MPAS Year 2 – Clinical Rotations Attendance Policy

To provide clear, consistent expectations relating to attendance expectations and the consequences of inconsistent attendance pertaining to students enrolled in the Master of Physician Assistant Studies (MPAS) Program during Year 2 – Clinical Rotations (PA Trainees).  

This policy applies to all PA trainees enrolled in Year 2 – Clinical Rotations of the Master of Physician Assistant Studies (MPAS) Program, at the University of Saskatchewan, irrespective of the geographically distributed site to which they are currently assigned.

The MPAS program supports the development of high standards of professional conduct and attitudes and wants to ensure that graduates can work safely and effectively as physician assistants. Active participation by PA Trainees in learning opportunities is critical to their development, education, and training. Given the nature and design of the MPAS program, attendance at all scheduled types of teaching, clinical rotation, and assessment events is mandatory.

Acceptance of responsibility for attendance and participation in patient care is part of the PA Trainees’ professional education and responsibility. Appropriate attendance and punctuality are indicative of the trainee’s understanding of, and adherence to, expectations of professional behaviour. Significant absences may impact a trainee’s learning, and the program reserves the right to implement a limit on student absences or require remediation should the program deem necessary.  

There are several negative impacts on the learning and teaching environment associated with student absenteeism, including:

• The CanMEDS-PA framework and Entrustable Professional Activities require regular observation and frequent assessment, therefore missing sessions reduces the opportunities for feedback and for faculty to make entrustment decisions.
• Consistent attendance is an expected professional behaviour in health professions. Chronic absenteeism raises concerns about trainee reliability, accountability, and future workplace performance.

The MPAS program recognizes that unanticipated events arise and appreciates the thoughtful actions of trainees not attending clinical placements in-person when they are ill.

Mandatory Sessions: ALL Year 2 activities are considered mandatory unless expressly indicated otherwise by the Rotation Director or a Designated Preceptor.

PA Trainees: MPAS Learners completing their second year of the MPAS program, focused primarily on clinical learning in various health care environments, are referred to as PA Trainees.

1. Attendance and Punctuality Expectations

Full and punctual attendance is expected at all types of session activities throughout the Clinical Rotations Year. Regardless of the nature of the session, students are responsible for knowing the content as listed in the curricular / course objectives. Students may be required to make up missed time, regardless of the nature of the session, reason for absence, or whether the absence was approved appropriately, to ensure academic success.

Failure to abide by these regulations without appropriate prior approval, or notice after the fact for emergent absences, may be deemed as unprofessional conduct as outlined in the MPAS Professional Behaviours and Expectations Policy and related procedures. If a PA trainee disregards the decision of the MPAS program or other authority in relation to the absences, this may also be considered unprofessional conduct.

Unexplained absences may be reflected in the final course or rotation assessment and may constitute grounds for failure of the rotation or course, even if the composite grade for other aspects of the assessment meets or exceeds the required passing grade.

The MPAS office must be notified of any prolonged or unexpected absences – please see the MPAS Leave of Absence Procedures.

If a PA trainee misses time from a rotation and there is concern that the learner has had inadequate experience in the rotation to perform well on assessments, the learner may be requested to complete additional time in the rotation prior to completing assessments. 

2. Session Types in Year 2

While Year 2 consists primarily of clinical practice learning, PA trainees are required to participate in several other forms of learning as well.

Year 2 session types include, but are not limited to:

• Transition to Clinical Rotations Week(s)
• Clinical Activities
• Scheduled Assessments
• Consolidation Days/Week
• Academic Days
• Capstone Project Work

In addition to the above session types, PA trainees will be assigned one FLEX Week. The MPAS Program will assign each trainee a FLEX week at some point during Year 2 of the program, in accordance with scheduling availability of clinical rotations. FLEX weeks are intended to be utilized at the PA trainee's discretion (e.g. Capstone Research work, vacation, etc.). PA trainees are responsible for ensuring the use of their FLEX week does not impede their transition to their clinical rotations immediately before and following their FLEX week. 

3. Total Absences

While specific types of absences (e.g., education leave) may outline the maximum permitted time away from clinical rotations, the total number of absences overall is also considered.

1. The maximum amount of time away from a rotation for any reason (including statutory holidays) is approximately 15% of the overall clinical rotation time.
   
   
2. Clinical Rotations may outline rotation-specific attendance requirements related to the coordination of the individual rotation. For example, a rotation syllabus may outline specific weeks of the rotation during which absences cannot be accommodated.
   
   
3. For illnesses that exceed 5 days, please see the Leave of Absence Procedure.

Rotation Length	Rotation Type	Max Time Away, for any reason  (incl. Stats & Illness and other leaves)
11-week Rural Rotation	Core Rotation	8 days*
6-week	Core Rotation	5 days*
4-week	Core Rotation	3 days*
2-week	Core Rotation	1 day*
4-week	Elective Rotation	3 days*
2-week	Elective Rotation	1 day*

*Please see individual Rotation Syllabus for details regarding allowable absence types for specific rotations.

Exceeding the maximum of any of these will prompt a meeting with the MPAS Director of Faculty and Clinical Placements. This may necessitate extending the duration of a course(s) to complete required components.

It is expected that PA trainees should not request approval for absences from scheduled class or clinical hours to prepare for assessments. 

4. Time Off from Clinical Rotations 

MPAS PA trainees are entitled to time off for the December break (weeks may vary), as well as their FLEX week during their Clinical Rotations year. Any further leaves from Clinical Rotations must be made in accordance with the Leave of Absence Procedure and must be requested at least 6 weeks in advance of the impacted rotation. Requests submitted less than 6 weeks in advance may not be considered.

All requests will be reviewed and approved or denied on a case-by-case basis, given the individuality of the Clinical Rotations year. The MPAS Program reserves the right to decline leave requests should the Program determine a leave may not be reasonable. For instance, a leave may be denied should the Program determine the leave may place the learner at risk of academic difficulty, or should the leave be unfeasible to accommodate due to scheduling, capacity constraints, or coordination needs of clinical rotation sites.

5. Types of Absences

5.a. Sick Time

Trainees who are acutely ill may be required to miss clinical learning activities, both for their own wellbeing and the wellbeing of patients. Illness can include both physical illness and mental health concerns.

If a trainee is ill and unable to fulfill their clinical duties, as identified by the trainee or Designated Preceptor or supervising physician, the student must:

1. Notify the MPAS program
2. Notify hospital switchboard, as applicable
3. Notify Designated Preceptor / Supervisor / Ward attending.
4. Complete a leave request following the MPAS Leave of Absence Procedure (Short Term).

If a PA trainee becomes ill while on duty, it is important that they:

1. Notify their Designated Preceptor / supervisor as soon as possible to ensure their duties are transferred to others.
2. Notify the MPAS Program
3. Notify hospital switchboard, as applicable
4. Complete a leave request following the MPAS Leave of Absence Procedure (Short Term). 

The PA trainee must make this notification as soon as possible after attending to emergent concerns. The trainee should make every effort to advise the rotation administrative staff in advance of the absence if possible, for both classroom sessions as well as clinical activities.

Note: Non-urgent health care appointments should be booked outside of normal work hours, whenever possible. If unable to book outside of normal work hours, absences should be requested under sick time. Trainees shall request sick time to accommodate health care appointments at least 6 weeks in advance of starting on the rotation.

If a PA trainee has already taken the maximum days or percentage of time away from a core rotation, and subsequently requires additional time away from the rotation due to illness, they may be required to make up learning time after the scheduled rotation end date. This will be determined by the Rotation Director/Elective Coordinator. If a trainee disagrees with a Rotation Director/Elective Coordinator decision related to additional time on rotation, they may appeal the decision to the Director of Faculty and Clinical Placements, whose decision is final.

Extended illness may require a formal medical leave request, with documentation. Please see MPAS Leave of Absence Procedure for more information.

5.b. Moving Leave 

Trainees are expected to relocate to a location away from their Year 2 home site to complete an 11-week Rural Clinical Rotation. Trainees may use up to 2 days total to support their move to or from the rural location. It is expected that trainees will utilize this leave before and/or after their rural rotations.

5.c. Compassionate Leave

Compassionate Leave can be taken for reasons of death of a person close to the PA trainee. Under regular circumstances, compassionate leave will not exceed 3 days. Extended leaves for compassionate reasons may be accommodated. Trainees are encouraged to work with the MPAS Office if considering a leave of absence. See the MPAS Leave of Absence Procedure.

If a PA trainee has already taken the maximum number of days away from a rotation for education leave and/or sick leave, and subsequently requires additional time away from the rotation for compassionate leave, the student may be required to make up learning time after the scheduled rotation end date. This will be determined by the Rotation Director/Elective Coordinator. If a trainee disagrees with a Rotation Director/Elective Coordinator decision related to additional time on rotation, they may appeal the decision to the Director of Faculty and Clinical Placements, whose decision is final.  

5.d. Education Leave

Trainees are permitted to access a maximum of 3 days of education leave during the Clinical Rotations year for the purpose of presenting at educational conferences or attending the CAPA Conference.

Note: Education Leave days contribute to the overall maximum time away that is permitted for each Rotation.

It is expected that trainees presenting at a conference will use their Education Leave to attend. However, in the exceptional circumstance that a trainee is invited to present at a conference after using their allotted Education Time, additional time to attend may be granted by the Rotation Coordinator and Director of Faculty and Clinical Placements. Such cases will be individually considered.

PA trainees shall request education leave, including documentation confirming their registration/presenting status at the educational activity, at least 6 weeks in advance of starting on the rotation. Requests submitted less than 6 weeks in advance, or without adequate documentation to confirm attendance, may not be considered. Education Leave will not be granted during Orientation week(s), Consolidation week(s), or Assessment week(s). Trainees should consider timing of education leave requests as some rotations may not permit leaves during certain times of the rotation.

Apart from timing considerations for Education Leave, standards for successful completion of rotations will not be amended.

5.e. Statutory Holidays

Trainees are typically not scheduled to work on statutory holidays. However, if a PA Trainee is required to be on duty on a statutory holiday for 8 hours between 0800h and 2300h, they are eligible for time off in lieu of that day.

Time off in lieu must be taken on the rotation in which the time was earned. If the stat falls at the end of a rotation, the day in lieu may be requested on a day prior to the stat in the same rotation, with the understanding that if the PA Trainee is absent on the Stat day for any reason, they will be required to make up the time on that rotation. If a PA Trainee requests to be on duty to work on a Statutory holiday, they will not be eligible for a day off in lieu.

Statutory holidays for PA Trainees include:

• New Year’s Day
• Family Day
• Good Friday
• Easter Monday*
• Victoria Day
• Canada Day
• Saskatchewan Day
• Labour Day
• National Day for Truth and Reconciliation
• Thanksgiving Day
• Remembrance Day
• Christmas Day
• Boxing Day

*Note: While Easter Monday is not considered a statutory holiday by the University of Saskatchewan, PA Trainees are still entitled to a day in lieu if they are required to work on this day.

If the statutory holiday falls over a weekend, the day in lieu must be on the day observed by the University of Saskatchewan.

Any student who anticipates difficulty in meeting requirements due to religious observances during the Clinical Rotations year must inform the program by September 8th, before the start of the clinical rotations year. These will be reviewed on a case-by-case basis.

6. Exceptions

Trainees in academic difficulty may have their application for approved absences declined if there is concern that additional absences may put them at further academic risk, regardless of the number of approved absences used to date. This limitation would only be applied in consultation with the trainee and the Director of Faculty and Clinical Placements.

Trainees who have unplanned absences due to illness or personal circumstances and who subsequently request approval for absences which would result in an excess of the maximum number of days absent per rotation should anticipate that further absence requests will be declined.

Exceptions may be considered depending on academic performance, the relative importance of the activity for which the trainee is requesting an absence, and the potential impact of the individual and cumulative absences on learning and assessment. The Rotation Director and Director of Faculty and Clinical Placements will be consulted on this decision.