Phase 2-3 Attendance Procedures

Approved by College Committee on Instruction and Appraisal (CCIA) on April 7, 2021

Duty hours considerations
Students on clinical rotations are considered active working members of the patient care team, and one goal of the clinical rotations is to prepare students for their postgraduate role as residents, providing direct patient care under the supervision of faculty attending physicians. As such, the College of Medicine policies for students’ participation in and absences from clinical educational experiences parallels those policies in effect for residents, under the aegis of the Accreditation Council on Graduate Medical Education:

1. The maximum number of required hours at clinical sites (hospital, clinic, nursing
   home, etc.) should not exceed 80 hours per week, on average over a month’s time.
2. Students should not work longer than 16 continuous hours.
3. Students should have an average of at least 24 continuous hours each week free of clinical responsibilities (including lectures, seminars, clinic, and rounds). Students must have eight hours free of duty between scheduled duty periods.
4. In addition, students will be provided a full day for study prior to the administration of the clerkship final examination.

The above limitations do not include independent study time apart from clinical duties or optional activities in which the student voluntarily participates.

Expectations for weekend duties and attendance on university holidays will be at the discretion of the clerkship director.

Scheduled and unscheduled absences
With prior approval, students may have up to four days of excused absence within an eight‐week clerkship before being subject to any need to make up the missed time; likewise three days for a six‐week clerkship, two days for a four‐week clerkship and one day for a two‐week clinical experience. Beyond this threshold, the need for a student to make up missed time will be at the discretion of the clerkship director, and dependent upon the student’s access to opportunities to fulfill all clerkship learning objectives within the time remaining.

During Phase 2/3 non‐clinical courses, either in‐person or online, students may seek excused absence from up to 10% of total classroom time. Beyond this 10% threshold, any need to make up missed experiences will be at the discretion of the course director. In any case, all structured course assignments must still be completed and submitted in order to obtain course credit.

These absence thresholds are expanded for students, on elective clerkships and courses only, between October and January of their M4 year, who may accrue up to one day of excused absence per week of total clerkship time, or up to 20% of scheduled class time, to help accommodate residency interviewing.

This policy is also intended to accommodate students’ needs for regularly scheduled appointments that require absence at a defined time each week. An appointment schedule that results a full half‐day absence each week will accrue absence time according to the above limitation.

College of Medicine‐required student meetings and educational activities are excused absences that do not count when calculating the amount of time a student is allowed to miss within a clerkship.

Outside of illness or unexpected urgency/emergency, other absences require advance notice, without which an absence would be considered unexcused. Unexcused absences may have an impact on the student’s grade and ability to progress through the curriculum. These procedures will be detailed at the point of orientation to Phase 2 and are available on each campus web page.

Examples of absence requests that are typically approved:

1. Illness of student, significant other or immediate family member
2. Health care appointment for student
3. Funeral of family member
4. Religious holidays
5. Presentation at a medical conference
6. Own wedding
7. Jury duty or court date (provide notice immediately upon receipt of summons)
8. Residency interviews
9. USMLE Examinations

Examples of absence requests that may be approved at the discretion of the Clerkship/Elective Director:

1. Illness of extended family member or friend
2. Funeral of a friend
3. Wedding of a family member or participation in a wedding of a non‐family member
4.  Teaching Electives
5. Attendance at a medical conference (not presenting)

Attendance and Absence Request Policy and Procedures (from University of Illinois College of Medicine ‐Chicago syllabus for Clinical Intersections, AY 2022‐2023)

The Clinical Intersections attendance procedure is similar to the procedure for Transition to Clerkships (TTC). M3 students attend designated in‐person sessions that are scheduled throughout Phase 2 of the Illinois Medicine Curriculum. Dates for this course are provided to students in advance. Note that students should not schedule outside activities on the days they are assigned to attend Clinical Intersections, since they may start as early as 7:00 am and may end as late as 6:00 pm. The Clinical Intersections dates may vary across campuses.

All segments of Clinical Intersections must be completed to satisfy graduation requirements. This includes all scheduled activities such as assignments, workshops, TBLs, and group sessions. This is to ensure that all students are provided with the tools that will help them to stay safe, build their community of practice, foster their own wellness in the clinical setting, and to excel in the clinical environment.

Requesting Excusal in Clinical Intersections and Phases 2/3: Remember that planning ahead for any time off is very important, especially in your clinical training. In Phase 2/3 students follow the Expectations for Participation in Phase 2 and Phase 3 to request absences in writing from clerkships, electives, and other courses. Permission for absences is granted by course, clerkship, or elective directors and is consistent with the College‐wide policy. Note that you must ask permission in your written requests; you should never assume that a request will automatically be granted.

Absence: Absences for this course and any other experience in Phases 2 and 3 should be reported via email in advance to the designee identified by the course or clerkship. Documentation may be required with the exception of absences due to the observance of religious holidays. To request an absence from the Clinical Intersections course, you must submit an Absence Request Form in advance of the session. If possible, the student may make up the session during their M3 year. If not, the student will be required to make up the intersections day during their M4 year.

Late Arrival: Students should always plan to arrive 10 minutes prior to the session start time. If a student knows they are going to be late, you must submit an Absence Request Form either in advance or immediately following the session to explain the reason for the late arrival. The course administrator will begin tracking late arrival 10 minutes past the posted start time for the session.

Leaving Early: Leaving a session prior to its completion without proper notification is considered an unexcused absence. If a student must leave a session due to an emergent issue, or if the situation meets the criteria for excused absence, the student must submit an Absence Request Form as soon as feasible. The course administration will work with course faculty to deem the absence to be excused or unexcused.

Unexcused absences, unexcused late arrivals, and missed assignments: Unexcused absences, arriving late, and missing assignments are never acceptable in Phase 2/3, nor are they acceptable in Clinical Intersections or either of the other portions of Clinical Connections and Competencies (TTC and TTR). An unexcused absence, late arrival, and/or missing assignments may elicit a “Professional Development Concerns” form in addition to the student not receiving a passing grade in the course. If a pattern of late behavior or unexcused absences is detected, or if a serious professionalism breach is reported, the student will meet with the Curricular Dean, the Course Director and/or Course Coordinator and the Student Affairs Dean and/or the student’s advisor.

Making up missed time: Any missed time, whether excused or unexcused, must be “made‐up” before a passing course grade will be submitted. In the case of interactive sessions, this may mean completing missed course segments with the next class the following year. Other experiences or assessments cannot be used to fulfill required Clinical Intersections activities; e.g. missed skills sessions need to be made up even if a student has had a later summative assessment of skills.

Absence due to LOA: Students who are on a Leave of Absence will not be scheduled for Clinical Intersections and are not required to attend. Students who matriculated prior to the Class of 2023 and are on a Leave of Absence will be scheduled for Clinical Intersections after they sit for Step 1. These students should communicate with their OSA advisor and the Clinical Intersections Course Coordinator to confirm when their attendance will be required.

Attendance and Absence Request Policy and Procedures

The Transition to Residency attendance procedure is similar to the procedure for Clinical Intersections. M4 students attend designated synchronous sessions that are scheduled during Phase 3 of the Illinois Medicine Curriculum. Dates for this course are provided to students in advance.

Note that students should not schedule outside activities while they are assigned to attend Transition to Residency, since they may start as early as 7:00 am and may end as late as 6:00 pm. The Transition to Residency dates may vary across campuses.

All segments of Transition to Residency must be completed to satisfy graduation requirements. This includes all scheduled activities such as assignments, workshops, TBLs, and group sessions. This is to ensure that all students are provided with the tools that will help them to build their community of practice, master their clinical skills, foster their own wellness in the clinical setting, and excel in residency.

Requesting Excusal in Transition to Residency and Phases 2/3: Remember that planning ahead for any time off is very important, especially in your clinical training. In Phase 2/3 students follow the Expectation for Participation in Phase 2 and Phase 3 Clinical Experiences to request absences in writing from clerkships, electives, and other courses. Permission for absences is granted by course, clerkship, or elective directors and is consistent with the College-wide policy. Note that you must ask permission in your written requests; you should never assume that a request will automatically be granted.

Absence: Absences for this course and any other experience in Phases 2 and 3 should be requested via the Absence Request Form in advance. Documentation may be required with the exception of absences due to the observance of religious holidays. To request an absence from the Transition to Residency course, you must use the Absence Request Form in advance of the session. Students will be required to make up the days missed during their M4 year.

Late Arrival: Students should always plan to arrive 10 minutes prior to the session start time. If a student knows they are going to be late, use the Absence Request Form in advance or immediately following the session to explain the reason for the late arrival. The course administrator will begin tracking late arrival 10 minutes past the posted start time for the session.

Leaving Early: Leaving a session prior to its completion without proper notification is considered an unexcused absence. If a student must leave a session due to an emergent issue, or if the situation meets the criteria for excused absence, the student should contact the campus course coordinator or use the Absence Request Form as soon as feasible. The course administration will work with course faculty to deem the absence to be excused or unexcused.

Unexcused absences, unexcused late arrivals, and missed assignments: Unexcused absences, arriving late, and missing assignments are never acceptable in Phase 2/3, nor are they acceptable in Transition to Residency or either of the other portions of Clinical Connections and Competencies (TTC and Clinical Intersections). An unexcused absence, late arrival, and/or missing assignments may elicit a “Professional Development Concerns” form in addition to the student not receiving a passing grade in the course. If a pattern of late behavior or unexcused absences is detected, or if a serious professionalism breach is reported, the student will meet with the Curricular Dean, the Course Director and/or Course Coordinator and the Student Affairs Dean and/or the student’s advisor.

Lab Medicine (TBL) Sessions
LEAVING EARLY: Leaving a session prior to the completion of the application exercise is considered an unexcused absence and will result in a score of 0 (zero) for the IRAT and TRAT regardless of points originally earned. As this is also considered a professionalism issue, the student may be required to meet with the Assistant Dean for Curriculum and/or the Assistant Dean for Student Affairs.

LATE ARRIVAL: Since the ultimate goal of a TBL session is to learn and contribute to the team, students are expected to go to the session even if they are arriving after the posted start time. Late arrivals will be handled as follows:

• A student who arrives late for the IRAT may still receive any points gained within the remaining minutes allowed for the IRAT, and participate as usual in the TRAT and Application
• A student who completely misses the IRAT and shows up late for the TRAT may still participate in the remaining minutes of the TRAT and receive the full amount of points gained by the group for the The student will receive 0% for the IRAT.
• A student who arrives after both the IRAT and TRAT portions have ended will participate in the application exercise. The student will receive 0% for the IRAT and 0% for the TRAT regardless of points earned by the team for the TRAT. The student should contact the Course Coordinator immediately following the session to explain the reason for the late The Course Coordinator will deem the late arrival to be excused or unexcused after consultation with the Course Director.

Making up missed time: Any missed time, whether excused or unexcused, must be “made-up” before a passing course grade will be submitted, as attendance at all sessions is mandatory. In the case of interactive sessions, this may mean completing missed course segments later in the year, if they are offered again. For Lab Medicine TBL’s, students who are absent (excused or unexcused) will be required to make up the TBL and complete a make-up assignment, as below. In other cases, course work will be remediated with assignments (e.g. written assignment) to be determined at the discretion of the Campus Course Director.

• TBL Make-Up: PLEASE SEE COURSE COORDINATOR TO If the absence is excused, the student will take the Individual Readiness Assurance Test (IRAT) for his/her IRAT score, and receive the TRAT score of his/her team. If the absence is unexcused, the student will have the option to take the IRAT, but will receive a score of 0 (zero) for the IRAT and TRAT.
• Make-up Assignment: The student will write two multiple-choice questions based on the learning objectives and preparatory material from the session. Below is a list of the required elements for the questions:
  • Clinical vignette. Begin with the presenting problem of a patient, followed by the history (including duration of signs and symptoms), physical findings, results of diagnostic studies, initial treatment, subsequent findings,
  • Four (4) answer options. All distractors (incorrect options) should be They should fall into the same category as the correct answer (e.g., all diagnoses, tests, treatments, prognoses, etc.). Avoid using “double options” (e.g. do W and X; do Y because of Z) unless the correct answer and all distractors are double options. All distractors should be plausible, grammatically consistent, logically compatible, and of the same (relative) length as the correct answer.
  • Brief explanation for correct and incorrect answers
  • Focuses on important concepts rather than trivial facts
  • Can be answered from studying the preparatory materials and without looking at the options
• Includes all relevant facts; no additional data should be provided in the options
• Is not negatively phrased (i.e., avoid using except or not in the lead-in)

Absence due to LOA: Students who are on a Leave of Absence will not be scheduled for Transition to Residency and are not required to attend.   These students should communicate with their OSA advisor and the Transition to Residency campus course coordinator to confirm when their attendance will be required.

Chicago Student Absences:
In Chicago, the entirety of TTR is scheduled as a 2 week course that repeats 3xs (with approximately 1/3rd of the class participating at a time). While every attempt should be made to avoid scheduling conflicts during TTR course components, it is understood that students may need to request excused absences. To account for this, students will be allowed a maximum of 3 days excused absence during the 2 week TTR course with no more than 2 days of absence in one week. As always, any absences should be communicated to course coordinators via the Absence Request Form with as much advanced notice as possible and will require make-up, usually during another round of the course (or as a written assignment when this is not possible), before a passing grade will be submitted to the registrar.

Grading
Student assessment in Transition to Residency is based upon the direct observation of student skills, attitudes, and problem-solving abilities, thus students must be present at all sessions. Grades for the course are either Successful or Unsuccessful.

TBLs are graded with the IRAT comprising 60% and TRAT 40% of the TBL grade. The minimum pass level (MPL) for the TBL component of the course is 67%.

To receive a Passing grade in Transition to Residency, students must meet the MPL for TBLs and adhere to the following:

1. Attend all sessions and sign-in as announced prior to each
2. Be on time for all
3. Complete all assignments on
4. Be professional at all
5. Participate fully in all
6. Complete any assigned

Course evaluations will be made available for each session by the end of each Transition to Residency day. Students must complete ALL assigned evaluations.

Failure to meet the above expectations may result in a failing grade for the course. Students will be expected to work with the campus course coordinator and/or course director to make up/remediate any course time, assignments, or professional attributes that were missed or not achieved.

Students with any incomplete course sessions (excused or unexcused) or assignments after the designated time frame, will receive an “NR” (Not Reported) or a grade of “Incomplete”, which will remain until all course requirements are satisfactorily completed. Students have one year (unless otherwise noted by the Course Director) to complete any remaining course requirements otherwise a grade of “ Unsuccessful” will be assigned and remain on the student’s transcript until the course is completed in its entirety. Only when all requirements have been completely satisfied will a grade of  “Successful” be submitted to the registrar.