Attendance and Time Off Policies


Clinical rotations require a full-time commitment by students. The educational component of the 3rd and 4th years of medical school consist of involvement with patient care as part of the healthcare team, attendance at all didactic activities, completion of assignments and self directed learning. Students must be at the hospital at least five days a week with daily hours and night and weekend on-call as scheduled by the clerkship director. Unexcused absences are not permitted while doing a clinical rotation. If a student must be absent for a few hours or a day, permission must be obtained from the clerkship director and/or DME before leaving. Longer absences from a rotation without permission from the clerkship director, DME and the Office of Clinical Studies can be grounds for failure in that rotation. Absenteeism and/or tardiness can result in an “F” in professional behavior and loss of credit for any rotation.

The scheduling of clinical clerkships requires a great deal of work by the Office of Clinical Sciences and hospitals. Requests for change cannot be accommodated without disrupting the schedule of hospitals and other students and will rarely be approved. Because orientation is given at the beginning of each clerkship, students are responsible to be at the hospital at the assigned time. If a student cannot make the assigned starting date or plans to be late, the student must notify the Office of Clinical Sciences and the DME at the hospital at once. Core rotations cannot be cancelled except for emergency reasons.


Study Time

Students are expected to study for exams throughout their Clinical Medicine rotations. No extra time off will be given to sit for or study for exams. It is the student's responsibility to coordinate their exam schedule around the days they are scheduled for rotation.


Residency Interviews

Senior rotations, once approved by the hospital, may not be cancelled by the student without consent of the hospital and XUSOM dean. XUSOM has a policy for senior students taking time off during clinical rotations, including electives. Students must take this policy into consideration when scheduling residency interviews in the months leading up to the match. Failure to do so in may lead to problems that jeopardized students’ graduation dates. Our policy above states that "Unexcused absences are not permitted while doing a clinical rotation." An appointment for a residency interview does not qualify as an "excused absence”. An "excused absence" means the student has permission from an attending physician (DME, Clerkship Director or Preceptor) to take time off for the interview. This needs to be discussed ahead of time, preferably even before the rotation starts. Absences from a rotation without such permission, even for interviews, can be grounds for an incomplete or failure in that rotation. The reason for this is that DMEs, clerkship directors and/or preceptors must certify that the student has attended the rotation for the designated number of weeks. From a legal and regulatory point of view, a week is defined as five full days.

If students travel to interviews and miss several days of the rotation, asking that the evaluation form attest to a full rotation without making up that time would be fraudulent. Any days off or lost clinical time from rotations must be made up by utilizing additional on call or weekend time at the discretion of the clerkship director. Educational projects, such as a research assignment and/or presentation of a topic, could also be used by the clerkship director to make up time away from the rotation. No time off is permitted during sub-internships.

Students are advised to arrange for a four week LOA or bridge time to attend many or all residency interviews. However, not every student can afford the time off. Students are encouraged to look at their clinical calendar to see if they can take the time off without jeopardizing their graduation timeline. Students who cannot take any time off should try to plan their interview season so that interviews are dispersed among the four months of "interview season," if possible. Any questions about this policy should be referred to the students' OCGSD advisors.

Cancellation Policy

A student must give Clinical Science department notification of cancellation at least 12 week ahead of the start date of the rotation. XUSOM is not responsible for the hospital fees. If cancelled less than twelve weeks, the student will be responsible for all fees for the cancelled rotation. The student will lose their tuition payment for that rotation, be required to submit tuition again and will receive a letter of reprimand from the Dean for unprofessional behavior. The student must write a letter of apology to hospital.

A second cancellation may lead to suspension from the school and mention of the suspension in the students’ MSPE.

Cancellation of a sub-internship is not allowed

  • If a student cancels, the student is responsible for full tuition for the cancelled rotation.
  • Hospitals should not cancel electives. Students should notify the Office of Clinical Sciences if a hospital cancels.

APPEALS to cancel will be reviewed but only for serious reasons. All appeals should be sent to Grievances Committee at

Illness Policy for NBME Clinical Subject Exams

All students must take the NBME Subject Examinations at the end of the clerkship. The end-of-clerkship NBME exam is, in fact, an educational part of the clerkship. Students should not consider this an academic exercise requiring additional preparation to be completed at a later date.

Any student who is sick must submit a Medical Excuse Form as detailed in the Student Manual with an additional email to Dr. Ahmad Abazid, Only one such excuse is permitted during the third year; a second medical excuse results in a mandatory medical LOA. Unless the proper medical excuse procedure is followed, any student who does not take the clinical subject exam as scheduled can receive a failing grade or be cited for unprofessional behavior. Students who have a medical excuse must take the exam within two weeks but cannot take time-off from any subsequent rotation to do so. All make-up exams are subjected to the rescheduling fee.