2.02 Attendance

Students pursuing the MD degree at Harvard Medical School (HMS) are physicians in training who must meet standards of professional conduct and responsibility (see Section 4.01) to develop into effective physicians. As a professional school, HMS requires attendance and active participation in all components of the curriculum. Active participation in the School’s course and clerkship activities indicates the student’s understanding and mastery of professional responsibilities. The granting of the MD degree attests that the student has demonstrated a commitment to their professional responsibilities through participation in all aspects of the curriculum as defined by the faculty. When it is necessary for students to be absent from a required MD program activity, students must approach such absences with the same standard of professional responsibility required of practicing physicians; professional responsibility extends to one’s patients and members of one’s team. See Section 4.01, Responsibilities of Teachers and Learners.

Pathways Preclerkship
HST Preclerkship
Principal Clinical Experience (PCE)
Elective Clinical Clerkship
Required Subinternship
Advanced Integrated Science Courses (AISCS) and Essentials of the Profession II
Required Clinical Capstone Course
Religious Observance

Preclerkship Phase

Pathways Preclerkship

The Pathways MD curriculum is designed to promote active engagement of each student in all components of the curriculum with the following goals:

To build a deep foundational knowledge to support lifelong learning;
To develop a sense of the values expected of a health professional;
To promote shared responsibility for learning, problem-solving, and patient care;
To engage students in teaching one another;
To provide opportunities to develop collaborative and leadership skills by working in teams in which different backgrounds and expertise are heard and represented.

Meeting these goals requires each student to be present and an active participant.

Students in the Pathways MD program are “doctors-in-training.” They are expected to treat each other, their instructors, and their patients with respect, value the community of learning created at HMS and act in a manner consistent with the professionals they are becoming. With that in mind, high value is placed on patient-related and collaborative team learning sessions in the Pathways preclerkship phase (e.g., CBCL sessions, classroom-based patient clinics, clinical sessions in the hospitals or clinics, and anatomy labs).

The integrated curriculum of the Pathways MD program is designed to promote an engaging, collegial interchange of ideas among students and faculty in all sessions, including large-group formats such as lectures or patient clinics. It is the expectation that students will arrive to class on time and attend and participate in all sessions unless an absence notification has been submitted, as outlined below. In formats that involve collaborative work, participation will be assessed and comprises an important element in the satisfactory demonstration of competence. Because the patient must be the center of all healthcare activities, attendance is particularly important in all sessions that involve patients, including large- and small-group formats. In addition, students are expected to attend all sessions that specifically involve written or oral examinations. A student who arrives late will not ordinarily be allowed additional time on an examination. See the examination policy in Section 2.03.

A central tenet of the HMS attendance policy is that students provide faculty with timely and valid notifications of absences from any curricular activities. Faculty rely on a student’s honesty and integrity when presenting a compelling reason for an absence from a required activity; honesty and integrity are core values for doctors. Multiple absences not only impair individual learning but also impact group learning and teamwork in both the classroom and clinical settings, which is vital to the success of the Pathways curriculum for all students. On the part of the School, the attendance policy will be evenly and fairly applied to all students. Official academic calendars are posted online.

Pathways Preclerkship Absence Policy

Pathways students are expected to attend all class sessions. However, it is understood that situations may
occasionally arise that require an absence, including:

Illness/healthcare appointment or personal/family emergency;
religious observation;
a highly significant personal event, limited to one day;
a podium or poster presentation of academic work at a scientific conference, limited to one day.

For all absences in line with the criteria above, a student must submit a Course Absence Notification Form. This form is sent to the relevant course director, course manager, academic society advisor, and academic society program manager. The Course Absence Notification Form must be submitted at least two weeks in advance, regardless of whether the course during which the absence will occur has started, except in the case of illness or personal/family emergency, for which it must be submitted as soon as possible. In the event of illness or a personal/family emergency, if the absence occurs during POM or BRIDGES, the student should also inform the appropriate clinical preceptors via email as soon as possible.

If a student submits a Course Absence Notification Form for an absence that does not meet the criteria above, the relevant course staff member will direct the student to submit a request to the Student Policies and Procedures Committee (see below).

An absence is not allowed:

unless an absence notification form is submitted at least two weeks in advance, except in the case of
illness or personal/family emergency;
on the day of a course quiz, examination, or other assessment activity, except in the case of a religious observation, illness, or personal/family emergency (see Section 2.03, Grading and Examination);
during any portion of Professional Development Weeks (PDWs), except in the case of a religious observation, illness, or personal/family emergency;
for more than one day, except in the case of a religious observation, illness, or personal/family emergency;
for non-course learning activities, such as shadowing clinicians in an affiliated clinical institution;
to extend a scheduled break (e.g. holiday recess) beyond periods specified in the academic calendar;
to take Step 1; students should schedule Step 1 outside of required class sessions.

It is the student’s responsibility to understand and comply with the attendance policy. If a student wishes to request an exception to the attendance policy, they may do so by submitting a request to the Student Policies and Procedures Committee. Students should not contact course directors or faculty to request policy exceptions. The Student Policies and Procedures Committee will aim to respond to policy exception requests within seven to ten business days. If a student’s attendance policy exception request is approved, the student must then submit the Course Absence Notification Form.

Patient-Related Sessions

Absence during a patient-related session (e.g., classroom-based patient clinic, clinical session in a hospital or clinic, anatomy lab) is highly discouraged and will be closely monitored. As the material and skills learned during a patient-related session can be difficult to obtain through recordings, readings, or student notes, course directors may require make-up assignments for missed patient-related sessions. In addition, during patient sessions, we emphasize the importance of timely arrival, respectful dress, and avoidance of device usage for personal reasons.

Remote Participation Policy

In very special circumstances, remote participation in class sessions (via Zoom) may be considered to help students keep up with content when they are unable to attend class. This option is only applicable if the course director, academic society advisor, session faculty, and small-group tablemates agree. In the event that all parties agree, remote participation arrangements are the responsibility of the student who will be absent and not the Office of Medical Education or course faculty.

Class Recordings

Course sessions may be recorded by the Program in Medical Education for educational support purposes. The Office of Disability Services may authorize the recording of course sessions to provide required accommodations for students with documented disabilities. Questions about such accommodations should be directed to the Office of Disability Services.

In some cases, Pathways preclerkship students may be granted access to available course session recordings due to approved absence reasons (see Section 2.02, Attendance).

All recordings are the property of Harvard Medical School and may be used only for relevant and approved educational purposes. Students may not copy, share, post, publish, sell, or otherwise distribute course recordings.

Unauthorized Recording

Harvard Medical School prohibits unauthorized recording of any kind, including audio, video, or photographic recordings. Secretly recording a conversation, meeting, or course session is not permitted, whether held in person or through a video conferencing platform.

Academic Factors to be Considered

Data indicate that students who are absent from a number of class sessions tend to struggle to succeed academically. Under no circumstances will an absence relieve a student of meeting all of the academic requirements of the course. If the absence request conflicts with a session or sessions that cannot be otherwise made up or completed, the student should be aware that the absence may or will affect their evaluation/grade in the course.

Consequences of Noncompliance with Attendance Policy

Students who fail to comply with the MD program’s attendance policy face a number of serious consequences. These include the following:

Failure to pass a required course.
Students who accumulate an excessive number of absences during an academic year will be reported
to the Dean for Students and PROGRESS, and may be referred to the Promotion and Review Board
(PRB).
Absences in which there is concern about lack of integrity or honesty will be referred to the PRB.
Failure to report any absence from any course session will be referred to the PRB.
The PRB will review attendance policy noncompliance to determine whether such unprofessional
behavior warrants official censure in the student’s academic record.
Summative comments in the evaluations of preclerkship courses may include excessive/unreported
absences or tardiness.

Any student who does not attend their scheduled classes or clerkships for a period of 30 days without approval and has not been placed on an official leave of absence (LOA), absent extenuating circumstances, will be considered absent without leave and withdrawn from Harvard Medical School. See Section 2.09, Leaves of Absence.

HST Preclerkship

HST trains physicians, scientists, and engineers to have a deep understanding of the analytical and molecular basis of medicine by integrating engineering, science, and technology into medicine and biomedical research. Implicit in the HST educational experience is a high-quality, expertly managed course-based curriculum that includes clinical training as well as a broad range of enrichment opportunities. In particular, HST students complement their classroom and laboratory exposure to the cutting edge of modern biomedical, physical, and engineering sciences by participating in research in leading laboratories at Harvard, MIT, and HMS and HMS-affiliated institutions. Active participation in all learning modalities is considered integral to an HST education. Nevertheless, HST fully realizes that it is sometimes difficult for students to balance these competing and potentially mutually exclusive commitments.

HST Preclerkship Absence Policy

HST believes that, within these guiding principles and philosophies, its reciprocal faculty-student educational “contract,” culture of respect, and unique range of objectives and opportunities necessitate a broad, context-based absence policy. Class attendance and participation are expected as a cornerstone of the HST curriculum and out of obligation to fellow students. Course directors and other faculty are also responsible for organizing in-class time efficiently and effectively and maximizing learning and value to the students. Although HST courses include a diverse group of students with a broad range of career objectives, approaches to learning, and programmatic requirements, all students benefit equivalently from the rigorous HST educational approach.

Thus, it is reasonable that all students in HST courses (including both HST MD and graduate students, as well as non-HST students) uniformly be expected to attend class sessions to the greatest extent possible. In this regard, students are explicitly NOT allowed to extend vacations beyond the periods specified in the academic calendar or to miss academic exercises for frivolous reasons. Occasional absences from class, however, can occur for:

Attendance at a national or international research conference at which the student presents his/her work; attendance at the student’s qualifying doctoral examination; or the need to use critical, difficult-to-schedule equipment, etc.
A highly significant personal event, such as attendance at a sibling’s wedding
Observance of religious holidays
Illness or family emergency

In all circumstances except illness or family emergency, it is the obligation of the student to notify the preclerkship course director in advance of the absence. If the absence is outside the above-stated guidelines, permission MUST be obtained from the course director in advance. This allows a quantifiable means to verify adequate attendance to ensure that graduating students have achieved a level of competency as measured by performance on tests and have shown a commitment to professional responsibility with participation in the entire educational experience that is defined by the curriculum.

Failure to accurately notate absences will be grounds for disciplinary action by the HMS Promotion and Review Board (PRB). Excessive absences may require repeating coursework. Course directors are encouraged to reiterate and clarify this policy during the first class session and include it in writing in the course materials.

Implementation of this policy in a manner that serves the best interests of students, faculty, and others (including patients) requires understanding, flexibility, and communication among all parties. While commitment to all aspects of the HST curriculum is generally expected, class attendance is only one measure of a student’s commitment. Students are therefore encouraged to seek the advice of their research supervisors, academic advisors, and course directors to schedule research, classes, and clinical training in such a way that they do not conflict with each other. Should a situation arise that might affect the fulfillment of some of the student’s obligations (e.g., course attendance) or the student’s course of study, it is the student’s responsibility to consult with their academic advisor and/or course directors to find a solution that guarantees the student’s professional development. Consultation on issues related to attendance or absences and arbitration of disputes will be done by the London Society Advisory Dean and Associate Director at HMS.

PCE Phase

Pathways and HST: Principal Clinical Experience and Core Clerkships

Students completing their PCE are physicians in training who should meet the highest standards of professional conduct and responsibility. Given the nature of clinical training and the important role of students on the healthcare team, the clerkships expect full attendance.

Students are required to attend all clerkship and longitudinal activities during the PCE; absences are detrimental to the educational experience and should only occur under special circumstances. However, HMS is committed to student health and well-being, and it is understood that situations arise that may require absence from a clerkship or PCE session.

Absences during the PCE will only be automatically excused for:

Emergent life events
Illnesses or non-emergent medical appointments
Religious observances

Students must log these absences using the PCE Absence Notification Form. If an absence form is not filled out within 24 hours, the absence will be considered unexcused and referred to PROGRESS, with the potential for Promotion and Review Board (PRB) referral. In some cases, a student may receive a grade of Incomplete in the course pending this review.

A planned absence in the above category, including a non-emergent medical appointment or a religious observance, must be communicated to course leadership at least four weeks in advance.

With the exception of the three categories above, students requesting an absence for any other reason must request an exception from the Student Policy and Procedures Committee (SPPC). All exception requests must be submitted at least four weeks in advance of the affected clerkship and no less than four weeks prior to the event. The SPPC has a typical turnaround time of seven to ten business days for reviewing and responding to exception requests.

The SPPC will review all exception requests and notify students directly of the outcome.

If a request is approved by the SPPC:

The student must then submit a PCE Absence Form in order to log the absence and will
be expected to communicate about their absence to the appropriate clinical team.
The clerkship will determine (in accordance with curricular objectives) whether and how
missed time should be made up. This will be communicated to the student when closing
the loop from the SPPC decision.

Making Up Time Due to Absences

Make-up policy on the experiences and time needed to be made up will be at the discretion of the Clerkship and PCE Directors. The PCE is based on experiential learning; any missed days are subject to makeup requirements at the discretion of the clerkship director. Holidays and vacation time, as well as nights and weekends, may be used to make up missed clinical time, if necessary. When possible, students will be scheduled to make up missed time during their
current rotation. If not feasible from a student or clerkship perspective, the student will receive a grade of Incomplete on their transcript until the makeup occurs, as determined by the clerkship director. Please note that all absences for any reason are included in this calculation. Depending on duration, extensive absences may result in needing to repeat parts of or, in some cases, the entire rotation.

PCE Holiday Policy

During your PCE year, you are expected to be fully engaged in the care of patients. As patient care occurs every day of the year, you may be required to work on a weekend or holiday during your clerkships. Note: to see the holidays that all PCE sites observe, please reference the HMS
Student Handbook section 7.02 Vacations and Holidays. Per that policy, “if a student misses time due to illnesses or other factors, holidays may be used for make-up time as needed if decided in advance by the student, the clerkship director, and the society advisor. Students would be expected to work weekends and night shifts per clerkship standards.”

Please note that a small number of minor holidays may be site-dependent.

A Note About Vacations and Holidays

Vacation or recess periods are built into all years of the curriculum. All students have a recess at the end of December (this break includes Christmas Day and New Year’s Day), which is determined annually by the academic schedule. In the PCE and post-PCE, Thanksgiving and the Friday after Thanksgiving are official Harvard Medical School holidays; students are not required to report for clerkships until the Monday after Thanksgiving. All students are required to be present for clerkship responsibilities until 5:00 PM on Wednesday before Thanksgiving.

The full policy can be found here: 7.02 Vacations and Holidays | Student Handbook.

A Note About Weekend Responsibilities

The Clerkship Site Directors and Administrators will provide students with their weekend schedule for each clerkship as soon as they have it. Students may be assigned to work a weekend preceding a Monday Holiday, although no students will be assigned during the Thanksgiving break. Students should confirm with their Clerkship Site Directors and Administrators regarding clinical duties during the last weekend of each rotation (the Saturday/Sunday following the Shelf or AMSER exam). Policy around clinical assignments during that weekend will be left at the discretion of the clerkship directors.

Post-PCE Phase

Pathways and HST: Required Subinternship Absence Policy

In the core (required) subinternship in Medicine, senior medical students function as “intern equivalents.” Given the level of responsibility students assume in this clinical setting, other than religious observance, no planned absences (including travel to professional conferences) are allowed during these core clerkships. If a student anticipates a need for time off, the subinternship should be scheduled during a different block, pending availability.

Pathways Advanced Integrated Science Courses (AISCs) and Essentials of the Profession II Absence Policy

AISCs and Essentials of the Profession II are full-time courses that require student engagement in regularly scheduled activities in the classroom and in clinical or other experiential settings.

If a student is absent, the student is expected to keep up with the material covered in missed sessions. For any absence, students should contact the course directors to ask if specific make-up activities are required, in addition to following the procedures described below.

Planned absence: A planned absence from a course must be reported at least two weeks in advance. The student will notify faculty and administrators by submitting the Course Absence Notification Form with the date of the session to be missed, the affected course, and the reason for the absence. The number of planned absences should not exceed one day during any individual course, with the exception of residency interviews (see below).

Residency interviews: Students are expected to make all reasonable good-faith efforts to avoid scheduling interviews at any time that would conflict with a course activity. If conflicts are unavoidable, up to two absences may be taken specifically for residency interviews, and the reason should be indicated on the Course Absence Notification Form. This is in addition to the one planned absence described in the previous paragraph, which may be used either for a residency interview or for another purpose. If a student has questions or concerns about scheduling interviews, they should consult their society advisor.

Illness or family emergency: When it is not feasible to provide advance notice (illness, family emergency), the course directors, society advisor, and society coordinator must be informed as soon as possible, ideally on or before the day of the absence. In the case of illness requiring a student to stay home, the student should email the society coordinator and involved faculty, including clinic and hospital preceptors, in addition to filling out the Course Absence Notification Form on the morning of the absence.

Absence Notification Forms will be collected and monitored centrally. The society, the course directors, and the appropriate course faculty will be notified of all absences.

An in-person (or remote) meeting with the society advisory dean will be required if, during an individual course, the student exceeds ONE absence for purposes other than residency interviews, exceeds one absence for any purpose plus TWO additional absences for residency interviews, or for ANY unreported absence. Such cases may also be referred to PROGRESS and the Promotion and Review Board (PRB). Please reference the Pathways Preclerkship Absence Policy for further information about the potential consequences of noncompliance.

Pathways and HST: Required Clinical Capstone Course Absence Policy

In the core (required) Clinical Capstone course, senior medical students function as “intern equivalents.” Given the level of responsibility students assume in this clinical setting, other than religious observance, no planned absences (including travel to professional conferences) are allowed during these core clerkships. If a student anticipates a need for time off, the Clinical Capstone course should be scheduled during a different block, pending availability.

Pathways and HST: Elective Clinical Clerkship Absence Policy

The clinical components of the curriculum mandate the student's full-time commitment to all patient care and didactic activities. The student’s presence during all patient-care activities - on the clinical floors of the hospital, in clinics, in physician offices, and in diagnostic settings, is critical to the learning experience because it provides opportunities to observe and participate in acute medical management decisions. Students are required to attend all lectures, rounds, case presentations, conferences, clinics, on-call periods, and other experiences as designated by the clinical elective director.

Absences for religious observance, family emergencies, presentations at scientific conferences, or required legal activity (e.g., jury duty) should be discussed (in advance whenever feasible) with the Society Advisory Dean and relevant clerkship or course faculty. The Society Advisory Dean must be informed of all absences, including cases of acute illness.

Consequences of Noncompliance with Elective Clinical Clerkship and Required Subinternship/Clinical Capstone Attendance Policy

Students who fail to comply with the School’s attendance policy face a number of serious consequences. These include the following:

Grades may be affected.
Students who accumulate an excessive number of absences during an academic year may be reported to PROGRESS and may be referred to the Promotion and Review Board (PRB).
Failure to report any absence from any course or clerkship session will be referred to the PRB.
The PRB will review attendance policy noncompliance to determine whether such unprofessional behavior warrants official censure in the student’s academic record.
Summative comments in the evaluations of clinical elective or subinternship courses may include excessive/unreported absences or tardiness.

Religious Observance

To review Harvard Medical School's policy on absences for religious observance, please see Section 7.01, Policy Regarding Religious Holidays.

Updated 5/13/26

Reviewed and approved by the EPCC.