# Attendance Standards **This section of the handbook details the medical school's attendance policies including mandatory activities, legitimate absences for health, religious, or family reasons.** Please note: * Students who matriculated in 2024 and thereafter are subject to ASCEND policies. * Students who matriculated in 2023 or earlier and who are graduating in 2027 or earlier are subject to the LEGACY curriculum policies. * Students who matriculated in 2023 or earlier who are graduating in 2028 or thereafter will be subject to a mix of policies depending on when their progression was delayed or temporarily halted. These students will be subject to ASCEND policies when they resume or continue their studies. *** ### **Legacy**
Year 3 and 4 Attendance and Absence Policy
This policy outlines attendance requirements and procedures for absences for Years 3 and 4.
Applicable for:
Graduating Classes of 2025, 2026, 2027		Approved by:
Executive Oversight Committee
Relevant LCME Standards:
12.4 Student Access to Health Care Services		Approval Dates:
6/2/2023
3/8/2024
*** **RELATED POLICIES** * Academic Standing Policy * Yearly Progression Policy * Leave of Absence Policy *** **POLICY** Active participation in the medical education program is a critical component of the professional development of a physician. Medical school is a full-time commitment, and it is expected that students prioritize their academic schedule and requirements. In Year 3 and 4, students are required to attend all course and clerkship experiences including assessments, classroom-based sessions, course/clerkship meetings, and clinical experiences including night, holiday, and weekend duties. For any absences that occur in the course or clerkship, the course or clerkship directors may offer make-up experiences, if available or possible. If make-up experiences are not possible, then at the discretion of the course or clerkship director, the student may need to reschedule the course or clerkship. Students must request their planned absences one (1) month in advance. For unplanned absences (see list of approved reasons below), students must submit the request as soon as possible and prior to the start of the session. Students will not be approved for absences that exceed 50% of a course (e.g. for InFocus and Introduction to Internship courses). Students who have questions or concerns about absences are encouraged to reach out to their course or clerkship director(s) to discuss. *** **PROCEDURE** 1. ***Absence Requests:*** To request an absence from a required Year 3 or 4 course or clerkship, students must fill out the [Year 3 and 4 Absence Request form.](https://mountsinai.formstack.com/forms/y3_4absence_approval) This form will notify the appropriate course or clerkship director(s) and the Office of Student Affairs. It is the student’s responsibility to inform their team members (attending, resident, etc.) of their absence; these individuals are not notified via the form. Failure to complete the absence request form within the timeframe as outlined will result in an unexcused absence. The following will be considered excused absences: * Sitting for a USMLE Step exam * Religious holiday observance * Significant family event (e.g. wedding or religious ceremony) * Interview for residency/job or scholarly year experience * Presenting work at a regional, national or international conference (a maximum of three days will be approved) * Attending a meeting of a national committee (e.g., AMSA, AMA, AAMC) of which student is a member with a leadership role (a maximum of three days will be approved) * Attending an Executive Oversight Committee (EOC), Promotions Committee, or Mistreatment Committee meeting as a student member * Jury Duty Students must use the[ Academic Calendar ](https://icahn.mssm.edu/education/students/registrar)on the Registrar’s website when planning any advance travel. 2. For planned time off, the student must notify the course or clerkship director one (1) month in advance of the mandatory session using the Year 3 and 4 Absence Request form. Students who have questions or concerns about the timing of their absence and the request timeline are encouraged to reach out to the clerkship or course director(s) for guidance. 3. For unplanned time off, students must fill out the absence request form as soon as they know and prior to the start of the session. The student must indicate a reason for a last-minute request. Only the following reasons for unplanned time off will be reviewed for approval: * Acute illness * Urgent medical evaluation * Unexpected family/personal emergency\* or caregiver obligation *\*In the event of an emergent situation where a student cannot access the form, a student may email* [*medstudentabsence@mssm.edu*](mailto:medstudentabsence@mssm.edu) *AND their Clerkship/Course Director for an immediate response prior to session start. The student must also fill out the absence form as soon as they are able to document their request.* 4. ***NBME Clinical Sciences Subject Examinations (AKA “Shelf Exam”):*** To request to delay sitting for a shelf exam, students must submit the [NBME Postponement Request formstack.](https://mountsinai.formstack.com/forms/nbme_postponement_request_form) 5. ***Electives***: Students who require an absence from an elective should not use the absence request form. Students should reach out directly to the electives director and coordinator one (1) month prior to their absence. Make-up of any missed activities is at the discretion of the electives director. 6. ***Unexcused absences***: Unexcused absences are considered unprofessional behavior, will be recorded, and may have an adverse effect on a student’s course or clerkship grade including failure of the course or clerkship (as described in the Course/Clerkship Information Sheet). Unexcused absences will have the following additional consequences: * 1st unexcused absence: student placed into monitored academic status * 2nd unexcused absence: student placed into serious academic status 7. Make-up of absences Monitored Academic Status
AbsenceRequires absence request form?Makeup ExperienceAdditional info
Short (1-2 hour) AbsenceYesNot required (unless
multiple, see below)		Students should
prioritize: 1) flextime
or 2) suggested times
within each clerkship
for scheduling short
absences
1st day (or multiple short absences totaling 8 hours)YesVirtual/online/ asynchronous modules or
activities*
2nd and additional daysYesIn person make- up
sessions*
\*Type and duration of make-up sessions at discretion of clerkship director(s) and subject to\ availability. 8. ***Monitoring***: Student attendance will be tracked and monitored for all required curricular\ activities. Requests for absences are reviewed by the relevant course or clerkship director(s) and monitored by the Office of Student Affairs. The Office of Student Affairs reserves the right to request a doctor’s note or other documentation in the event of a pattern of absences or any absences immediately preceding or following a holiday.
### **ASCEND**
Phase 2 and 3 Attendance and Absence Policy
This policy outlines attendance requirements and procedures for absences for Phases 2 and 3.
Curriculum Structure:
ASCEND		Approved by:
Executive Education Committee
Relevant LCME Standards:
12.4 Student Access to Health Care Services		Approval Dates:
12/5/2025
*** **RELATED POLICIES** * Academic Standing Policy * Yearly Progression Policy * Leave of Absence Policy *** **POLICY** Active participation in the medical education program is a critical component of the professional development of a physician. Medical school is a full-time commitment, and it is expected that students prioritize their academic schedule and requirements. In Phase 2 and 3, students are required to attend all module, scheduled elective, clerkship, and acting internship experiences including assessments, classroom-based sessions, module/elective/clerkship/acting internship meetings, and clinical experiences including night, holiday, and weekend duties. All absences from required module/elective/clerkship/acting internship activities must be made up. Options and procedures for making up absences in required modules, clerkships and acting internships are delineated in the Module or Clerkship Information Sheet. Options for making up elective absences are determined by Elective Director. If make-up experiences are not possible, then at the discretion of the module/elective/clerkship/acting internship director, the student may need to reschedule all or part of the module/elective/clerkship/acting internship. Students must request their planned absences (see list of approved reasons below) 28 days (4 weeks) in advance. For unplanned absences (see list of approved reasons below), students must submit the request as soon as possible and prior to the start of the session. Students will not be approved for absences that exceed 25% of one or two-week module, elective, or clerkship. * For 1-week electives and modules (e.g. Transition to Phase 2 and 3, CAMP weeks), students will not be approved for absences longer than 1 day. * For 2-week electives, modules, and clerkships (e.g. Palliative Care Clerkship), students will not be approved for absences longer than 2 days. On days designated as “restricted days,” planned absences cannot be requested or approved. These restricted days are indicated on the Academic Calendar. The following curricular days/elements are designated as “restricted:” * Transition to Phase 2 Module and Transition to Phase 3 Module * Direct Observation Assessments in the Morchand Center * NBME Clinical Science (“Shelf”) Exams * NBME Customized Assessment Services (CAS) Exams * CAMP Weeks – Wednesday, Thursday, and Friday * The Palliative Care Clerkship knowledge assessment * The Palliative Care Skills Workshop/session are designated as restricted days. * Peaks Weeks Students may request an exception to the restricted days policy for major religious holidays (e.g. Rosh Hashana, Eid al-Fitr, Good Friday). Requests for holiday absences must be submitted at least 28 days (4 weeks) in advance. This policy does not extend to religious ceremonies (e.g. weddings, baptisms). *** **PROCEDURE** 1. ***Absence Requests (modules, clerkships, acting internships)**:* To request an absence from a required Phase 2 or 3 module, clerkship, or acting internship, students must fill out the [Absence Request Form](https://mountsinai.formstack.com/forms/y3_4absence_approval). This form will notify the appropriate module/clerkship/acting internship director(s) and the Office of Curricular Affairs. It is the student’s responsibility to inform their team members (attending, resident, etc.) of their absence; these individuals are not notified via the form. Failure to complete the absence request form within the timeframe as outlined will result in an unexcused absence. The following will be considered excused absences: * Religious holiday observance * Significant family event (e.g. wedding or religious ceremony) * Interview for residency/job or scholarly year experience * Presenting work at a regional, national or international conference (a maximum of three days will be approved) * Attending a meeting of a national committee (e.g., AMSA, AMA, AAMC) of which student is a member with a leadership role (a maximum of three days will be approved) * Attending an Executive Oversight Committee (EOC), Promotions Committee, or Mistreatment Committee meeting as a student member * Jury Duty Students must use the[ Academic Calendar ](https://icahn.mssm.edu/education/students/registrar)on the Registrar’s website when planning any advance travel. 2. For planned time off, the student must notify the module or clerkship director one 28 days (4 weeks) in advance of the mandatory session using the FORM LINK. Students who have questions or concerns about the timing of their absence and the request timeline are encouraged to reach out to the clerkship or module director(s) for guidance. Students cannot be approved for planned time off during restricted days 3. For unplanned time off, students must fill out the absence request form as soon as they know and prior to the start of the session. The student must indicate a reason for a last-minute request. Only the following reasons for unplanned time off will be reviewed for approval: * Acute illness * Urgent medical evaluation * Unexpected family/personal emergency\* or caregiver obligation ***\*In the event of an emergent situation where a student cannot access the form, a student may email*** [***mdstudentaffairs@mssm.edu***](mailto:mdstudentaffairs@mssm.edu) ***AND their Clerkship/Course Director for an immediate response prior to session start. The student must also fill out the absence form as soon as they are able to document their request.*** 4. ***NBME Clinical Sciences Subject Examinations (AKA “Shelf Exam”):*** To request to delay sitting for a shelf exam, students must submit the [NBME Postponement Request formstack.](https://mountsinai.formstack.com/forms/nbme_postponement_request_form) Only the following reasons for examination delay will be reviewed for approval: * Acute Illness * Urgent Medical evaluation * Unexpected family/personal emergency or caregiver obligation * Lack of academic readiness 4. ***Electives***: Students who require an absence from an elective should not use the absence request form. Students should reach out directly to the electives director and coordinator one (1) month prior to their absence. Make-up of any missed activities is at the discretion of the electives director. 5. ***Unexcused absences***: Unexcused absences are considered unprofessional behavior, will be recorded, and may have an adverse effect on a student’s course or clerkship grade including failure of the module or clerkship (as described in the Module/Clerkship Information Sheet). Unexcused absences will have the following additional consequences: * 1st unexcused absence: student placed into monitored academic status * 2nd unexcused absence: student placed into serious academic status 7. **Make-up of absences:** Absences from required module, clerkship, and acting internship activities must be made up. Options and procedures for making up absences are delineated in the module or Clerkship Information Sheet 8. ***Monitoring***: Student attendance will be tracked and monitored for all required curricular activities. Requests for absences are reviewed by the relevant module or clerkship director(s) and monitored by the Offices of Curricular Affairs and Medical Student Affairs. The Office of Medical Student Affairs reserves the right to request a doctor’s note or other documentation in the event of a pattern of absences or any absences immediately preceding or following a holiday
## ASCEND and LEGACY Policies ### **These policies are applicable to students in the ****Legacy**** Curriculum and the ****ASCEND**** Curriculum.**
Pre-Clerkship Attendance Policy
This policy outlines attendance requirements for absences in the preclerkship curriculum for all medical students.
Applicable for:
All Medical Students in Legacy and ASCEND		Approved by:
Executive Oversight Committee

Relevant LCME Standards:
3.5 Academic Learning Environment/ Professionalism

9.9 Student Advancement and Appeal


12.4 Student Access to Health Care Services

Approval Dates:
7/12/24 (*)
*** **RELATED POLICIES** * Academic Standing Policy * Progression Policy * Leave of Absence Policy *** **REVISION HISTORY** (\*) Policy clarifications not requiring EOC approval, 7/31/2025 *** **POLICY** Medical students are required to participate in all sessions designated as mandatory within the curriculum. These mandatory sessions are clearly marked on the phase/module calendars and/or within the learning management system. Students are allowed up to five (5) personal days per semester to be used for both planned and unplanned absences. Personal days must be requested at least 14 days (2 weeks) in advance of the planned absence using the Absence Request Form. All submitted absence requests where a student has already taken five (5) personal days will be automatically declined. In cases of unplanned absences, including acute illness, urgent medical evaluations, or unexpected family/personal emergencies, students are not required to provide 14 days notice, however, students must fill out the Absence Request Form prior to the start of the mandatory session. If a student’s need for absence extends beyond the scope of this policy, the student is responsible to directly contact the Office of Medical Student Affairs, [mdstudentaffairs@mssm.edu](mailto:mdstudentaffairs.com) and cc [**preclerkships@mssm.edu**](mailto:preclerkships@mssm.edu), with reasons for absence and number of personal days already used. The Office of Medical Student Affairs will be responsible for providing guidance to students in such cases. Days with assessments are designated as restricted days, during which absences cannot be requested. These restricted days are indicated on the Academic Calendar. Exceptions for medical or other emergencies are permissible, but students must request an absence prior to the start of the assessment. Students may request an exception to the restricted days policy for major religious holidays (e.g. Rosh Hashana, Eid al-Fitr, Good Friday). Requests for holiday absences must be submitted at least 14 days (2 weeks) in advance. This policy does not extend to religious ceremonies (e.g. weddings, baptisms). Students are not permitted to request planned absences that would result in missing more than 50% of mandatory sessions in any single Phase 1 module. At the discretion of the module director(s), and where feasible, make-up activities may be required depending on the nature of the session and the amount of time missed. Students who request absences during non-restricted day assessments (e.g. quizzes) are still expected to complete the quiz within the quiz completion timeframe. If illness prevents a student from completing the quiz within this timeframe, they must notify the **** before the quiz timeframe closes. **Unexcused Absences:** * Unexcused absences are defined as missing a full mandatory session, or tardiness to a mandatory session that prevents meaningful engagement as defined by the module director, without prior submission of an approved absence. * Unexcused absences are considered unprofessional behavior, will be recorded, and may have an adverse effect on a grade including failure of a component of a module or an entire module. Unexcused absences in a module or across the semester will have the following consequences: * 1st unexcused absence: Reported to the Office of Medical Student Affairs. * 2nd unexcused absence: Placed on academic monitoring * 3rd unexcused absence: Placed on intensive academic monitoring and module failure if all occur during a single module. *** **PROCEDURE** **Registering Attendance in Mandatory Sessions** **Attendance Process**: * Students must scan their personal attendance QR code in the room scanner for all mandatory sessions * Attendance is then registered in the system. * Students must scan in for every mandatory session including those occurring back-to-back. **Addressing Unregistered Attendance**: * If the system registers a student as absent, it will cross-check approved planned and unplanned time off for that day **Notification Process**: * If no approved absences are found, an email is generated at the end of the day to inform the student of the unregistered attendance in a mandatory session. This email includes a link for the student to provide a short explanation of their unregistered attendance (optional). * If there is no response from the student within one day, an email is automatically registered informing the student that the absence is unexcused. **Requesting for Absences In Mandatory Sessions** *Each student is allocated 5 days of time off for planned and unplanned absences per semester.* To request an absence, students must fill out the [Absence Request Form](https://ismms-md-program.gitbook.io/medical-student-handbook/academic-information-and-resources/attendance-process-how-to-report-an-absence) (the form can be found in Blackboard). Students must use the [Academic Calendar](https://icahn.mssm.edu/education/students/registrar) on the Registrar’s website when planning any advance travel, as the year/phase calendars are not considered final until the tentative designation is removed from the calendar and may be changed without notice. **For Planned Absences**: * Requests made on time and within the 5-day time off allowance are automatically approved. * Requests made less than 2 weeks before the planned absence will be reviewed according to policy and can be approved if within the 5-day limit. * If the planned absence exceeds the 5-day allowance, the request will be reviewed, and the student will be notified of the decision by the Office of Student Affairs (SA). **For Unplanned Absences (In cases of acute illness, urgent medical evaluations, or unexpected family/personal emergencies ONLY)**: * The absence request form must be completed prior to the start of the mandatory session. * Requests for unplanned absences are automatically approved if within the 5-day time off limit. * If the request exceeds the 5 days, the student will be notified, and SA will be informed. **Unexcused Absences:** * Unexcused absences are considered unprofessional behavior, will be recorded, and may have an adverse effect on a grade including failure of a component of a course or an entire course. Unexcused absences in a course or across the semester will have the following consequences: * 1st unexcused absence: Report to The Office of Student Affairs; * 2nd unexcused absence: Placed on monitored academic status; * 3rd unexcused absence: Course failure if all occur during a single course; placed in serious academic status **Monitoring:** Student attendance will be tracked and monitored for all required curricular and non-curricular activities. The Office of Student Affairs reserves the right to request a doctor’s note or other documentation in the event of a pattern of absences or any absences immediately preceding or following a holiday.
Leave of Absence Policy
This policy outlines all details related to various types of medical student leaves of absence for all medical students.
Applicable for:
All Medical Students in Legacy and ASCEND		Approved by:
Executive Oversight Committee
Relevant LCME Standards:
9.9 Student Advancement and Appeal Process
11.0 Medical Student Academic Support, Career Advising, and Educational Records		Approval Dates:
6/7/2024
*** **RELATED POLICIES** * Progression Requirements Policy * Academic Status Policy * Attendance Requirements *** **POLICY STATEMENT** A leave of absence (LOA) is a period of temporary non-enrollment in the MD program. A LOA constitutes a mutual agreement between the School and a student regarding utilization of time during the leave, as well as the requirements that must be met prior to reentering the curriculum. *** **POLICY REQUIREMENTS** All requests for a LOA are made directly to and granted by the Office for Student Affairs' discretion. Students who wish to pursue a research year should reach out to the Medical Student Research Office (MSRO) for more information about taking a Scholarly Year. Student Initiated LOAs: * Personal Leave of Absence: A student in good academic standing may request a Personal LOA to take time off to address issues of a personal nature, including to pursue outside work or interests, those related to the health and well-being of a family member or partner, childbirth, adoption, or other parental responsibilities. The leave may be extended for a second year at the Office for Student Affairs' discretion. Any request beyond Time to Degree is reviewed for approval or non-approval by the Promotions Committee. * Medical Leave of Absence: Students may initiate a Medical LOA for health-related reasons. Students on a Medical LOA will require physician’s clearance prior to return. The term of the leave is up to one year. The leave may be extended for a second year at the Office for Student Affairs' discretion. Any request beyond Time to Degree is reviewed for approval or non-approval by the Promotions Committee. * Educational Leave of Absence: Students in good academic standing may request an Educational LOA. Students who choose to pursue an additional academic degree at another institution or at the Icahn School of Medicine at Mount Sinai (ISMMS) and are not working towards their MD degree, will be considered on an Educational Leave of Absence from the MD program. The term of the leave is up to one year. The leave may be extended for a second year at the Office for Student Affairs' discretion. Any request beyond Time to Degree is reviewed for approval or nonapproval by the Promotions Committee. This does not apply to students enrolled in the MD-PhD program at ISMMS. * Leave of Absence for Military Service: A student may request a LOA for military service. This includes students who will fulfill service in the US armed forces and students from countries outside of the US that require compulsory military service. Students returning from a LOA due to military service will return for any term within a year after the student’s release from active service. Students should direct any questions about the return from active service process to the Office of Student Affairs. School initiated LOAs: * Administrative Leave of Absence: Students may be placed on a mandated Administrative LOA by the Deans for Medical Education, the Promotions Committee, or their representative. This LOA is usually as the result of students not complying with the School’s administrative, academic or professional requirements, or if students present a potential harm or has engaged in or is alleged to have engaged in behavior that is dangerous or deleterious to the educational, research, clinical or community environment. Students on an Administrative LOA must complete a fitness for duty evaluation before returning to the program. **Withdrawal** Students who wish to withdraw from the MD Program must meet with the Office of Student Affairs to discuss their intent to separate from the School. * Students may request a withdrawal from the MD program if in Good Academic Standing. * Students who are Not in Good Standing or are at risk for Dismissal may be granted permission by the Senior Associate Dean of Student Affairs to request to withdraw with a transcript and MSPE notation of “Not in Good Standing.” *** **PROCEDURES** A. Clearance to Take a LOA: * Meeting Requirements: Students who wish to go on a LOA must obtain clearance beforehand. Students must meet with the Office of Student Affairs to discuss the reason for and understand the implications of the LOA before filling out the appropriate forms. Students will be provided with all support options and appropriate referrals to make an informed decision. * Once given clearance, students must fill out the Request for Leave of Absence form located on the [Office of the Registrar website](https://icahn.mssm.edu/education/students/registrar), which will go through various approvals. Students will receive a final approval letter with the timing and conditions of the leave, including information about communication and initiation of the return process. B. Documentation and Implications of a LOA: * Documentation of a LOA: The dates for a LOA will be noted on the Transcript and the Medical Student Performance Evaluation (MSPE). The reason for the LOA will not be included in these documents, except for an Administrative LOA, which will be designated as such on the transcript and MSPE. * Financial Implications of a LOA: Students on a LOA are not eligible for financial support during their leave through the ISMMS Office of Student Financial Services. For students with prior or current educational loans, deferment ends after 180 days. * Health Insurance: Students on LOA are not eligible to continue with the School’s health insurance plan unless granted approval by the Senior Associate Dean of Student Affairs. * Housing Eligibility: Students who reside in student housing are required to vacate while on LOA. * Status within the MD Program: Students who take a LOA from the MD program do not retain student status with the School. Students may not participate in any educational activities, access any student resources, and are not eligible for conference funding or other internal funding for scholarly pursuits from Medical Education. * Patient Care: Students are not covered by malpractice insurance during their LOA and may not participate in any patient facing activities that provide direct care, such as shadowing or EHHOP. C. Returning from a LOA: Student should refer to the individualized terms of their leave letter to understand the expectations and timeline for return. * Return Forms: Students must complete the Return from Leave of Absence form located on the Office of the Registrar website by the date specified in their approval letter. * Failure to Complete the Return Form: Students who do not complete the form by the return date specified in their approval letter will be automatically withdrawn from the School, as it will be assumed the student no longer wishes to be considered enrolled. Students who wish to\ apply for reinstatement at a later date may complete a new application for admission. * Return Tasks: Students are responsible for checking their email periodically during their LOA to ensure all return requirements are completed. Requirements include completing the return form, compliance, entering the class lotteries, and other class specific tasks. * Approval: The Office of Student Affairs is the final approval for return from a LOA. D. Withdrawals: Students who wish to withdraw from the MD program must meet with the Office of Student Affairs. * Paperwork: Upon approval, students will be provided with the Withdrawal form to complete their check out. * Documentation: The student will receive a letter documenting their request with their withdrawal date and academic standing. The withdrawal will also be noted on the students’ transcript and Medical Student Performance Evaluation (MSPE).
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