

Throughout the Fundamentals phase, neglecting to record attendance will be considered equivalent to an unapproved absence to a mandatory curricular activity. Repeated incidents of unapproved absences may indicate that a student is struggling, and as such, the intent of tracking attendance is to provide students with feedback on expectations and access to resources as early as possible so that issues that may impact performance may be addressed effectively. 

Attendance will be tracked longitudinally, and students will be notified when they have an unapproved absence. 

After the first unapproved absence, the student will receive an email from the course director that notifies the student of their unapproved absence. The student will be given a reminder about the attendance policy and process and encouragement to seek support if needed.  

When a student has a second unapproved absence, they will receive an email from the course director that notifies them that this is the second missed activity. The student’s Advisory Dean and coach will also be notified and may arrange a meeting with the student. 

With a third unapproved absence, the student will receive an email that indicates the student has missed three mandatory sessions, and that the student’s performance, including their attendance record, will be reviewed by the Fundamentals Faculty Committee (FFC). The members of the FFC will review the missed sessions in the context of the student's record of academic progress and professional conduct to date and will make recommendations intended to help the student address and successfully remediate concerns that are identified. Unapproved absences will also be noted in the relevant course's final student performance evaluation and will contribute to assessment of MEPO (Medical Education Program Objective) 5.2. The FFC will review the performance of students who miss more than 10% of mandatory sessions in any given course, whether or not the absences are approved. The consequences of crossing that threshold could be a failing grade or an incomplete since attainment of the knowledge and skills needed to care for patients in MCY (Major Clinical Year) may be lacking. 

Failure to present or complete a required assessment without satisfying the above requirements will result in a failing grade for that assessment attempt and submission of a professionalism concern report.  

Policy History/ Approval Date:  

VP&S Policy for the Clinical Curriculum

On clerkships, students are required to be present every weekday and on weekends if on call or scheduled for clinical duties. On electives, students must be present from the first to the last day of the calendar month, with more variable hours expected (including possible weekend and overnight work) and flexibility for away elective scheduling at the discretion of the course director.

Students may be absent for acute illness, a personal crisis (e.g., death in the family), a first-author presentation at a scientific conference or a religious observance as described in the Columbia University Regulation on Religious Holidays.  Please refer to 'Religious Observance Scheduling' Policy below for more guidance. As soon as they are able, students must notify the NewYork-Presbyterian clerkship or elective director and copy psmcy@cumc.columbia.edu (for clerkships) or pselectives@cumc.columbia.edu (for electives). Approval for all absences is at the discretion of the clerkship or course director.

While working in clinical settings, it can be challenging to balance self-care with professional duties. To help maintain their self-care, students who need accommodations to attend medical appointments should notify the Office of Education at psmcy@cumc.columbia.edu (for clerkships) or pselectives@cumc.columbia.edu (for electives). Students do not need to disclose their specific medical need. The Office of Education will provide a list of students needing accommodations to clerkship and elective directors without reference to students’ specific medical need. Students are also asked to alert clerkship and elective directors of their accommodation at least four weeks prior to the start of the clerkship or elective.

Some Clerkship and Elective Directors will also allow a brief absence for a wedding in which the student plays a significant role or a graduation of a close family member, but they are not obligated to do so. In all such cases, students must email the NYP Clerkship or Elective Director and copy the Office of Education (psmcy@cumc.columbia.edu or pselectives@cumc.columbia.edu) well in advance. If approved, students should advise site directors, attendings, preceptors and house staff of the dates of anticipated absences well in advance so that appropriate arrangements for on-call scheduling, patient care, and makeups can be made.

Schedules on clinical rotations including clerkships and electives are governed largely by the patient care duties of students’ teams. In the Major Clinical Year, which excludes Christmas and New Year's, vacations are detailed on students' individual rotation schedules. The only protected time for holidays in the Major Clinical Year is Thanksgiving day and the Friday following Thanksgiving. Holiday schedules during electives are determined by the patient care needs of the specific elective. Students should direct questions about holiday coverage to their clerkship/elective directors.

When required, arrangements for make up or repetition of the clerkship or elective will be at the discretion of the clerkship or course director. If students miss 20% or more of a clerkship (e.g., five or more days for five-week clerkships, one or more days for one-week clerkships) or four or more days of an elective, they will receive an incomplete for the clerkship or elective and be required to make up the missed time and possibly the entire course.

Revised by MCY Subcommittee 12/17/14, edited for clarity 7/6/17

Approved by Curriculum and Education Policy Committee 12/19/14

Religious Observation Scheduling

Overview/Rationale

It is the policy of Columbia University Vagelos College of Physicians (VP&S) and Columbia University to respect the religious beliefs of its faculty, students, and staff. In accordance with New York State law, no student may be penalized for absences due to religious beliefs. Observance of religious holidays and daily practices such as prayer may impact a student's schedule of preclinical coursework and clinical rotations and assessments. To be respectful of all religious cultures, the VP&S policy is to support students’ religious practices, including students who wish to observe religious holidays that are not also official university holidays, while minimizing disruption to the delivery of patient care. 

Stakeholders

Students, course and clerkship directors 

Policy

A. Fundamentals Phase Courses 

Course Directors are expected to avoid conflicts with religious holidays as much as possible, particularly with required activities such as examinations and assignment deadlines. When scheduling conflicts are unavoidable, course directors are expected to find alternative means by which students who must be absent for religious observance can complete missed academic requirements. 

Columbia University's Office of Religious Life maintains a calendar of religious holidays, and instructors are asked to be aware of the holidays and dates listed. Please note that the list represents those religious holidays that are most likely to impact students, faculty, and staff at Columbia, but there is a more comprehensive list linked for reference too. 

Students are required to inform their Course Directors of their plans to observe a religious holiday at the beginning of the semester, so that there is plenty of time to plan for any necessary alternative arrangements. It is important for students to understand that no matter what absences might be accommodated, they will still be responsible for all course requirements, which may include in-class participation or other assignments that will need to be made up in some alternative way. 

If a suitable arrangement cannot be worked out between the student and the Course Director, they should consult the Associate Dean for Student Affairs, Support and Services. 

B. Clinical Rotations 

Students on clinical rotations may request an absence to observe a religious holiday from their clerkship director. Details of the absence will be worked out directly between the student and the clerkship director on an individual basis. Modifications to schedules (including breaks for prayer), will be supported as long as these requests do not alter the fundamental requirements of the clinical rotation, require substantial program modification, or pose safety risks to patients. Allotted non-work days may need to be used to allow for schedule adjustments or to make up missed time that results from religious holidays or other religious-related absences. Students should make such requests of the clinical rotation director as soon as possible after the student’s clinical rotation schedule is known or, ideally 2 weeks prior to the beginning of a course or clerkship/elective block or month. 

C. Assessment Schedule 

1. It is the policy of VP&S that a course or clerkship director will make a reasonable attempt to accommodate students’ needs in the case of serious incompatibility between a student's religious creed and a scheduled assessment activity. 

2. Arrangements for an alternative assessment date will be worked out directly and individually between the student and the relevant course or clerkship director. It may not be possible to reschedule some assessments, such as laboratory practical examinations and standardized patient exams. 

3. Students should make such requests to the course/clerkship director as soon as possible after a conflicting examination date is announced or, at the latest, at the beginning of a course/clerkship. 

4. The clerkship director or site director is responsible for communicating the agreed-upon accommodation(s) to the relevant clinical attending/team, to ensure that the clinical attending/team understands the policy and that the student has done due diligence in working out the accommodation(s) with the course leadership.