Clinical clerkships require direct patient care experiences that are inherently time-sensitive and non-reproducible. Patient interactions, team-based care, procedural exposure, and professional development cannot be fully replicated through alternative means. Attendance requirements therefore reflect the minimum exposure necessary to ensure that all students demonstrate the essential competencies required for safe and effective clinical practice.

Students with disabilities who require absence-related accommodations should contact the Stanford Medicine Student Disabilities Resource Office prior to the start of a clinical clerkship. Eligibility for accommodations is determined through an individualized interactive process. Students with approved accommodations should timely work with the clerkship director and coordinator to ensure that needs are in place.

All students are expected to seek necessary health care to maintain their physical and mental well-being. Examples of necessary health care include preventive health services and screening (e.g., annual check-ups, routine dental cleaning, and vaccinations), new and follow-up visits for acute illness, ongoing care for chronic illnesses, physical therapy, and counseling and psychological services. Consistent with University policies and the law, students have a right to privacy when seeking care.

Students must contact the clerkship director and coordinator to obtain explicit advance approval for any planned absence from the clerkship. Please note that until approved, the absence is considered a request and not a guarantee. Unanticipated absences for illness or emergency must be communicated to the clerkship director as promptly as possible.

Students may attend recurring medical or dental appointments during core clerkships. Clerkship director/s, site director/s, and preceptor/s or patient care teams (depending on the service) must be notified in advance of these planned absences to coordinate time away from the clerkship. Clerkship students have a right to privacy when seeking care and need not disclose the specific type of healthcare that is being sought. A student’s decision to seek healthcare consistent with this policy will not, by itself, negatively affect his or her performance evaluation. Absences that exceed the limits described below will be addressed as set forth in this policy, including, where applicable, through the interactive accommodation process described above. Any questions or concerns may be addressed to the Assistant Dean for Clerkship Education and/or the Associate Director for Clerkship Education by email, phone, or in person.

To ensure that students have sufficient time to develop the core competencies required of clerkships, absences may not exceed more than two days for four or six-week rotation or more than three days during an eight-week rotation for any reason. Students that exceed these limits will be required to make up missed time either within the scheduled period or must be available to make this time up at a later time dependent on clerkship capacity and availability. Students that will need to miss more than the allotted time must petition and receive approval prior to making any plans to be absent, and these absences must be made up by the student

Students who will miss more than 20% of the total duration of a clerkship – for any reason – will be asked to reschedule the clerkship. For a student with an approved disability accommodation, application of this provision will be considered through the accommodation process described above.

Failure to communicate with the clerkship director about unavoidable absences is a potential reason for failing the clerkship.

Frequently Asked Questions

• What constitutes an excused absence?
  • Planned excused absences include presenting research – not merely attending – at a professional organization conference, a residency interview, or any critical family commitment. 
  • Emergent, unplanned absences include major events affecting loved ones (e.g. illness/death in the family) and personal events (e.g., unexpected illness). If you are experiencing burnout, this would also be included in this category. 
• If I need to be absent, what should I do?
  • Send an email to the clerkship director and coordinator as soon as you know that you will need an absence.  If it is an acute illness/unexpected absence, it is good to notify your site contact so they are aware you will not be showing up.  Names and emails of clerkship directors and coordinators can be found here.
  • We generally recommend that the email include a reason for requested absence.  For medical or family concerns, no further details are required beyond simply sharing that there is a medical or family concern; your privacy and wellbeing are paramount.  For social or meeting requests, more detail is helpful in determining the appropriateness and duration of the absence.
  • Please see the example* at the bottom of this document for some sample language.
• How should I approach medical, dental etc. appointments?
  • To the extent possible, you should seek to schedule these for RCM days after the components of that day’s schedule has concluded (remember: RCM days are required, not optional). If that’s not possible, you should try to schedule in the early mornings for ambulatory clerkships or late afternoon for inpatient clerkships so that patient care is not disrupted. Notify the clerkship director, coordinator, and your teams as soon as possible.
  • We understand that time selection may not be under your control, though, in which case we encourage you to reach out to the clerkship director as soon as possible so they can plan schedules accordingly, ensure sufficient patient care experience, and notify site directors (you do not need to disclose the nature of these appointments, only that it is for a medical appointment).
  • If you have recurring medical appointments (e.g. therapy, ongoing care for chronic illness), please share the day of week/ time with the clerkship director and coordinator as soon as possible, well before the first day of the clerkship, so that they can plan schedules accordingly, ensure sufficient patient care experience, and notify site directors.  You do not need to disclose the nature of these appointments.
• How are absences tracked?
  • We cannot emphasize enough that there is no penalty for seeking medical or other necessary care, so if you have recurring appointments or regular flares, these will not count against you and your performance.  If the frequency or duration of recurring appointments is extraordinary, those absences may be counted toward the absence limits described above unless they have been approved as a disability accommodation. You may choose to obtain a letter from the Office of Disability Resources in order to have documented support for these needs. This documentation is needed only if you are requesting a disability-related accommodation for absences beyond the limits described above; it is not required for routine health care needs within the standard absence allowances.
  • All other absences will be tracked centrally by the Core Clerkship program.  If there is a pattern of over-utilization of absences across core clerkships, electives, selective, and IND 297, or if there a pattern of taking absences repeatedly before long weekends or the day before final exams, this will be flagged as a professionalism concern, and coaching will likely be implemented.

updated August 2026