Policy of the Graduate Medical Education Committee
Section: Resident Support/Conditions for Appointment
Subject: Leave for Residents
Number: 2.200
Date Developed: 1/89
Last Review/Revision: 12/06
Replaces: previous policy of same name, dated 5/03;
incorporates previous GME Policies 2.200 and 2.210
ACGME Requirement: Institutional II.D.4.h
Purpose
To define the policies
and procedures as well as the related responsibilities of the UAMS College of Medicine (COM), Program Directors, and the residents/fellows
for leave while enrolled in the GME program.
Definitions:
Sick Leave is
paid absence from scheduled work for reason of illness, maternity, paternity, or
injury.
Family Medical Leave Act FMLA):
See provisions of UAMS Administrative Guide No.
4.6.11.
Professional Leave
is paid absence to
attend an approved function related to the specialty program of the resident.
Leave of Absence
is unpaid absence from the
educational activities of the residency program when no sick or vacation leave
exists to cover the absence and it is leave other than FMLA-qualified leave.
Bereavement Leave
is paid absence to attend a
funeral of the resident’s immediate family.
Immediate Family:
father, mother, sister, brother, spouse, child,
grandparents, grandchild, mother-in-law, father-in-law, or any other person
acting as parent or guardian of the resident.
Military Leave:
absence from the residency program to fulfill obligations of
the National Guard or any of the Uniformed Services of the United States as
defined in 38 U.S.C. 4303.
Vacation Leave:
paid absence from the residency program typically used for
the purpose of personal travel or recreation; however, it may also be used for
personal business.
Effect
of Leave on Completion of Training
Each program must provide its residents with
(a) a written policy in compliance with its Program Requirements concerning the
effect of leaves of absence, for any reason, on satisfying the criteria for
completion of the residency program, and;
(b) information relating to access to eligibility for certification by the
relevant certifying board (American
Board of Medical Specialties web site
http://www.abms.org/Who_We_Help/Member_Boards/contactinfo.aspx.)
Resident physicians are in the unique position of having a role as students and
employees. Although brief periods of leave usually
can be accommodated, extended absences from the residency (fellowship)
program for any reason may adversely affect both the resident’s timely
completion of the educational program and the program’s responsibilities
for patient care, allocation of clinical teaching opportunities, and funding for
resident stipends. Most specialty boards specify a minimum number of weeks of
education (or training) that must be completed for a resident to receive credit
for the educational (or training) time.
The resident should consult
the appropriate Board regarding qualifications and requirements to sit for their
specialty boards when requesting extended periods of leave from the program.
I.
Policy
It is the
responsibility of the Program Director to:
1. Keep
accurate records of sick leave, vacation leave, leaves of absence, and training
status in order to have adequate information for Board certification;
2. Determine whether the resident will be required to spend additional
time in the program to compensate for the leave period and be eligible for
certification for a
full training
year;
3. Provide the resident with written documentation concerning the effect
of leave, for any reason, on satisfying the criteria for completion of the
residency
program;
4. Notify the Director of Housestaff Records to discuss the accounting
of the leave, financial compensation, and record keeping requirements.
It
is the responsibility of the resident to:
1. Notify the Program Director as soon as possible about the need to
take leave for any reason;
2. Supply the necessary written information about the reason for any
type of leave;
3. Gain a thorough understanding of the effect the leave will have on
meeting the requirements of the residency (fellowship) program and board
certification.
II. Sick Leave
Policy
Sick leave for
medical reasons will be granted with pay for a maximum of 12 days during each
year of the residency program. Weekdays and weekend days during which the
resident is assigned to work will be charged as sick leave if the resident is
unable to work due to illness. Residents will not be charged sick leave for days
on which they were not assigned to duty (i.e. scheduled days off).
Sick leave cannot be carried over from one year to the next,
nor will residents receive
payment for unused sick leave at the completion of the program.
To access sick leave a resident must notify the Program
Director or his/her designee. The specific procedure for notifying the Program
director of brief absences due to illness is developed within the individual
program. A resident may be placed on sick leave for extended periods of time
(generally in excess of one consecutive week only) with the approval of the
Program Director, according to the following:
Procedure for extended sick leave
1. The resident submits a written request to the Program Director
stating the nature of the illness or injury
and the reason for the requested extension of sick
leave.
2. The request is reviewed by the Program Director who determines the
effect of extended leave on continued
participation in the residency program and the
possible need
for and availability of remedial training. This information must be provided to
the resident in writing.
The Program Director
may require a
statement
from the resident’s treating physician to help in these determinations.
3. The Program Director must notify the Director of Housestaff Records
about the planned leave period.
4. Unused vacation time must be used after the exhaustion of sick
leave. When maximum sick leave and vacation time have been exhausted, the
resident is
placed on leave without pay as described on
Section V.
5. The Program Director shall decide whether the resident may return to
full duties upon consideration of all circumstances involved. The Program
Director may
require a
statement from the resident’s treating physician to help determine if the
resident is medically qualified to return to duty and if any restrictions are
necessary in
the resident’s clinical activities because of the illness.
Special
Provisions for Pregnancy – Maternity Leave
In recognition of the
variations in physical demands among the residency programs in the UAMS-COM, the
interdependence between the numbers of the residents in a particular residency
program, the educational and patient care experiences, and to ensure optimum
consideration for both the mother and the unborn child, the following procedures
should be followed:
1. The resident should see a physician as soon as she believes there may
be a pregnancy. When the pregnancy is confirmed, she should notify her Program
Director
promptly in order to plan future assignments within the residency program. She
should also provide the date on which she will most likely cease
program
responsibilities.
2. By the end of the sixth month of pregnancy, the resident must provide
the Program Director with a statement from her personal physician certifying the
expected date
of delivery, her physical ability to continue working, and the date to which
she is permitted to work. Any subsequent change in medical
condition
that might alter these health guidelines is to be documented by an additional
statement from her physician.
3. The maximum period of maternity leave with pay is 33 days (12 days of
unused sick leave plus 21 days of unused vacation time). Time off-duty beyond
that
amount is
without compensation. The time off-duty is to be used in the following order,
unless the Program Director gives permission to use the leave in
another way:
a. unused
sick leave
b. unused
vacation time
c. leave
without pay
4. Under special circumstances, most commonly for reasons of pregnancy,
the resident may request permission to start and complete
one year of residency
program over a
two-year period. Such requests must be made in writing and in advance
to the Program
Director. Approval will be based upon the educational
curriculum of the
program, the requirements of the clinical service, and the Residency Review
requirements of the residency program.
Paternity Leave
A male resident may
request leave in order to care for his newborn child or spouse who has delivered
a newborn child. He must make the request in writing to the Program Director,
who will consider all aspects of the residency program in granting or denying
permission for leave. In order for the leave to be granted, the following
procedure must
be followed:
1. Request for paternity leave must be made to the Program Director
at least four (4) months before the date of the leave.
2. The time will be used in the following order:
a.
one day of sick leave for the birth
b.
unused vacation time
c.
leave without pay
III. Family Medical Leave
Policy
Residents who meet the
definition of “eligible employee” as defined by UAMS Administrative Guide No.
4.6.11, Family and Medical Leave Act (“FMLA”), may be entitled to leave benefits
under that policy.
In order to request FMLA leave,
the resident should notify the Program Director as soon as possible and
complete and return
the requisite forms
to the Program Director. In
order to use FMLA
for the birth of a child or to
care for a newborn, the resident must notify the Program Director at least
four (4) months before the date of the leave. The terms of 4.6.11 apply to
the use of FMLA leave.
IV. Professional Leave
Policy
Each Program Director
must provide the residents in the program with written guidelines for leave to
attend educational activities (e.g. professional meetings, taking board or other
standardized examinations, employment or professional interview) related to the
specialty. Professional Leave is usually not counted as vacation. The
resident must complete a Travel Authorization form, return it to the Program
Director, and receive approval prior to the beginning of the leave.
V. Leave of Absence (non FMLA qualified)
Policy
The Program Director
has the sole authority to grant a leave of absence for a resident. Leave of
absence if leave other than FMLA-qualified leave. Leave of absence is
ordinarily unpaid; however unused vacation or sick leave may be used at the
discretion of the Program director for certain circumstance such as serious
health conditions affecting a resident’s spouse, child or parent and for whom
he/she is needed to provide care. In order for a leave of absence to be
granted, the following procedure must
be followed:
Procedure
1. The resident
must discuss the reasons and estimated length of time for a leave of absence
with the Program Director.
2. The discussion must include whether the resident will be paid, the
financial source for stipend and other benefits, the estimated length of time
for the leave of
absence, and
a full determination of whether or not the resident is required to spend
additional time in the residency program to compensate for the leave period
and be
eligible for certification for a full training year. The decision regarding
additional time in the program should consider the requirements of the
individual
specialty
Boards.
3. Prior to making a final decision regarding the request for leave of
absence, the Program Director must contact the Director of Housestaff Records to
discuss
the
accounting of sick leave, vacation time, restrictions about family medical
leave, financial compensation (stipends and benefits), and the record keeping
requirements.
4. After consultation with the Director of Housestaff Records, thorough
discussion with the resident regarding reasons for the leave, review of
necessary
documentation
regarding the medical or other condition, and thorough review of the residency
requirements for board eligibility, the Program Director makes
the final
decision regarding granting a leave of absence.
5. The Program Director provides a decision in writing to the
resident and the Director of Housestaff Records which must include the starting
and ending dates of
the absence,
financial support (stipends and benefits) if applicable, and the amount of
additional time in the residency program that is required to compensate
for the leave
an fulfill board eligibility requirements.
6. Once the resident is placed on leave of absence, the Program Director
must notify the Director of Housestaff Records if there is any change in the
dates of the
leave
of absence and confirm the date the resident will return to
the residency program.
VI. Bereavement Leave
Policy
Residents may request
leave of one (1) to three (3) days due to death of a member of his/her
immediately family. Requests for this leave or extension of this leave beyond
three days must be approved by the Program Director. Extended bereavement leave
is administered under provision of Section V above.
VII. Military
Leave
Policy
The Uniformed Services
Employment and Reemployment Rights Act does not apply to residents enrolled in
the GME program. Residents who are members of the National Guard or any of the
Uniformed Services of the United States may be called to duty in such uniformed
service. The resident shall notify the Program Director in writing upon
learning that he/she has been called to duty in a uniformed service. Prior to
leaving the program for active duty, the resident and Program Director shall
discuss the tentative plans for the resident’s return to the program including
the level of re-entry. Within the abilities of the program to accommodate the
resident’s re-entry in the program, the duration of absence from the program and
the resident’s activities during the absence, the program will make every effort
to ensure that the resident re-enters the program at the level commensurate with
his/her abilities.
VIII. Vacation Leave
Policy
Each Program Director has the authority to determine the length and scheduling
of vacation time for residents with in the program.
The Program Director shall provide written
instructions to residents within their program and to Program Directors of
off-service residents about the procedures and rules for scheduling vacation
time. Failure to follow the specified procedure could result in
loss of vacation time.
The annual vacation allowance is three weeks (15 working days plus weekends to a
maximum of 21 days) for all residents. Weekends and UAMS holidays are not
charged as vacation time. Vacation leave must be approved by the appropriate
department/program representative. An individual Program Director may alter the
amount of leave but only in order to comply with the Residency Review Committee
requirements.
Approved professional leave typically is not counted as vacation if the
resident’s department sanctions the activity.
Each department shall grant vacation time to residents from other departments on a FTE basis proportionate to the time spent on service in the other department. For example, if four residents from Department A rotate on a Service of Department B for three months each, Department B must grant three weeks (15 working days plus weekends to a maximum of 21 days) to be distributed among the four residents [4 residents x 3 months = 12 months of 1 FTE; therefore 1 FTE = 3 weeks vacation]. The Program Directors of Departments A&B will arrange the appropriate allocation of the vacation time among the residents.
The nature of some educational experiences may preclude taking vacation time. In this case, the Program Director shall communicate this decision to Program Directors of visiting residents in a timely manner so that this can be considered when preparing the overall rotation schedules.
Vacation time does not accrue from year to year and must be scheduled and taken in the same academic year the vacation is earned. Further, residents are not paid unused vacation leave at the time of the completion of their program.