|  Days-off Policy for Senior Medicine- In general, the subinternship is an immersion experience. Attendance is essential in order to gain experience.
- Your role is that of an "acting intern." Students must realize that their team's are depending on them. Taking extra days off is not the same as missing a class. It directly affects patient care and creates additional work for your team.
- Expectations are that subinterns should be functioning at (or very near) the level of their PGY1 colleagues. As such, subinterns should expect to have the same number of days-off as the PGY1 interns at their site. This means subinterns get an average of 1 day off per week (4 days off for the month). Exactly which days off the subintern takes depends on multiple variables: their team's call schedule, days off for their pgy1 colleagues, their resident's clinic conflicts, and subinternship related educational concerns. The specific days off for the month should be determined by their senior resident on the first day of the rotation.
- Sometimes emergencies happen. To accommodate for unforeseen circumstances, a student's grade will not be affected if a subintern miss one additional 5th day (provided there is a valid reason for the absence). This is basically a floating 5th day-off for unexpected/emergency developments. But the student should expect that 4 days off is the norm.
- Days-off requests: Important events which the student had knowledge of BEFORE the start of the rotation will not be considered for the "5th day emergency day-off" (some examples: previously scheduled USMLE exams, previously scheduled interviews, family weddings, national meetings/conferences, research projects, other personal trips, etc). Days-off request for events such as these should be brought to the attention of the clerkship coordinator BEFORE the start of the clerkship so that we can try to find a team assignment with the fewest call-day conflicts. Most day-off requests can be granted if we know in advance- but these events will count toward your 4 days off for the month. Subinterns do not get extra days off in order to attend weddings, exams, meetings or interviews which they knew about before the start of the rotation. Students who miss on-call days for these types of issues may receive a professionalism form and could have their grade affected.
- Subinterns should work with their residents to try and minimize scheduling days off on required conference days (Tues & Thurs at NMH). More than 1 absence from the required bi-weekly conference could impact the student's final grade.
- Subinterns are expected to work the entire 4 weeks (all 28 days). The final day of the rotation is Sunday (not Friday). Outgoing subinterns are expected to write off-service notes for their current patients on the final day of their rotation. We also expect that the outgoing subinterns should contact the incoming subinterns and give a brief sign-out of their patients to help avoid errors with the transition of care.
- Students who miss days due to family emergencies and/or illness will be handled on a case-by-case basis by the site director. Again, more than 5 days missed out of the 28 day rotation may required some additional remediation to gain the necessary clinical experience.
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