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 elective/ course directorSchedules are created in accordance with the VP&S Duty Hours Policy for the clinical phase.

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 Day, vacations are detailed on students' individual rotation schedules. The only protected time for holidays in the Major Clinical Year is Juneteenth, Independence Day, Thanksgiving and the day after 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.

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 clerkship and elective/course activity to which they are assigned.

• Attendance is mandatory for all clerkship and curricular events in MCY/ D&I phases, including clinical and didactic experiences. Any exceptions to this policy are outlined by individual clerkship/electives directors.

• 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 Clinical Faculty Committee.

Expectations from Faculty and Staff:

• Students will receive the clerkship/electives calendar in advance of the start of the clerkship/elective so that they are aware of expectations and plan vacations accordingly.

• Clerkship and electives directors must describe the attendance policy in the syllabus and make clear that repeated absences may lead to a clerkship/elective failure.

• The attendance policy will be communicated to students in person during MCY orientation, and the policy will be posted on the VP&S website.

• Faculty, housestaff and others in student supervisory roles should notify the clerkship director of any absences if a student fails to attend a curricular event.

Requesting 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. 1. 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. Residency interview
      7. Significant life event not otherwise specified

If a student anticipates missing a mandatory session or assessment during MCY or D&I phase for any of the above reasons, they must request an anticipated approved absence as soon as possible but at least 4 weeks in advance of the start of the clerkship/rotation via this Qualtrics form(link is external and opens in a new window). The student will be notified that the absence is approved within 1-2 weeks of the request.

Clerkship/electives directors will be notified of approved anticipated absences. Once approved, students should contact their clerkship directors, preceptors, attendings, and housestaff of the dates of approved absences well in advance so that appropriate arrangements for on-call scheduling, patient care, and makeups can be made.

In cases of unanticipated absences involving illness and unexpected emergencies, students must notify the Office of Medical Education of an unanticipated absence through a Qualtrics form(link is external and opens in a new window)as soon as is feasible and must also notify their clerkship directors and preceptors and/or team senior residents and attendings by email of their absence.

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

When required, arrangements for make up or repetition of the clerkship or elective will be at the discretion of the clerkship or electives 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.

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(link sends e-mail)(link sends e-mail) (for clerkships) or pselectives@cumc.columbia.edu(link sends e-mail)(link sends e-mail) (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.

Monitoring of Student Absences in Clinical Phase

Throughout the MCY and D&I phases, both approved and unapproved absences will be tracked. Repeated incidents of 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. Any unapproved absence during MCY phase will trigger review of student’s record by the CFC. The CFC will also monitor the total number of approved absences that a student takes across MCY phase and D&I phase.

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.

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.

Policy Details