Policy of the Graduate Medical Education Committee Section: Resident Support/Conditions for Appointment Subject: Leave for Residents Number: 2.200 Date Developed: 1/89 ACGME
Requirement: Institutional II D.4.h.
Last Review/Revision: 2/04, 12/06, 6/09, 12/2011, 6/12
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 physical absence from the training site that is paying
that day’s stipend.
This
policy defines paid vacation, sick, and educational leave which the scheduled
payment source will honor. The scheduled
payment source is not obligated to pay stipend and benefits for any other
physical absence. When there is a
physical absence in excess of, or not included in, leaves addressed in this
policy there must be an alternate stipend and benefit payment source.
The
financial accounting for resident salary and benefits is by the day. Every calendar day (work days, off, sick and
all of the leaves defined below) for
every resident must be paid from some source, except in instances of leave
without pay. An institution (ACH,CAVHS,
UAMS MC, etc) or a program are usually the funding source.
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.
Parental leave: Time off duty, by the mother or
father, for the birth of a child or the placement of an adoption.
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
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.
Professional or Educational Leave: paid time away from the training site that is paying that day’s resident stipend, for educational or professional meetings.
Holiday: paid time off only if resident’s scheduled assignment (clinic) is closed.
Responsibilities for
Administering Policy
Resident
physicians are in the unique position of having a role as students and
employees. Although brief periods of
leave usually can be accommodated, time away from
the residency (fellowship) program may affect not only the resident’s ability
to sit for boards, but also may negatively impact the program financially and through
its accreditation status. Extending the
program may not be possible due to the lack of salary funding, and/or fine
imposed by the U.S. Citizenship & Immigration Service (INS). Additionally, the program may not receive
approval from the ACGME to increase the resident complement for the additional
educational time.
It is the responsibility of the Program Director to:
1. Keep
accurate records of sick leave, vacation leave, leaves of absence, professional
or educational leave and training status not only for billing purposes but also
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 an extended leave period and be eligible for certification
for a full training year;
3. Provide
the resident with the program’s written policy concerning the effect of leave,
for any reason, on satisfying the criteria for completion of the residency
program. The policy will contain information on access to eligibility
requirements, usually the American Board of Medical Specialties web site
http://www.abms.org/Who_We_Help/Member_Boards/contactinfo.aspx.
4. Provide resident in writing, the consequences of
exceeding the amount of leave set by the ACGME and/or the Specialty Board.
5. Notify
the Assistant Dean for Housestaff Affairs 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.
I. 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. Each program will inform its
residents/fellows of the specialty Board regulation on leave used vs. Board
eligibility. 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. 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 Assistant Dean for Housestaff Affairs 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 in
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.
6. Under
special circumstances, 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.
Special
Provisions for Pregnancy
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. When
the pregnancy is confirmed, the resident should notify her Program Director
promptly.
2. The
Program Director should be sensitive to the confidential nature of this information
during the early part of pregnancy.
3. By
the end of the sixth month of pregnancy, the resident must provide the Program
Director with a written statement about the expected date of delivery, and the
intended dates of leave. Any subsequent
change in medical condition that might alter this information should be
submitted in a revised statement.
4. The
Program Director may request a statement from the treating physician,
especially in the case of extended leave
5. See
UAMS Administrative Guide No. 4.6.11, Family and Medical Leave Act (FMLA) if
leave is without pay or if she elects to take a leave of absence without pay
before exhausting her unused sick and vacation time.
II. Parental Leave Policy
1. The
maximum period of parental 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.
2. Time
off for parental leave must be requested in writing to the Program Director as
soon as it is known, preferably at least four (4) months before the date
of the leave.
3. The
program director will consider all aspects of the residency program in granting
or denying permission for leave.
4. See
UAMS Administrative Guide No. 4.6.11, Family and Medical Leave Act (FMLA) if
leave is without compensation.
III. Family Medical Leave Policy
1. 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 under that policy.
2. The
terms of UAMS Administrative Guide No. 4.6.11 apply to the use of FMLA leave.
IV. 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 is ordinarily unpaid. 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 Assistant Dean for Housestaff Affairs 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 Assistant Dean for Housestaff Affairs, 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 Assistant
Dean for Housestaff Affairs 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 Assistant Dean for Housestaff Affairs 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.
V. Bereavement Leave Policy
Residents may request leave of one (1) to three (3) days
due to death of a member of his/her immediate 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 leave of absence in
Section V above.
VI. 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
VII. Vacation Leave Policy
Each Program Director has the authority to determine the
length and scheduling of vacation time for residents within 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 21 days. Only 15 week days (i.e. Monday – Friday) may
be taken. Each program will inform its residents/fellows of the specialty Board
regulation on leave used vs. Board eligibility. 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 American
Board of Medical Specialties requirements.
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.
VIII. Professional or Educational Leave Policy
Programs will define and allocate professional and
educational leave up to a maximum of 5 days per year, in addition to sick and
vacation time. Professional and
educational leave may not be carried over from one year to the next.
Interview days may not be counted as professional or educational leave.
Professional or educational leave may be used to take primary or subspecialty boards.
USMLE exams may be taken using professional or educational leave.
For audit purposes, professional or
educational leave must be noted as such on the schedule submitted to the
Housestaff Office.
Special exceptions for more than 5 days per year will be considered by the finance committee under this policy. Those exceptions include but are not limited to: advanced recognition, exceptional research or academic performance. Exceptions should be requested in advance of the registration deadline/leave date.
A UAMS Request for Travel Authorization should
document professional or educational leave.
See UAMS Administrative Guide Policy 8.4.04. That policy can be found at
www.uams.edu/adminguide/WIN08404.html
American Board of Medical Specialties
Requirements on leave
July 12, 2011
|
Program |
Board
Requirement |
|
Anesthesiology |
Total of any and all
absences may not exceed 60 working days (12 weeks) during the CA1-3 years; up
to 5 working days for scientific meetings is considered part of the training
program. |
|
Dermatology |
Absence should not more
than 6 weeks in an academic year or a total of 14 weeks over the three years,
including vacation |
|
Emergency Medicine |
Leaves of absence,
vacation, sick must not exceed 6 weeks per year (must complete 46 weeks/year) |
|
ENT |
Must not exceed 6 weeks per
year |
|
Family Medicine |
Absence from the program must
not exceed 1 month (4 weeks) per academic year for vacation, illness,
personal business, leave, etc., must not exceed a combined total of one (1)
month per academic year. Time away from the residency program for educational
purposes, such as workshops or continuing medical education activities, are
not counted in the general limitation on absences but should not exceed 5
days annually. |
|
Internal Medicine |
Must not exceed 1 month (4
weeks) per academic year Up
to one month per academic year is permitted for time away from training,
which includes vacation, illness, parental or family leave, or
pregnancy-related disabilities. Vacation leave is essential and should not be
forfeited or postponed in any year of training and cannot be used to reduce
the total required training period. |
|
Neurology/Child Neurology |
Must follow overall
institutional policy |
|
Neurosurgery |
|
|
Ob/Gyn |
Must not exceed 8 weeks in
any of the first three years, or 6 weeks during the fourth year, or a total
of 20 weeks over the four years of residency |
|
Ophthalmology |
No board requirement. ACGME requirement: Length of training must
be at least 36 calendar months, including appropriate short periods for
vacation, special assignments, or exceptional individual circumstances
approved by program director |
|
Ortho Surgery |
Must not exceed 6 weeks per
year (46 week year) |
|
Pathology/Subspecialties |
Sick, vacation, parental
and other leave must not exceed 4 weeks per year (48 week year) |
|
Pediatrics/Subspecialties
and combined training |
Absence must not exceed 1
month (4 weeks) per academic year |
|
PM&R |
Must not exceed 6 weeks per
academic year |
|
Psychiatry/Subspecialties |
Must follow overall
institutional policy |
|
Radiology/Subspecialties |
Must not exceed 6 weeks per
academic year |
|
Surgery |
One month per academic
year; For documented medical problems or maternity leave, 46 weeks of
training in one of the first three years and 46 weeks in one of the last two
years, for a total of 142 weeks in the first three years and 94 weeks in the
last two is acceptable. |
|
Urology |
Residents must work a
minimum of 46 weeks/year |