POLICY

It is the policy of the University of Tennessee Health Science Center (UTHSC) College of Medicine (COM) to provide a training environment in which students’ educational and work requirements can be balanced with family and life obligations, including maintenance of one’s own health. Also, as a component of professional development it is critical for students to recognize when they are not well and learn to take appropriate steps to ensure that patient care and/or the health of fellow learners is not compromised.

RATIONALE AND PROCEDURE

1. It is recognized that professional activities can at times be impacted by other obligations and responsibilities, either anticipated or emergent. This policy delineates the mechanisms by which provisions are made for such disruptions, whether involving excused absences for specified reasons or discretionary wellness days that need not be explained.
2. Such disruptions should have no influence on a student’s performance evaluation, with the recognition that it may be necessary to make up, or in some cases repeat, any mandatory training elements that may have been missed. Some missed events may not be amenable to remediation, and alternative evaluation methods may be used.
3. Excused absences:
   1. Excused absences may be granted to allow for the following activities:
      1. Funerals (Death of a close family member)
      2. Acute illness/urgent medical appointments (e.g. Sick days)
      3. Preventive or routine healthcare (e.g. anticipated medical appointments)
      4. Religious observances/Holy Days
      5. Jury duty and other legal obligations
      6. Step 2CK/CS (*restrictions apply)
      7. Residency interviews (*restrictions apply)
      8. Attendance at professional meetings if presenting or representing the COM
         
         *Not allowed during required M3 clerkships or JIs.
   2. There are no formal limits on the total numbers or durations of excused absences since many of the circumstances are beyond personal control. However, the following guidelines should be considered:
      1. For non-emergency, preventative or routine healthcare, a Limited Leave Request must be submitted 30 days before a mandatory attendance event during the pre- clinical years, or 30 days prior to the start of a clinical rotation, so the student can be scheduled with the least impact to his/her education. Documentation of the visit should be provided to the Course or Clerkship Directors and sent to the Office of Medical Education.
      2. For acute illness or urgent healthcare issues, pre-clinical Course Directors must be immediately informed (telephone or email) if any mandatory attendance event will be affected. During clinical rotations, the Clerkship Director, Attending, and other pertinent team members must be immediately informed (telephone). Under unusual circumstances, the Clerkship Director may contact the student’s Attending and team.
      3. If an absence due to an acute illness extends beyond 2 days involving mandatory attendance events, documentation (e.g. doctor’s note) must be provided.
      4. Absence for religious observance must be requested at least 30 days in advance of the event (pre-clinical years) or start of a rotation (clinical years). If the date of the observance is not known 30 days in advance, then requests should be made as soon as the date is determined.
      5. Attendance at professional meetings must be approved by Course or Clerkship Directors and the Associate Dean of Medical Education. Approval should be requested as far in advance as possible, and no less than 30 days prior to the meeting (pre-clinical years) or the start of a clerkship (clinical years). Approval is typically based on presentation of original work or otherwise representing the COM in an official capacity at a recognized professional meeting. Every effort should be made to minimize the time away from the curriculum. Other participation or attendance may be approved at the discretion of Course or Clerkship Directors and the Associate Dean of Medical Education.
4. Wellness days:
   1. Wellness days encompass any absence not otherwise justified as an excused absence. These may be used for any important life event (weddings, reunions, etc.), or in circumstances for which a student may not wish to disclose a reason. Indeed, students will not be required to provide a reason for requesting a wellness day.
   2. Students will be invited to share their reasons via an anonymous survey maintained by the Medical Student Executive Council (MSEC).
      1. Use of the anonymous survey will result in students receiving a list of services and resources that are available, and will encourage students to reach out should they be in crisis.
      2. De-identified data from the anonymous surveys will be shared with the Office of Medical Education to evaluate the effectiveness of the Wellness Day Policy.
   3. Wellness days are limited to 4 per academic year and to no more than 2 days per rotation.
      1. No half days or hourly counts will be permitted.
      2. Wellness days may not be used during 2-week clinical rotations.
      3. Anticipated (non-emergent) wellness days (e.g. weddings, religious holidays, etc) must be requested at least 30 days in advance of the event during the pre-clinical (M1-M2) years, or 30 days in advance of the start of a clinical rotation (M3-M4 years) using the Limited Leave Request form.
      4. Anticipated (non-emergent) wellness days may not be used during the following events:
         
         1. Course/subject exams
         2. SPEDs/clinical skills sessions/PCM case studies
         3. Clerkship orientations
         4. Simulation/skill training days
         5. OSCEs
         6. Oral, slide exams
         7. JI rotations
         8. Days before or immediately after vacations/administrative closings
         9. On-Call
      5. For emergent wellness days, pre-clinical Course Directors must be immediately informed (telephone or email) if any mandatory attendance event will be affected. During clinical rotations, the Clerkship Director, Attending, and other pertinent team members must be immediately informed (telephone). Under unusual circumstances, the Clerkship Director may contact the student’s Attending and team.
5. If by any combination of excused absences or wellness days more than 2 mandatory attendance events are missed in a single pre-clinical course, the student may be required, at the discretion of the Course Director, to make up the missed events.
6. During clerkships, if, by any combination of excused absences or wellness days, more than 2 days are missed in any single rotation, the student may need to make up the time missed, or an Incomplete (I) may be assigned. Incompletes may be remediated by returning later in the year to complete the rotation. Make-up time or remediation of Incompletes are at the discretion of the Clerkship Director. If more than 20% of a clinical rotation is missed, the student may be required to repeat the entire rotation, which is at the discretion of the Clerkship Director.

APPROVAL HISTORY

Effective: 02/18/19 Revised: 04/19/21