Major Life Events and Personal Circumstances

Medical school is challenging, both mentally and physically, and students may face situations where they have to balance the demands of the curriculum with major life events or personal circumstances that also require attention, care and energy. These situations include the birth or adoption of a child, a major personal illness, or an illness of a loved one. How to balance personal demands and academics requires careful consideration and planning. At times, the best option for a student may be to take a leave of absence until the student can more fully engage in the curriculum (see section “Leave of Absence.”) Other times it may be better to remain enrolled in school with modified attendance expectations and with additional support services in place. The Department of Medical Education is committed to engaging with students to create viable approaches to situations as needs arise. It is essential that students be open and proactive in these discussions, and the Department of Medical Education will likewise strive to be fair and transparent.

Any modified educational plans must involve discussion with and approval from the Senior Associate Dean for Undergraduate Medical Education and Student Affairs. Plans may require input from Enrollment Services and Financial Aid, as well as from course and clerkship directors when relevant.

Leave of Absence

Life circumstances may require students to take time away from courses or rotations. When the need for time off is limited (see below), students may remain enrolled and will be permitted excused absences (see excused absence policies). If the time away is extensive or indeterminate, a leave of absence (LOA) may be considered. A LOA is a period of temporary non-enrollment. A LOA constitutes a mutual agreement between the School and a student with regard to utilization of time during the leave, as well as the requirements that must be met prior to reentering the curriculum. All requests for a LOA are made directly to and granted at the discretion of the Office for Student Affairs

Year 1 and 2 courses are only offered once per year and have prerequisites, and all requirements in the first semester must be completed before moving on to the second semester. Because of the schedule and volume of material, having to spend significant time away from studying and mandatory sessions may place a student at risk of poor academic performance. In Years 1 and 2, the Office for Student Affairs typically grants up to two (2) weeks of excused absences for students who require time off to attend to personal circumstances, followed by a return to all coursework thereafter. Any need for time off beyond two (2) weeks may prompt the consideration of a LOA. A LOA may last for a period of up to one year, but a student can choose to convert the leave at any point to a scholarly period, during which the student is considered enrolled as a full time student (see section about the Scholarly Year). In that situation and in partnership with the student, Student Affairs will work closely with the Medical Student Research Office to help the student identify a mentor and project and, when possible, funding. In the event of a LOA, the student would return to courses the next academic year where the student had left off.

In Year 3 or Year 4, excused absences longer than two days will require students to make up the missed parts of a rotation. A student who requires more time off may have up to eight (8) weeks, schedule permitting. In that event, clerkships may need to be rescheduled but students may remain enrolled. Anything longer than eight weeks may affect the student’s ability to graduate on time and may require a LOA, which may be granted for up to one year. A student who takes a LOA may return to rotations at any point before the 12 month period ends (see section on return from LOA below), or convert the leave to a scholarly period. Based on when the leave is taken, the student may be required to make up parts or all of the rotation missed. The length of the leave may affect when a student is able to graduate.

LOAs may be Medical, Personal, or Administrative. See below for details.

Either the student or Student Affairs may initiate a medical LOA. A medical LOA may require a physician’s endorsement and/or an administrative psychiatric or medical evaluation. The term of the leave is up to one year. The leave may be extended for a second and final year at the discretion of the Office for Student Affairs upon recommendation of a physician. All students on medical LOA are required to have health insurance and are eligible to continue with the School’s student health insurance plan.

A personal LOA enables a student to take time off to address issues of a personal nature, including those related to the health and well-being of a family member or partner. A LOA may also be granted for issues related to childbirth, adoption, or other parental responsibilities.

A personal LOA will not be granted for non-health or non-family related circumstances (for example to pursue a time-limited opportunity in athletics or other interests) until after the completion of the first semester of Year 1. Personal leaves for such non-extenuating circumstances may not be taken at any time when the student is not in good academic standing, as defined in the Academic Standing Policy, or in Serious Academic Status, as defined in the Academic Status Section.

Ordinarily, personal leaves may not exceed one year; however, requests to extend a personal leave into a second and final year will be considered under exceptional circumstances.

All students on personal LOA are required to have health insurance and are eligible to continue on the School’s student health insurance plan.

A LOA can also be administrative. An Administrative LOA is mandated by the Department of Medical Education and is usually as the result of a student not complying with school’s administrative requirements.

The dates for all LOAs will be noted on the Transcript and the MSPE. The reason for the LOA will not be included in these documents, with the exception of an Administrative LOA, which will be designated as such on the transcript and MSPE.

To be eligible to receive federal and institutional student aid, the student must meet and maintain the School’s standards of satisfactory academic progress. (Please refer to the section entitled “Satisfactory Academic Progress for Financial Aid” under the “Financial Aid” heading in this handbook.)

A Leave of Absence status greater than 180 days will move students out of their loan deferment period. The last date of attendance before the LOA is the "Out of School" date. After 180 days, the grace period ends and all educational federal loans will go into repayment. Students are expected to meet with the Office of Student Financial Services before a LOA is finalized in order to fully understand the consequences of the LOA on loan repayment.

A student who resides in student housing is required to vacate student housing while on LOA, based on the nature and anticipated length of the LOA. Students may petition to the Housing Committee to remain in housing if the LOA is anticipated to be brief. Students on LOA may not participate in any educational opportunities at the Icahn School of Medicine for credit.

Students who go on a LOA must obtain clearance beforehand from the Office for Student Affairs. Students are required to meet with their Faculty Advisor and/or Senior Associate Dean for Undergraduate Medical and Student Affairs before filling out the appropriate forms. The student will receive a letter of leave and individualized conditions will apply. All students must meet the criteria and confirm agreement with the terms of the leave in writing. In addition, students must complete a sign-out form (see link below) requiring the signatures of the requisite offices indicating that there are no outstanding debts or other encumbrances to the student's record and that all medical school property has been returned. When all the signatures are obtained, the student must return the form to the Office of the Registrar.

Leave of absence sign out and return forms can be found on the Medical School Forms webpage.

The Office of Student Affairs approves students for return from a LOA. The point person for the return process is the Assistant Director of Student Affairs. Students should refer to the individualized terms of their leave letter and must complete all required evaluations or testing prior to return. In general return from a medical leave of absence requires a physician’s note that the student is cleared to return to school. At the end of a specified period of LOA, if the student does not notify the Assistant Director of Student Affair of their intentions, it will be assumed the student no longer wishes to be considered enrolled and will be dismissed. If a student wishes to apply for reinstatement at a later date, a new application for admission must be completed.

Students who choose to enhance their medical training by pursuing an additional academic degree at another institution will be considered on Extended Scholarly Status. In this status students are not enrolled in medical school courses or clerkships but because they are pursuing an additional degree, this leave of absence is considered in a similar status as that of students who are on Scholarly Year. The School is obligated to report all matriculated students and their active or inactive status at ISMMS to the Department of Education. As an inactive student at ISMMS, the student is not eligible for federal loans from ISMMS during this period. This policy does not apply to students getting an additional degree (like a PhD, or Masters) from the Icahn School of Medicine at Mount Sinai.

Students must be in good academic standing to be eligible for this status. Students interested in an additional degree should initiate the process by discussing their plans with their Faculty Advisor. Students who pursue an additional degree between year 1 and 2 must compete all academic requirements for year 1. Students who pursue an additional degree between year 2 and 3 must compete all academic requirements for year 2 and take Step 1. Students who pursue an additional degree between year 3 and 4 must compete all academic requirements for year 3 and take Step 2CK and take Step 2 CS by the deadline established by Medical Education. Any needed course remediations must occur before students begin an additional degree.

The following are additional factors and requirements for students in this status:

Loans: as mentioned above students will not be eligible for federal or school originated loans while on Extended Scholarly Status through the ISMMS Financial Aid Office. Students who are citizens/permanent residents are eligible to apply for federal student loans at the institution where they are getting the additional degree. As long as students are enrolled here or elsewhere previous loans will not be in repayment status. Students who received federal or institutional loans, and are no longer enrolled in their additional degree institution or considered not enrolled at ISMMS, will go into student loan repayment. Loan repayment usually starts six months after the last day of enrollment is reported by the additional degree institution or ISMMS. For further information about federal loans, please go to the National Student Loan Database at www.nslds.ed.gov to view loan servicer information and loan balances.

Housing: students who are pursuing an additional degree at an institution within New York City are eligible to retain their ISMMS housing. They will be responsible for rent and must show proof of income to cover rent for the duration of the additional degree.

Health insurance: students must have health insurgence during this status. They can be on the ISMMS plan, a plan from the other institution, or another plan of students’ choosing.

Patient care: Students on this status may retain their ISMMS ID and may engage in clinical activities like shadowing or participation in EHHOP.

Library services: All library items associated with the user's library account must be returned in good condition and all fines and fees paid, regardless of the date that the fine or fee was originally issued, prior to starting on Extended Scholarly Status. If payment is required, the library can make arrangements for payment over the phone with a valid credit card.

MSPE and Transcript: Students’ MSPEs and transcript will read: “Student pursued a (name of degree, i.e., MPH, MBA) at (name of institution) for academic year(s) ________.” The dates of degree start and end will also be noted.

Transcript: Face of transcript reads: [Start Date] – [End Date]: Extended Scholarly Status – Degree type, Name of institution.”

Degree length and timing: Students who take an additional degree must review the start and stop dates of that program with their Faculty Advisor and, if needed, the Registrar to ensure that they can meet the requirements for the medical degree in time for the projected date for graduation from medical school.

The purpose of a decelerated curriculum is to allow a student to complete one academic year’s required coursework over two years. Students must maintain half time enrollment in order to continue to receive both financial aid and loan deferment status. Students may decelerate one of the four years of medical school in order to maintain satisfactory academic progress. Consideration for deceleration of a second year is at the discretion of the Promotions Committee. Reasons for deceleration include for academic reasons or for personal ones like a student's health or life circumstances. 

Students who wish to decelerate must contact their Student Affairs Faculty Advisor to discuss the possible advantages and disadvantages of a decelerated year.  f the students wishes to decelerate after consultation with their Faculty Advisor, the request should be submitted to the Senior Associate Dean for Student Affairs who will then make a referral to Promotions Committee and a subcomittee will make the decision about deceleration.  Alternatively, deceleration may be mandated by the Promotions Committee to allow a student to complete an academic plan. Once approved, Student Affairs will reach out to the Registrar’s office for an academic plan. Each plan is individualized per the student’s needs, with the academic plan structured so that students will complete the requirements for the respective year by the end of the second decelerated year. (Note: Students must be registered in every academic term in order to maintain their decelerated student status.) The decelerated plan must comply with the School’s Satisfactory Academic Progress requirements for graduation and financial aid. Students who are approved should meet with Office for Student Financial Services (SFS) to review the impact of a decelerated curriculum on their finances.

  1. Student Affairs contacts Registrar once a student is planning to take deceleration, and a plan is outlined by the Registrar’s Office for the student to meet curricular requirements over the span of two academic years.
  2. Once approved for a decelerated curriculum by the Registrar’s Office, the Office of Student Financial Services (SFS) will adjust student billing and award as ¼ of tuition and financial aid (for each term),spread out over two years. Scholarships and loans will be adjusted accordingly. Students will need to apply for financial aid each year. It is not a guarantee the student will receive the same amount of financial aid they received previous years as student/parent income and institutional awarding/funding policies change. Tuition will be posted at the rate charged for that academic year. There will be no proration of tuition or discount.
    1. With this set up, students can still receive financial aid and in-school loan deferment because they will be considered half-time status. Students who are unable to follow the deceleration schedule will be required to take a Leave of Absence (LOA).   Students who are unable to follow the deceleration schedule and take an LOA will be subject to all LOA policies regarding Financial Aid and Housing (see LOA section of handbook).  They would return from LOA at the start date of appropriate curriculum year.
  3. Students must meet the pace at the end of their decelerated two years.                
    1. Year 1 & 2 curricular requirements -  must complete approved Registrar plan over two decelerated years to complete either Year 1 or 2 basic science courses.
    2. Year 3 curricular requirements – must complete approved Registrar plan over two decelerated years to complete all year 3 clerkships and at least 10 weeks of elective credit.
    3. Year 4 curricular requirements – must complete approved Registrar plan over two decelerated years to complete all year 4 clerkships and the remaining weeks of elective credit (28 weeks total over years 3 and 4).
  4. After completing the decelerated curriculum plan, students will return as full time students on a regular track and pace.

The following processes are in places for students who are decelerated in year 3:

  1. Shelf scores: students will be compared to the nomogram based on the order in which they take the clerkship. For example, a clerkship that occurs in the first of the 4 decelerated semesters will be compared to the quarter 1 nomogram, a clerkship that occurs in the 3rd decelerated semester will be compared to the quarter 3 nomogram, etc.
  2. Gold Humanism Honor Society: GHHS selection is determined primarily by peer nomination. Students on a decelerated year 3 curriculum will be included in the voting for both of the academic years that they are in year 3.
  3. Timing of Compass 2: Students will take Compass 2 in the 2nd of the two academic years.
  4. Timing of Step 2 CK: Students may take Step 2 CK once they have completed all year 3 core clerkships
  5. Timing of Step 2 CS: Students may take Step 2 CS once they have completed Compass 2 and their performance has been reviewed by the Compass 2 committee.
  6. Students are required to stay up to date on their yearly compliance requirements and should reach out to compliance@mssm.edu with any questions.

While the limit for excused absences in Year 1 and 2 is two (2) contiguous weeks, students may watch the recordings of lectures at their convenience and only need to report to school for required patient presentations, small groups and laboratory experiences. This allows for significant time when a student is not required to be present at school.