A high rate of attendance is key to the success of medical students, given the competency-based, experiential nature of medical training and the central role played by highly interactive small-group modes of instruction at the University of Toronto. However, there are instances which may necessitate medical students requiring time away from the MD Program, as defined below. These regulations and guidelines permit and support absences from mandatory learning activities in order for students to seek needed health care services.

These regulations and guidelines describe reasons for health-related and other types of absences that are normally acceptable and corresponding procedures that are intended to:

• be clear, user friendly and implementable with available resources
• minimize disruption to student learning and patient care
• enable consistent and equitable decision-making
• maintain the educational integrity of the MD Program’s goals, objectives and competencies
• facilitate the early identification, in a safe and confidential manner, of students who may require support
• ensure students are empowered to succeed in their progress through the program

Absences from mandatory learning activities fall into two categories:

1. unplanned absences (absences that arise due to unforeseen and often emergent circumstances)
2. planned absences (absences that arise due to known or anticipated circumstances)

Changes to rotation call schedules are not considered planned absences. Students who would like to request a change to their call schedule should contact the relevant Clerkship course director and Clerkship course administrator.

A prolonged absence or series of absences that affects the ability of a student to complete a course or curricular component within its normal timeframe or a reasonably extended timeframe (as defined by the relevant curriculum leaders) may be more effectively addressed and supported by a Leave of Absence (LOA), defined as an official, temporary withdrawal from studies. Further details regarding LOAs are included in the program’s Regulations and guidelines for leaves of absence from the MD Program.

Submission of a U of T Verification of Illness (VOI) Form is required for health-related absences from assessments or for health-related absences of more than two consecutive days of mandatory learning sessions. The completed U of T VOI form must be submitted normally no more than five business days after the last day of the unplanned absence. Depending upon the type or duration of the absence, or the number of prior absences, students may be required to submit other supporting documentation.

For both planned and unplanned absences:

• Course and Component Directors (or their delegates) are responsible for determining if deferred/make-up work or assessment is required, and communicating next steps to the student.
• Students are responsible for covering material and knowing the content from any missed sessions and, if applicable, completing any deferred/make-up work or assessments.

Please note that the following are considered unprofessional behaviour that may be reflected in a student’s professionalism assessment:

• Failure to attend a mandatory learning activity for an urgent/emergent reason (unplanned absence) without providing notification within a reasonable timeframe
• Failure to attend a mandatory learning activity for a reason that was known or anticipated, or can reasonably be expected to have been known or anticipated, but for which a planned absence request was not submitted
• Disregarding the decision of an MD Program leader regarding a planned absence request

Mandatory Learning Activities

Unplanned Absences

Unplanned absences are absences that arise due to unforeseen and often emergent circumstances, including for:

• Illness/injury/personal crisis
• Family emergency
• Funeral/memorial service
• Travel/transportation emergencies (e.g., accidents, subway breakdowns)

Notification Procedures (Unplanned Absences)

Students are responsible for using the MD Program’s unplanned absence notification form to submit notification of an unplanned absence as soon as possible after attending to the immediate needs arising from the situation.

In the event that the student believes that an extended absence of three or more days may be required, this should be conveyed in the notification, and will normally require submission of supporting documentation after the immediate needs arising from the situation have been attended to. If the matter is sensitive, the student may elect to first consult with the Associate Dean, Learner Affairs or a counsellor in the Office of Learner Affairs to determine appropriate notification procedures.

Please see Appendix A for an Unplanned Absence Notification Procedures Flowchart.

Planned Absences

Planned absences are absences that arise due to known or anticipated circumstances and require prior approval by the Course or Component Director. Students should not assume that approval will be granted for planned absences and are strongly advised not to commit to any plans before receiving confirmation of approval from the Course or Component Director(s) (or delegate).

Notification Procedures (Planned Absences)

Students are responsible for using the MD Program’s planned absence request form to submit planned absence requests in a timely manner, as follows:

• For planned personal day absences in Foundations and Clerkship, at least two weeks' notice are required prior to the start date of the missed activity(ies)
• For Clerkship clinical rotations, at least 30 days prior to the start date of the rotation in which the missed activity(ies) are scheduled to take place.
• For all other Clerkship courses and all Foundations courses, at least 30 days prior to the activity(ies) to be missed.
• Note: Where relevant, travel and accommodation should not be booked until approval has been received

Planned Personal Day Absences

Students in years 1, 2, and 4 of the MD Program are allotted 3 planed personal day absences per academic year. Students in year 3 of the MD Program are allotted 4 planned personal day absences per academic year. The following limitations apply:

'Blackout periods refers to periods in which a planned personal absence day cannot be requested.

• No more than 1 Personal Day can be taken per Foundations course
  • Blackout periods: Assessment dates (includes MEs, progress test, HSR presentations, ICE:CS observed assessments, OSCE, and any dates where a student must reassess)
• No more than 1 Personal Day can be taken per Clerkship rotation in Year 3 or per elective/selective in Year 4
  • Blackout periods: ME, OSCE dates, during a course of two weeks or less in duration, on days marked for course orientation, scheduled call days, and centralized teaching days (TED, TTR Campus Weeks, Portfolio sessions)
• Personal Day absences cannot be combined with any other planned absence types (e.g., conferences)

If the planned absence request is approved, the student is responsible for informing the immediate education supervisors of the activities they will be absent from. If the matter is sensitive, the student may elect to first consult with the Associate Dean, Learner Affairs or a counsellor in the Office of Learner Affairs to determine appropriate notification procedures.

Please see Appendix B for a Planned Absence Request Procedures Flowchart.

Information and Decision-making Guidelines (Planned Absences)

In general, the following factors will be taken into consideration regarding planned absence requests:

• Reason for the absence
• Duration and type of learning activities to be missed, including their relative importance or uniqueness in the curriculum
• Student’s academic record, including professionalism
• Student’s attendance record/absence history

For more details regarding common reasons for planned absences, including corresponding information requirements and typical decision outcomes, see Table 1 (Foundations) and Table 2 (Clerkship) below.

Planned absence requests for reasons other than those included in Table 1 and Table 2 will be considered on a case-by-case basis, but will normally not be approved.

Absence Monitoring (Check-in Meetings)

The MD Program is committed to monitoring absences from mandatory learning activities in order to help ensure that the program is able to provide an accurate assessment of a student’s progress through the program and that students are well positioned and supported to succeed in achieving course learning objectives and program competencies. A check-in meeting may be required of a student who has a recurrent or problematic absence history, typically defined as (but not limited to) the following:

• eight or more full day equivalent unplanned and/or planned absences in an academic year,
• two or more unplanned and/or planned absences on days on which assessments are scheduled in an academic year, or
• two or more deferred assessments in an academic year.

In such cases, the Assistant Registrar, Registration & Student Success will review the student's absence history, where appropriate, to determine next steps, including if a check-in meeting is warranted.

If warranted, the student will be invited to a check-in meeting with the Assistant Registrar, Registration & Student Success, which is intended to:

• provide students an opportunity to discuss their absences in a safe and confidential environment,
• help ensure they are aware of the various supports available to them, and
• determine if the student is able to complete a course or curricular component within its normal timeframe or a reasonably extended timeframe (as determined by the relevant curriculum leaders).

The MD Program’s Regulations and guidelines for leaves of absence from the MD Program will help inform next steps in cases where a student is unable to complete a course or curricular component within its normal timeframe or a reasonably extended timeframe and may benefit from a LOA.

Tables and Appendices

• Table 1: Planned Absence Information Requirements and Typical Decision Outcomes: Foundations (Years 1 & 2)
• Table 2: Planned Absence Information Requirements and Typical Decision Outcomes: Clerkship (Years 3 & 4)
• Appendix A: Unplanned Absence Notification Procedures Flowchart
• Appendix B: Planned Absence Request Procedures Flowchart

Date of original adoption: 20 September 2011
Date of last amendment: 20 June 2023