Resident and Fellow Leave Policy

To whom this policy applies

Residents and fellows participating in an ACGME-accredited Program.

Who needs to know this policy

Residents, fellows, program directors, program coordinators, department chairs, the Dean and UNR Med affiliates.

Purpose/background

The purpose of this Leave Policy is to set forth the University of Nevada School of Medicine (“UNR MED” or “Sponsoring Institution”) policies and procedures governing leave for residents and fellows (individually, a “resident” or collectively “residents”) participating in graduate medical education (“GME”) programs sponsored by UNR MED (each a “Program”).

Policy

Residents shall be afforded annual leave, sick leave, medical, parental and caregiver leave and other leave benefits as set forth in this policy, subject to the conditions or qualifications for leave. 

All Programs are required to comply with this policy and shall have policies, consistent with this policy and ACGME requirements, as applicable. 

All leave must be approved in writing, in advance of being taken, per resident training program policy. All Programs and residents are required to use New Innovations to track all leave time taken by residents.

1. Annual (vacation):
   
   • • Annual leave provides the resident with time for rest, for an extended period, in order to return to training with renewed vitality. This leave is beneficial for patient safety and resident well-being.
     • All residents will receive 15 days of annual leave which will be based on a five-day work week during the academic year. Annual leave for contract periods of less than a full academic year will be calculated on a pro rata basis.
     • Annual leave which is unused will not be carried forward to the new training year. No lump sum payment will be made for unused leave.
     • Annual leave must be requested in writing, through the training program, on approved leave request forms, in accordance with the home program's established procedure.
     • If a scheduled vacation includes a national or state holiday, no additional time will be given for that holiday.
     • Blocks of seven days are encouraged for residents to have a period of adequate rest.
     • Residents have the responsibility to schedule leave in a timely manner.
     • Annual leave must be used for any time away from the Program not specifically covered by other leave benefits below.
     • Residents may use annual leave for interview days.
2. Sick Leave
   • All residents receive 15 days of paid sick leave (which will be based on a five-day work week) during the initial 12 months of service. Beginning 12 months after the starting date of the contract, the resident will begin to accrue additional sick leave at a rate of 1-1/4 days per full month of service, to add to any remaining balance of unused sick leave from the first 12 months of service. Sick leave may be accrued from year to year; however, sick leave may not to exceed a cumulative total of 15 work days, as of the last day of any given month.
   • Sick leave must be documented in writing, through the training program, on approved leave request forms.
   • The sick leave policy is established in order to protect the resident from threats to their own health, for bona-fide medical conditions, to prevent patient exposure, and to allow for healthcare appointments.
   • Absence from work to care for an ill or injured member of one's immediate family (spouse, children, parents, and grandparents) may be charged to sick leave and should be done in advance of the leave, if possible.
   • A physician's statement of illness or injury may be required for absences of more than three (3) consecutive days or an excessive number of days throughout the year, as determined by the program director. The physician’s statement of illness or injury may not be provided by a peer resident in the same program.
   • No lump sum payment will be made for unused leave upon termination or completion of training.
   • Sick leave for contract periods of less than a full academic year will be calculated on a pro rata basis.
   • Use of sick leave may require make up time for purposes of Board eligibility, which is determined by the specific policy of each Board specialty, and should be discussed with the program director.
3. Family and Medical Leave Act
   • • The Family and Medical Leave Act (FMLA) of 1993 entitles eligible residents to take up to 12 weeks of job-protected leave in a rolling 12-month period for specified family and medical reasons.
     • FMLA may be used for the birth of a child, and to care for the newborn child; for placement of a child with the resident for adoption or foster care; to care for the resident's spouse, parent or child with a serious health condition; or because the resident is unable to work due their serious health condition.
     • To qualify, the resident must have been employed by UNR MED for at least 12 months.
     • The appointing authority (the Dean) may require paid leave be exhausted prior to an employee being placed on unpaid leave.
4. Maternity/Paternity/Family Leave
   • • UNR Med Graduate Medical Education programs recognize the legitimacy of integrating child-bearing and adoption into the years of graduate medical training.
     • Return to work after pregnancy and pregnancy-related conditions is to be determined by the resident’s personal physician.
     • Paid time off will not exceed the total of 15 days of sick leave plus available annual leave.
     • Leave of absence without pay may be extended to bring time off (the sum of paid and unpaid leave) up to a maximum of four months.
5. Educational Leave
   • • Residents are allowed up to five paid days for educational leave each academic year.
     • This leave is to be used for educational purposes such as attending conferences, presenting at scientific meetings or other educational activities approved by the program director.
     • Each program must have a departmental policy that articulates what constitutes an educational activity and describes when this time may be used.
     • This time will not be allowed to roll over from one academic year to the next.
     • This leave may not be used in conjunction with sick, medical, parental (maternity/paternity), caregiver leave, or ACGME leave.
6. Bereavement Leave
   
   • Residents may use three sick leave days per contract year for bereavement leave for immediate family members.
     
     
7. Holidays
   • Residents do not receive paid national or state holidays.
   • If annual leave is taken over a holiday, the time will be deducted from the resident’s annual leave.
     
8. Judicial Leave
   
   • Judicial leave is defined as an appearance in connection with one's official capacity as a university employee at a trial or other court proceeding, to include an arbitration or mediation hearing, whether it be as a party to the action, or as a witness for any party to the proceeding.
   • This is considered a short-term leave and may be authorized by the appointing authority (the Dean) for periods up to 5 calendar days without loss of salary. In special cases, paid leave will be granted to serve on a jury or if summoned to be a witness.
   • Judicial leave is not available for court appearances in connection with personal legal matters.
9. Leave of Absence - Leave without Pay
   • • The Dean may grant leaves of absence, at their discretion, for periods of short duration. Such request must come from the program director and the Associate Dean for Graduate Medical Education, and state their concurrence prior to sending the subject request to the Dean.
     • Arrangements for the premiums of health and dental insurance and all other University obligations are the responsibility of the resident during these leave periods and must be made through the individual program and/or the Office of Graduate Medical Education. Insurance premiums are charged at full institutional cost to those working fewer than fifteen calendar days per month, on unpaid leave or a leave of absence.
     • Leave of absence without pay may, at the discretion of the program director with approval from the Dean, be extended up to a maximum of 12 months. This leave must be documented in writing with copies to the Office of Graduate Medical Education.
     • Make up time for purposes of board eligibility is determined by the specific policy of each specialty board. Contact the program director for specific requirements for the specialty in question.
     • Residents, whose leave of absence extends beyond twelve months, will be required to reapply for admission to their UNR Med residency or fellowship program should they wish to resume their GME training at UNR Med.
10. Military Leave
    
    • • Paid military leave will be granted upon presentation of official orders at a rate of three weeks per academic year.
      • Any period beyond that time will be leave without pay.
11. Six Week Paid Medical, Parental (Maternity/Paternity), and Caregiver Leave (“ACGME Leave”)       
    REFERENCE
    Consistent with Section IV.H. of the ACGME Institutional Requirements, the Sponsoring Institution must have a vacation and other leaves of absence policy, which among other requirements, provides residents participating in ACGME-accredited programs with a minimum of six (6) weeks of approved medical, parental, and caregiver leave(s) of absence for qualifying reasons that are consistent with applicable laws, at least once during a resident’s Program, starting with the day the resident is required to report. A Sponsoring Institution’s vacation and other leaves of absence policy must also ensure that each of its ACGME-accredited Programs provides its residents with accurate information regarding the impact of an extended leave of absence upon the criteria for satisfactory completion of the Program and upon a resident’s eligibility to participate in examinations by the relevant certifying board(s) (each a “Board”). The policy must include additional components set forth in Section IV.H. of the ACGME Institutional Requirements.
    
    • Each resident will be provided up to six (6) weeks (30 calendar days based on a 5-day work week) of paid, approved ACGME leave of absence for qualifying reasons that are consistent with applicable laws, only once, and at any time during the resident’s program, starting on the day the resident is required to report. A resident, on approved ACGME leave of absence, shall be provided the equivalent of one hundred percent (100%) of their salary.
    • This paid approved ACGME leave of absence must be taken in a single, continuous period of time, e.g. a resident shall not take a 2-week period of ACGME leave, return to work, and then take another 2 weeks of ACGME leave.
    • This leave falls into three distinct categories: Parental, Medical, and Caregiver.
    • Health and disability insurance benefits for residents and their eligible dependents during any approved ACGME leave of absence shall continue on the same terms and conditions as if the resident was not on leave. 
    • Application and approval process: A resident wishing to apply for the leave described here shall obtain a physician’s statement that they meet FMLA eligible criteria. The Graduate Medical Education Committee, utilizing a leave subcommittee, shall determine if the requested leave is approved.
      1. Parental Leave
         • Paid parental leave is available to a resident for the birth or adoption of a child. Each resident, in an ACGME Program, is eligible for up to six (6) weeks (30 calendar days) of paid parental leave one time during their training program.
         • A resident’s six (6) weeks of paid parental leave is available in addition to annual and sick leave and should be used prior to any remaining annual and sick leave.
         • Parental leave does not accumulate if unused by a resident during their training program. In the event a resident uses the total of the six (6) week paid parental leave herein, and has or adopts another child while training in the same Program, only remaining annual and sick leave are available to the resident as paid time off. All FMLA and other protected unpaid time may still be available to the resident for leave. 
         • In the event both parents are residents, the residents may each use their leave concurrently, overlapping, or consecutively. Any remaining annual and sick leave may be used after this ACGME Leave. 
         • It is the responsibility of the resident and program director to discuss, in advance, what effect taking time off from the training program may have on Board, ACGME, and UNR Med requirements dictating a possible extension of training. 
      2. Resident Medical 
         • Resident medical leave is available to a resident for a serious health condition that makes the resident unable to perform their job. This six (6) week (30 calendar days) leave is available one time during their ACGME training Program. The paid time off for ACGME leave does not accumulate if unused. It is the responsibility of the resident and program director to discuss, in advance, what effect taking time off from the training program may have on Board, ACGME, UNR Med requirements dictating a possible extension of training.
      3. Caregiver Leave
         • Caregiver leave is available for any resident that needs to take time off for the care of a parent, spouse, or child. This six (6) week (30 calendar days) leave is available one time during their ACGME training Program. Paid time off for ACGME Leave does not accumulate if unused. It is the responsibility of the resident and program director to discuss, in advance, what effect taking time off from the training program may have on Board, ACGME, and UNR Med requirements dictating a possible extension of training.
           
           
12. Religious/Cultural Holidays and Activities 

    • UNR MED employs a diverse workforce, and as such will try to reasonably accommodate requests for specific days off upon request. Residents are not entitled to holiday leave, but when a resident wishes to have a specific day off due to a religious holiday, the Program will try to accommodate the request, when possible. Time off for religious/cultural holidays and activities is not considered paid holiday leave, but may be scheduled to align with a resident’s required 1 in 7 days off, or taken as part of annual leave, etc. The same reasonable accommodation should be granted, when possible, for other religious activities, such as daily prayer, fasting, etc. which may be accommodated through leave, schedule adjustments, call coverage changes, etc. A request is not guaranteed for approval, but will be accommodated when possible.

13. Administrative Closings/Inclement Weather 

    • Residents are essential personnel and provide essential services. The University, including the School of Medicine, may close its administrative offices during inclement weather for those individuals classified as non-essential employees. Residents, however, provide direct patient care in hospitals and clinics, and must report to training and work as scheduled. If a clinical site closes a clinic or service and does not require the resident’s attendance, the clinic manager or attending will notify the resident and/or program director as soon as possible. The resident must notify the program director if the resident is instructed that their clinical service is closed due to weather. The program director may elect to reassign a resident to another clinical assignment for patient care, or to allow the resident to stay home without having to use annual leave. If a clinical site/service remains open to provide essential patient care and the resident is unable to report to training/work due to travel/weather conditions, then the absence shall be charged as annual leave. Residents must notify their attending/site director and program director as soon as possible that an absence is required. The program director, or designee, is the only individual that may approve the resident to stay home. 

14. Impact of Leave of Absence 

    • General Impact of Leave. An extended absence, for any reason, may prevent a resident from fulfilling the requirements for participation in educational and scholarly activities and achieving the residency/fellowship responsibilities as further described in the GME Agreement of Appointment. Generally, leaves of absence will be granted for a maximum of twelve (12) months. Residents are subject to termination upon a) exhaustion of all available annual leave, sick leave and other approved or statutory leave, or b) failure to return to work as scheduled at the end of the authorized or statutory leave. 

      An absence will be charged against any accrued annual, sick, or other available approved unpaid leave program. If all such paid and unpaid leaves are exhausted, the absence will be unexcused and the resident subject to dismissal for job abandonment. The Associate Dean of Graduate Medical Education, in their discretion, may authorize additional leave but only in extraordinary circumstances. Programs and residents are advised that: 

      • Residency positions will be protected during the period of approved FMLA or as required by law. 
      • An unpaid leave of absence may affect a resident’s visa status. 
      • A leave of absence may require extension of training to meet Program or Board eligibility criteria. 
      • Compliance with Board Requirements for Absence from Training: It is the responsibility of the program director to verify the effect any absence from training will have on a resident’s ability to finish on time and meet ACGME Review Committee and Board eligibility requirements.
      • Board certification eligibility information is provided to residents by each Program and can also be accessed through the American Board of Medical Specialties: http://www.abms.org.
      • Consequences of Unapproved Leave: Failure to comply with leave policies, including obtaining written prior approval, may result in leave without pay and may be reflected in the resident’s final summative evaluation as a professionalism issue. 
15. Leave Records
    • Each resident shall keep accurate and complete records of used leave in Workday and in New Innovations.
    • It is the responsibility of the resident to follow all UNR Med leave policies and procedures.
    • Leave records are subject to examination by program leadership, by human resource officials, and by internal or external auditors.