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. (Note: A year off focused on research falls under a Scholarly Year and is referenced in a separate section.)

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. 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. 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.

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 or academic 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” under the “Academic Difficulty” 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 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 ISMMS or another institution will be considered on Extended Scholarly Status. In this status students are not enrolled in medical school courses or clerkships. 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 enrolled in an additional degree (like a PhD, or Masters) from the Icahn School of Medicine at Mount Sinai.

It is highly recommended that students considering pursuing a second degree do so between Year 3 and Year 4 of medical school; however, exceptions may be made for students in other years.

Clearance to Begin ESS

Students considering pursuing a second degree must be in good academic standing and should discuss their interests with their Faculty Advisor and the Senior Associate Dean for Student Affairs. These discussions allow for a review of the student’s interests and career goals, application planning and timeline. Requests to complete a second degree are approved by the Senior Associate Dean for Student Affairs. 

Once a student has been accepted to a degree program and have had a discussion of their interests, they should fill out the Request for Degree form listed on the Registrar’s website with information about the program, length of degree, letter of acceptance and source of funding (such as financial aid package letter):  This form must be completed by June 1 in the year they intend to begin their degree program.

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 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 insurance 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 are not covered by malpractice insurance by ISMMS (including those obtaining a second degree within the Graduate School for Biomedical Sciences) for the length of their ESS, but may continue to volunteer at EHHOP in non-patient facing roles. 

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.


Return from ESS

Students must complete the Return from Degree Form by March 15 of the year they intend to return. This form alerts the Office of Enrollment Services, including Financial Aid and Bursar; compliance team; Student Affairs; and the Registrar. The form is available on the Registrar’s website:

Failure to notify the school of intent to return or wish to extend time away by March 15 will be put on Administrative Leave of Absence for the following academic year. This impacts student privileges, including eligibility for housing and access to campus resources. 

Students are considered on leave from the MD program for the length of the academic year and may not return early from their Extended Scholarly Status (i.e in May or June) to complete requirements towards their next academic year.

The purpose of a part-time enrollment is to allow a student to complete one academic year’s required coursework over two years. Students remain eligible for housing, financial aid, and access to student services during the time. Part-time enrollment  may be recommended by the Office of Student Affairs in partnership with the student for reasons including, but not limited to student health or life circumstances that prevent full-time enrollment. Part-time enrollment beyond one academic year will be reviewed and approved  by the Promotions Committee. 

Students who wish to explore part-time enrollment should first contact their Learning Community  Faculty Advisor to discuss the impact of extending graduation by one year. If the student wishes to move forward, the student will work closely with the Office of Student Affairs to build an academic plan that will be coordinated with the Registar’s Office for final implementation.  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 enrollment status.).  The academic plan must comply with the School’s Satisfactory Academic Progress requirements for graduation and financial aid. Students should meet with the Office for Student Financial Services (SFS) to review the impact of part-time enrollment on their finances.

Once finalized, the Office of Student Financial Services (SFS) will adjust student billing, scholarships and loans accordingly. Tuition will be posted at the rate charged for that academic year. There will be no proration of tuition or discount. 

Continued part-time enrollment is based on the successful completion of the academic plan.  If a student does not meet the academic plan, the student may be required to enter into a Leave of Absence and/or be presented to the Promotions Committee.  Students will return to full-time enrollment after successfully completing the academic plan.  

Students must remain compliant to all student expectations and requirements, including but not limited to health assessments, compliance requirements, administrative tasks, financial responsibilities.  

Students with part-time enrollment during year 3 will be eligible for Gold Humanism Honor Society nominations in all semesters for which they are enrolled.  Additionally, student performance on the NBME shelf examinations will be compared to the passing score on 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.

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.