Time Away for Phase 3

It’s an exciting time of year as interview season approaches. While there is much to discuss when planning your interview season, this information will focus on the process for requesting time away for interviews. In prior years, consistent with many medical schools, time away from rotations was heavily restricted – even for residency interviews. In response to feedback and through extensive discussion and planning with multiple stakeholders, a couple of years ago, the school updated our interview policy to allow better flexibility for scheduling. This change came out of a recognition of the significant logistical challenges for everyone involved in interview season.  

With regards to interviews, the new policy balances four key considerations: 

• Your medical education is important. Increasing levels of responsibility and integration into team-based care are critical for your growth as a junior clinician.
• Matching into residency is critical for your success and future career. 
• Scheduling should be carefully managed and anticipated, but some level of conflict is inevitable. 
• Professionalism and timely communication are at the foundation of excellent patient care and professional expectations. 

The details of the policy for residency interviews are highlighted below, though you should be familiar with the entire Time Away Policy.

Students should discuss their options for managing both anticipated and short-notice interview scheduling conflicts with their lead advisor and/or career mentor in advance of making interview plans.

We are very pleased to offer increased flexibility as you prepare for success on your path to residency. Your lead advisor is an invaluable resource as you prepare to navigate this new terrain. You should use the new online time away form for all time away requests for interviews. Statewide Course Directors, Statewide Course Coordinators, and Elective Directors should be notified immediately upon becoming aware of a conflict between your rotation schedule and a residency interview. Your timely communication of residency interview conflicts is critical to allow your instructors and support staff to help you along this exciting phase of your career. 

For required rotations (Emergency Medicine, Sub-Internship, Critical Care Selectives, Radiology, and Transitions 3), students should contact the statewide and site course directors, course coordinator, and lead advisor and submit an online time away form immediately upon becoming aware of a conflict between the required rotation schedule and a residency interview in order to plan appropriately. Accommodation for time away for interviews is at the course director’s discretion and is based on the circumstances and availability of accommodations, with expectations to make up any time missed from the required curriculum. 

For elective courses, students should plan time away with the course director in advance of the elective and discuss the potential flexibility for unexpected interviews. All requests for time away for interviews should be submitted via the online time away form. Accommodation for time away for interviews is at the course director’s discretion and is based on the circumstances and availability of accommodations, with expectations to make up any time missed from the required curriculum. 

For unexpected interview opportunities that arise during the rotation, the usual appeals process may not be feasible. The student may request, within 48 hours of the course director’s decision on time away accommodations, an expedited review by the curricular directors for Phase 3; the course director’s decision will be final until and unless the review results in revision.

In most cases, students will be required to make up missed time. To clarify how students and directors will manage these logistical hurdles, here are two scenarios that illustrate how the new policy might be applied.

Sub-I

Sam anticipates that most of her interviews will occur in November and December, so she plans an interview and rotation schedule to include a Sub-I in January. She understands that the Sub-I is an intensive experience meant to simulate and prepare her for the intern year. This rotation allows four days away from the Sub-I (an average of one day off/out per week). Sam schedules one interview on the 10th, and requests the 9th and 10th off for travel. Sam starts communicating with the Sub-I coordinator/director immediately, as they can help her most effectively with advanced notice. How might she fit these two days for interviews into the four days away from the Sub-I?

• Students have four total days away from the Sub-I (average of one day off/out per week).
• Student requests OFF two days for interviews
• Sam chooses to work both weekend days during two weekends in order to attend the requested interview times. No additional days need to be made up outside of rotation.

Imagine that Sam’s interview plans became more complicated, and she receives last-minute offers for interviews at her two “dream programs.”  Unfortunately, this means she would miss significant time from the Sub-I.  

Per policy, students who miss three or more days of clinical responsibilities in a rotation may need to make up time in a continuous fashion to allow sufficient opportunity for integration into a clinical team, observation, feedback and assessment of performance. Such instances are handled on a case-by-case basis. Potential solutions might include rescheduling the month (assuming sufficient notice) or scheduling another week of rotation. Sam cannot make up these four days in February as she has another elective scheduled at that time, and adding too many additional days to a rotation could violate IU School of Medicine duty hours. In this case, Sam and the clerkship directors arrange for a one-week rotation to complete the Sub-I in March. Because this involves significant changes, MSE is involved in the discussions and Sam receives a placeholder grade of Incomplete until she completes the Sub-I. Thus, Sam completes her interviews and the requirements of the Sub-I.

Emergency Medicine

Lee is scheduled for Emergency Medicine in November. This clerkship includes a mandatory orientation, approximately 12-14 shifts for a total of 126 clinical hours, and a final exam. Students may request up to four days off from shifts during the heavy interview months of November through January. The Emergency Medicine clerkship also provides two exam dates from November through January, and Lee utilizes the earlier exam date to take his NBME final exam. Lee understands that clerkship orientation, including the Simulation, Procedure, and Airway Day during orientation is mandatory, and he avoids scheduling any interviews during orientation. He uses all four shift requests to coordinate several interviews at the end of November. When a last-minute interview initiation to his “ideal program” arrives near the end of rotation, Lee requests the time away and works with the clerkship team to reschedule two shifts for alternative dates in the upcoming December block.

Per policy, all makeup activities should be completed within 14 days of the end of the course to allow timely assessment of a grade. These activities may need to be completed during unscheduled time to avoid interference with other educational activities. All schedule adjustments will comply with IU School of Medicine duty-hour policies.

Lee understands that when he agrees to these makeup shifts, he is making a firm commitment to work with the clinical team in the Emergency Department on those dates. He also has an outpatient elective in the following block and makes sure to coordinate the makeup Emergency Department shifts with his upcoming elective director; it ends up working out to schedule these shifts the following weekend. Thus, Lee attends his interviews and completes both his Emergency Medicine rotation and clinical elective on time.