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Religious Obligations

Conflicts between religious obligations and patient care obligations are handled on clinical rotations much as they would be in clinical practice with patient care responsibilities taking precedence unless coverage has been previously arranged.

Departments should make every effort to respect students' religious customs and to adjust the on-call schedule to allow students to observe religious activities as long as this does not penalize other students or jeopardize patient care.

The student must inform the department of his or her request well in advance of the rotation if it is to be incorporated in the on-call schedule. When scheduling conflicts cannot be resolved, however, it is up to the student to make sure that their patient care and on-call responsibilities are met in full. In the event that students cannot obtain coverage, they are expected to take call themselves, regardless of the religious conflict.

Healthcare Services

Students are expected to seek necessary health care to maintain their physical and mental well-being and are excused to obtain these services. Examples of necessary health care include preventive health services, visits for acute illness, ongoing care for chronic illnesses, dental visits, physical therapy, and counseling and psychological services. 

For planned absences related to healthcare, students must contact the OME (Phase 1), clerkship director (Phase 2), or rotation director (Phase 3) in advance to coordinate time away. Students are expected to make these appointments in a manner that minimizes absence from required activities or service. Consistent with their rights under University policies and the law, students have a right to privacy when seeking care.

Approved by the Curriculum Committee: January 28, 2020 
Modified by the Office of Medical Education: April 20, 2020
Modified by the Office of Medical Education: March 12, 2021
Approved by the Curriculum Committee: March 22, 2022
Approved by the Curriculum Committee: November 22, 2022
Modified by the Clerkship Directors: March 14, 2023
Approved by the Curriculum Committee: March 28, 2023
Approved by the Curriculum Committee: November 28, 2023

ATTENDANCE/ ABSENCE POLICY: Students enrolled in the College of Medicine MD program have entered a professional program and are physicians in training; therefore as part of professional conduct, students are expected to attend all educational activities and approach absences with the same measure of professional responsibility that will be required in their future role as physicians.  Attendance and active participation in designated activities are part of the students’ final grade (see block syllabus grading grid and OASIS for further detail). 

EXCUSED ABSENCES: If absence from an activity, other than lecture, is unavoidable you must notify the Office of Medical Education (OME) if possible before the start of the activity by completing the Absence Request form (see below). An absence may be excused for the following reasons:

  • funeral/death
  • personal illness
  • presentation at a scientific conference
  • religious obligations

In addition, the College recognizes that “once in a lifetime” family events (e.g. weddings, reunions, etc.) occur during medical training.  Students may request up to 2 days per semester to attend these events as excused absences.  The OME must be notified at least 6 weeks in advance of the requested absence. 

**NOTE: Please do not make travel arrangements until after your request has been approved.

UNEXCUSED ABSENCES: As there are other events in students’ lives that are important but do not fall under the excused category, we allow three unexcused absences during the entire Phase One (M1 and M2 combined = Phase One) without incurring a letter of professionalism.  *However, please be aware that students are not permitted to make up quizzes or other graded assignments that are missed, therefore points may be lost due to unexcused absences.  Arriving 10 minutes or later to small group or lab will result in an unexcused absence.  

*Unexcused absences are tracked in a database and repeated or chronic absences are considered a sign of unprofessional conduct (Student Professionalism). As such, students with a history of greater than three unexcused absences may be referred to the Deans in the Office of Student Affairs.

ABSENCE FROM EXAMINATIONS AND OTHER GRADED ACTIVITIES: Absences from written examinations, clinical or practical examinations, and other graded activities are not permitted except for the following circumstances: funeral/death, personal illness, presentation at a scientific conference, religious obligations, or 'once in a lifetime events' (see absence policy).  When the absence is sudden, unplanned, or on the same day as the examination/assessment, students must notify the OME by email (ome@unmc.edu) in addition to filling out the online form.  If there is advance notice, students are responsible for requesting approval from the Office of Medical Education (ome@unmc.edu) prior to the start of the applicable block. Any absence request is not considered approved until you have received a response from the Phase Directors or representative of the OME.

  • All make-up assessments are managed by the OME; block directors or individual faculty members are not to be contacted regarding the scheduling or logistics of these assessments. 
  • Make-up written examinations will be scheduled by the OME on the first available date following the original examination. Make-up exams cannot be completed in advance of the original exam date.
  • Failure to complete an examination (e.g., ExamSoft administered written examinations, laboratory practicals), including make ups, as outlined by the OME without prior approval will result in a grade of "0%" on the exam.
  • Due to the nature of clinical examinations involving standardized patients, a make-up exam cannot be guaranteed and will be addressed on a case-by-case basis.
  • Students will not be allowed to postpone more than one assessment per block unless approved by the Phase Directors. If circumstances persist that require postponement of more than one assessment, the student may be advised to withdraw from the block and complete the content according to existing guidelines. 
  • Remediation or retake of more than two blocks per academic year is not allowed unless approved by the Student Evaluation Committee. 
  • Students who request postponement of more than three exams during Phase 1 will be referred to the Student Evaluation Committee. 
  • LATE ASSIGNMENTS: Late assignments will be accepted, however a late penalty of 25% per day will be imposed. Day one begins as soon as the deadline passes.  Late assignments applies ONLY to assignments and does not include exams or quizzes.

For any event, students need to follow the steps below for absence from a required activity or an exam.

Step 1: Complete the Absence Request form: Absence Request.
Step 2: A representative from the OME will respond to you and provide further instructions.
Step 3: The OME will request additional confirmation regarding absence, if needed. 

SPECIAL CASE: The Curriculum Committee may designate additional events as mandatory (for example IPE Day).

Students enrolled in the College of Medicine program have entered a professional program and are physicians in training. Students are expected to attend all educational activities and approach absences with the same measure of professional responsibility that will be required in their future role as physicians. Attendance and active participation in designated activities are part of the students’ final grade. Student duty hours are explained in the Duty Hour Policy. Students are responsible for all required content or assessment that occurs during an absence.

Excused Absences are defined as any of the following:

  • funerals
  • personal illness*
  • presentation at a scientific conference
  • religious obligations 
  • "once in a lifetime" family events**

Unexcused Absences are defined as any of the following:

  • Any absence not defined as an excused absence
  • Failure to clearly communicate absence to supervising faculty AND clerkship director/coordinator as directed

The clinical Phases of the curriculum afford more flexibility in scheduling.  Students are expected to communicate requests for time off, excused or unexcused, with their respective clerkship director/coordinator to attempt to adjust schedules at the discretion of the clerkship director. Planned excused absences require notification and approval from the clerkship director as soon as possible or at a minimum six weeks prior to the start of the clerkship/course. Requests may be unexcused if the appropriate notification is not provided. 

Phase 2 core clerkships are foundation educational experiences for the COM curriculum.  A core clerkship is fundamentally compromised if many absences occur within the rotation.  Each clerkship has defined a threshold for the total number of absences that jeopardize the quality of the clerkship education experience, defined below.  If the total absences within the clerkship regardless of make ups cross this threshold, then credit for the clerkship may not be given.  This is subject to the discretion of the clerkship director, and part or all of the clerkship may need to be rescheduled in order to give credit and assign a final grade.  Note: If 2 or more absences within the total absences for the clerkship are unexcused, then the “Fail Criteria for Core Clerkships” applies.

All excused absences may require make up if they exceed the number of days listed below for each clerkship. Make up of these activities must be completed during Phase 2***. Weekends and breaks during Phase 2 can be used to make up missed days.  All unexcused absences will require makeup or remediation of activity/clinical experiences. Clerkship directors will determine the makeup plan. Students should coordinate with current and future clerkships to arrange make up of activities in a reasonable manner that does not impact future clerkship performance. 

  • IM
    • Total Absence Threshold Placing Course Credit in Jeopardy: 10 days
    • Threshold to Make Up Excused Absences: 4 days
  • Psych
    • Total Absence Threshold Placing Course Credit in Jeopardy: 5 days​
    • Threshold to Make Up Excused Absences: 2 days
  • OB
    • Total Absence Threshold Placing Course Credit in Jeopardy: 5 days
    • Threshold to Make Up Excused Absences: 2 days
  • FM 
    • Total Absence Threshold Placing Course Credit in Jeopardy: 5 days
    • Threshold to Make Up Excused Absences: 3 days
  • Surg 
    • Total Absence Threshold Placing Course Credit in Jeopardy: 6 days
    • Threshold to Make Up Excused Absences: 3 days
  • Peds 
    • Total Absence Threshold Placing Course Credit in Jeopardy: 6 days
    • Threshold to Make Up Excused Absences: 3 days
  • ACCT
    • Total Absence Threshold Placing Course Credit in Jeopardy: 4 days
    • Threshold to Make Up Excused Absences: 2 days

Absences across clerkships are monitored.  Students who accrue 5 or more days of excused absences during Phase 2 may be referred by the Phase 2 Director to the Office of Student Affairs.  More than one unexcused absence will be discussed with clerkship directors and the Office of Student Affairs.  Documentation of multiple unexcused absences may be a part of your final clerkship narrative.  Multiple unexcused absences or a pattern of unexcused absences over several clerkships may result a referral to the Student Evaluation Committee. 

*Students who miss days due to quarantine/isolation only should be given every opportunity to participate in clerkship activities virtually if they are able.  Student Health will provide guidance on when learners can return to clerkship activities in person. 

**The following events are considered blackout dates for clerkship requests and will not be rescheduled unless approved by the clerkship director: orientation, mid-term clerkship meetings, OSCEs, NBME exams or other required training. The following events are considered blackout dates for Phase 2 courses/events and will not be rescheduled unless approved by the Phase 2 director:  OSCE and BLS training in the Acute Care and Clinical Transitions course and Intersession days. 

*** Make up of excused absences outside of Phase 2 may be considered. This must be approved by the Phase 2 Director, Associate Dean for Medical Education, and Student Affairs.

Phase 3

Students are expected to attend all educational activities and approach absences with the same measure of professional responsibility that will be required in their future role as physicians. Attendance and active participation in designated activities are part of the students’ final grade.  Student duty hours are explained in the Duty Hour Policy.

Required Rotations: Attendance is required for the Curriculum Enhancement Seminar and the Residency Preparatory Course activities. Please see Oasis and Canvas for details.

Elective Rotations: Please refer to any rotation specific attendance policy. Questions regarding attendance should be sent directly to elective directors and coordinators. 

Excused Absences are defined as any of the following:

  • funeral/death
  • personal illness
  • presentation at a scientific conference or Step testing
  • religious obligations
  • residency interviews (see below) 

The College recognizes that “once in a lifetime” family events (e.g. weddings, reunions, etc.) occur during medical training. As the clinical Phases of the curriculum afford more flexibility in scheduling than is present in Phase 1, students are expected to communicate requests for time off with their respective clerkship director/coordinator to attempt to adjust schedules at the discretion of the clerkship director and supervising faculty member(s).  Assessments will not be rescheduled for these absences. All such requests should be made at least 2 weeks prior to the beginning of the rotation.

All absences, excused or unexcused, require notification of both the elective director and coordinator. Planned excused absences require notification and approval from the elective director a minimum of two weeks prior to the start of the rotation. Arrangements for make-up, if required, will be determined by the elective director.   

Step 2 Clinical Knowledge Examination

Students may request two (2) days of any rotation within any rotation in Phase 3 (including the Residency Preparatory Course) for the purposes of taking this examination. Scheduling the examination during a day in which a Curriculum Enhancement Seminar is occurring is discouraged. Students may be required to make up required activities that are missed during their absence.

Absence requests should be made to the elective director at least two weeks prior to the start of the rotation. This rotation director must approve each student’s request individually and determine what make-up, if any, is required. Additionally, the student is to complete the Absence Request form, documenting the reason for the absence and that rotation director has given approval.

Residency Interviews

Students may request up to five (5) weekdays and two (2) weekend days off from each of four (4) non-required rotations/electives for the purpose of interviewing for a post-graduate position. Absence requests should be made to the elective director at least two weeks prior to the start of the rotation/elective. This elective director must approve each student’s request individually and determine what make-up if any is required.