Attendance Policy

Being able to deliver continuous, attentive and professional care to patients on a clerkship is considered an essential element of medical education. On the clinical clerkships you will be part of a team providing continuous medical care to patients. Your professional responsibilities as a team member include being accountable to the team or medical practice for your attendance, punctuality, and dress. Attendance on the clinical clerkships and clinical electives is required as is being on time and dressing appropriately and professionally. This policy holds for the didactic seminars during clerkships as well. Poor or tardy attendance at clinical experiences or didactics will be noted in student evaluations and may be considered by the Progress Committee as evidence of a student’s inability to meet the essential requirements for graduation.

The following constitute reasons why a student may be absent from a clerkship:

  • Personal illness or illness in immediate family member
  • Death in the family
  • Religious holiday observances
  • Participation in a scientific conference where the student is a lead author and is directly participating in the conference presentation.

Students who are unable to attend a required clerkship activity for one of these reasons should notify their attending clinical supervisor as soon as possible. Students should also notify the clerkship director or clerkship administrator by telephone and follow-up with an e-mail to the clerkship director, clerkship administrator and medical school registrar to inform them about the absence.

For all absences, the clerkship director will determine whether students must make up activities they have missed during their absence. If more than 2 days are missed during a 4 week or longer clerkship, the student may be required to repeat the clerkship. If any absence occurs during clerkships of 2 weeks, the student may be required to repeat the clerkship.

Medical Student Work Hours Policy

In an effort to address the effects of fatigue and sleep deprivation on learning, patient care and student well-being, Yale Medical School has adopted the following policy for all clerkships and elective rotations:
  • We will follow the AGCME duty hours requirements for interns as outlined in depth on the following site: http://www.acgme.org/acgmeweb/tabid/271/GraduateMedicalEducation/DutyHours.aspx
  • Work hours are limited to time spent in the hospital caring for patients and attending related educational activities. Calculation of work hours should not include time spent completing write-ups or study time during non-hospital. As an example, a student who comes to the hospital at 7am and stays until 10pm will have 15 hours of work time. A student could then go home and read to prepare for rounds the next day. This time at home reading is not considered part of work hours. In such a case the student would have 10p to 7a duty free (no direct patient care responsibilities or required educational in-hospital activities) before the next duty period.

Monitoring Compliance

  • Work hours will be monitored by each Clerkship Director and/or by each Elective Director.
  • As part of the routine electronic evaluation of the rotation, students will be asked whether they worked in excess of the ACGME guidelines described above.
  • Student concerns about work hours and reports of time spent in excess of the policy standard will be pulled from the system every 6 months. Responses indicating work hours above ACGME requirements will be sent to the Clerkship Director and to the Department Chair. The Clerkship Director will indicate to the Office of Education how they plan to address the concern.
  • Findings will be reported to the Curriculum Committee each year.

Absenteeism From Mandatory Module Workshops

The following constitute acceptable reasons for being absent from a mandatory workshop:

  • Personal illness or illness in immediate family member
  • Death in the family
  • Religious holiday observances
  • Participation in a scientific conference where the student is the lead author/presenter and directly participating in the conference presentation

A student who requests an excused absence from a mandatory workshop because of one of the above reasons must notify the module director as soon as possible, preferably before the absence. In case of illness or a family emergency, prior notice may not be possible. Students wishing to discuss personal reasons for absences may always contact the associate dean for student affairs.If any of the mandatory workshops is missed without being excused by the module director, the student must meet in person with the module director to discuss the unexcused absence, and the absence will be reported to the student’s academic advisor. In addition, the student must take and pass the self-assessment exam for that module.

Note that taking and passing the self assessment exam is not considered an acceptable alternative to attending mandatory workshops, but is required to ensure a minimal level of competency in the subject matter of the module.

Required Attendance at Module Workshops

Background

In keeping with the philosophy of the Yale System of Medical Education, attendance is required only in those teaching sessions designed to impart specific skills and/or teach material that cannot be effectively learned in other ways. The small group module workshops are intended to teach the skill of clinical reasoning and require active student participation.

Policy

Mandatory attendance in module small groups will apply to those modules that meet specific standards for small group teaching. These include:

  1. Emphasis on clinical reasoning and interactive pedagogy
    Workshop syllabus materials must be designed to require interactive participation and impart the skill of clinical reasoning.
  2. Preparation of workshop faculty
    Module Directors must ensure that workshop faculty understand the pedagogical approach and are appropriately prepared to conduct interactive, clinical reasoning skill-building sessions. This requires at least one orientation session for small group teaching faculty to discuss the materials and the environment to be used in creating an interactive and student-centered pedagogy. Longer modules are encouraged to have at least one mid-course session for faculty debriefing and faculty development.
  3. Consistent workshop leaders
    A module must have at least three workshops, all conducted by the same faculty member(s), so that faculty can develop a working relationship with their group of students. For longer modules that have different sub-components with workshops grouped by topic, there must be continuity of faculty through all of the workshops within each sub-component (and at least three workshops per component).
  4. Student preparation
    Students should be given specific instructions to prepare for the workshops, including reading assignments and guidance regarding weekly assignments and questions posed in the materials.
  5. Group size
    Such pedagogy is developed for small group sessions. Therefore, the class must be divided into a minimum of eight groups of students (~12 students per group). Consistent with all small group teaching, student switching between groups is discouraged. Students who wish to change groups must obtain permission of the module director and the leader of the assigned small group as well as the new group leader. This will ensure that the number of students per group is consistent with that which is optimal for effective teaching.