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Additional Policies Regarding Completion of Program

In This Section:

Graduation Requirements

Students who receive the MD degree from the Case Western Reserve University School of Medicine will:

  1. Satisfactorily complete all educational program objectives of the School of Medicine curriculum
  2. Pass the USMLE Step 1 and USMLE Step 2 CK and CS
  3. Pass the School of Medicine Clinical Skills Exam (CSE)*
  4. Satisfactorily complete the MD Thesis
  5. Meet financial obligations to the University
  6. Be approved to graduate by the Committee on Students
* CSE requirement updated by CME on 10/23/14

Participation and Attendance Policy

Policy submitted by the Office of Curricular Affairs, July 2009


At CWRU School of Medicine, students are considered junior colleagues. Here, student professionalism is valued equally as highly as mastery of the basic sciences and clinical skills; therefore, participation and attendance in WR2 are fundamental to meeting these professional and curricular responsibilities.

When the SOM confers the MD degree, the faculty is attesting not only that the student has achieved a level of competency as measured by performance on tests, but that the student has shown a commitment to professional responsibility and has also participated in the entire educational experience that is defined by the curriculum, the LCME and the state of Ohio.

Attendance is required in all instances where students collaborate or patients are involved. When students collaborate in the process of learning, the quality of what goes on depends on the contributions and interactions among the participants. Failure to attend and collaborate harms the knowledge exchange for the individual student and the group. Because the group setting involves putting one's thoughts into words to teach others, students can advance their learning in a group setting in ways that are not possible when studying independently.

Attendance at patient based activities is required out of respect for the individuals that allow us to learn from their lives. In all instances, students must be on time and well-prepared.

Policy for the Foundations of Medicine and Health (Pre-Clerkship Curriculum)

On time attendance is required at:


The Office of Curricular Affairs tracks attendance and tardiness for required learning experiences.

Life events

The medical school acknowledges that unpredictable events affecting attendance can and do occur. When these situations (such as medical emergencies, important changes in life circumstances, parenting issues, etc.) arise, the faculty will work with the student to find a solution. As soon as a student becomes aware of a situation that might affect fulfilling course obligations and attendance requirements, or influence the course of study, it is the responsibility of the student to consult promptly with his/her Society Dean.

Religious Practices

The CWRU SOM policy on religious observations follows that of the University which states that any student in an educational institution who is unable, because of his or her religious beliefs, to attend classes or to participate in any examination, study or work requirement on a particular day shall be excused from any such examination, study or work requirement. The student shall be provided with an opportunity to make up such examination, study or work requirement that she may have missed because of such absence on any particular day, provided that such makeup examination or work does not create an unreasonable burden upon the school. The school expects students to use careful discretion in judging the importance of a particular observance. It is the responsibility of the student to inform his/her society dean in advance as to whether or not she will be absent due to a particular religious observance.


Student vacations are limited to the periods specified by the official academic calendar. Students may not “bookend” their vacations by missing required activities to lengthen their time away. Required activities will take place as scheduled on the day prior to and the day following a vacation (i.e., IQ groups and other required activities will not be rescheduled).

Student Managed Flex Days

The attendance and participation policy respects individual student needs for some flexibility in scheduling academic and personal responsibilities. All students therefore have flex days that they may request at their discretion. If there is a need for flexibility beyond the flex days, students can work with their society deans to find solutions that address their individual circumstances. Students have the opportunity for up to 3 flex days in year 1 [Blocks 1-4] and 2 flex days in year 2 [Blocks 5-6]. 

Examples of flex day absences include weddings, family occasions, social obligations, summer job interview, family illness, child’s school conference, etc. 
Students need not provide a reason for requesting a flex day. Flex days do not carry over from year 1 to year 2.

Flex days may not coincide with the final IQ session of a block, clinical immersions, examination days, or be utilized immediately preceding or following vacations (“bookending”). These are "Blackout Days" and must be requested at least 72 hours in advance.

Requesting Flex Days and Other Absences

There are important limitations to requesting flex days: 1) flex day absences will not be granted to "bookend" any official school vacations or holidays (including 3-day weekends), during clinical immersions, on examination days, or on the final IQ session of a block; 2) the curriculum contains several categories of unique small group sessions that are not feasible to recreate (CPCP preceptorships, simulator sessions, communications workshops). Where possible, student rescheduling is supported, with timely communications that include all parties. Otherwise, such sessions are not eligible for "excused" absences.

Absences other than flex days must be approved by the Society Deans to be considered excused. Some examples of other approved absences include personal illness, personal or family emergency, religious observance, or speaking at a conference. These absences will generally not be approved during clinical immersion weeks, on examination days, or to “bookend” any official school vacations or holidays.

Out of respect, the student should discuss his/her planned absence with all faculty and students involved once approval for a flex day or other absence is received.

Procedure for Submitting a Request for Flex Days and Other Absences

A student who needs to miss scheduled/required activities must request approval at least THREE business days in advanceThe request must be made by submitting an Absence Request, available on the online portal.

Individual faculty leaders for any activity are not authorized to approve absences. They are required to keep track of attendance and tardiness and submit reports to their program directors. Tracking of Clinical Immersion attendance is determined by the block leaders.

Policy for Clinical Rotations

Attendance and punctuality during all aspects of clinical rotations are expected and considered an important part of a student's evaluation. Unless the absence in question is entirely unanticipated (death or serious illness in the family), students must enter their requests using the online Absence Request Form for Clinical Rotations. Students must discuss their absences with the appropriate people before submitting the form (see guidelines below). This policy applies to all clinical rotations (Basic cores, Acting Internships, and Electives). The online Absence Request Form for Clinical Rotations and the Instruction Sheet are available on the online portal. Note, flex days do not apply to clinical rotations - all absences must be requested in advance.

IQ+ Groups (Friday afternoon required curriculum)

IQ+ groups serve to integrate emerging basic science and advanced clinical skills into the patient care rotations. They depend on collaborative and inter-dependent learning. For these reasons, attendance and full participation in IQ+ groups is required of every student. IQ+ faculty assessments are given to the respective clerkship discipline leaders and used as a part of the review of the student’s clinical rotation performance.

Limited absence that can be approved by the Discipline Leader or IQ+ Director:

Absence that would require discussion with Discipline Leader/Course Director and Society Dean:

Guidelines for an Extension or Leave of Absence

Requests for an Extension:

Students may choose to extend medical school beyond four years. These extensions fall into three categories or a combination:

  1. Extension for Research: research and up to three clinical electives at CWRU, may pursue more at other institutions
  2. Extension for Academic Enrichment: remediation or additional academic work (up to three electives at CWRU, may pursue more at other institutions)
  3. Extension for Health Reasons: time spent focusing on personal or family health issues

While on an Extension, a student is fully enrolled at the School of Medicine.

A student may request an extension by meeting with their Society Dean, crafting a proposal for the additional time, and submitting a Request for Extension/Leave of Absence form from the Registrar.

An additional year may be requested in a written proposal to the Committee on Students.

The section on Tuition explains the financial ramifications.

The MD degree must be awarded within six (6) calendar years of first matriculation, except for those students in the Medical Scientist Training Program (MSTP).

Requests for a Leave of Absence:

A leave of absence must be approved by the student’s Society Dean (University Program) or the Associate Dean for Student Affairs (College Program). Students can encounter a variety of circumstances that can lead to a leave of absence. Students can submit a request for leave of absence in writing to their Society Dean for approval.   

Students returning after a leave of absence for elective reasons will pay tuition at the level of the class they join as outlined in the Tuition Policy.

Students on any kind of leave of absence are responsible for clearing all their financial obligations (loans, health insurance, computer, other) through the Office of Financial Aid.

Students on a leave of absence who have not completed one full semester should note that during the leave of absence they are:

All students on a leave of absence must notify their Society Dean of their intent to re-enter school by the April 1 preceding the academic year of re-entry.

The MD degree must be awarded within six (6) calendar years of first matriculation, except for those students in the Medical Scientist Training Program (MSTP).

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Special Services and Accommodations

Students with documented disabilities may be eligible for special services and accommodations. To initiate the process, a written request for accommodations should be submitted to the Coordinator of Disability Services in Educational Services for Students (ESS). Further information on how to proceed appears in the School of Medicine Technical Standards.

Medical Professional Liability

It is the policy of the School of Medicine that medical students can diagnose or treat a patient only under the supervision and control of a licensed clinical faculty member.  If in doubt, students must ask the faculty member for clarification.

The School of Medicine endeavors to select students carefully, to evaluate students thoroughly, and to provide adequate supervision in the clinical setting.  Clinical faculty members must supervise and evaluate students appropriately.  It is the right and obligation of a faculty member to define and, if appropriate, curtail an individual student’s activities consonant with the student’s abilities and trainee status.

All students must wear their identification badges that clearly designate their student status and are to be introduced to patients as trainees.  However, the trainee status of a medical student does not allow delivery of substandard care.

All medical students, upon becoming aware of any alleged injury, incident, claim or suit involving themselves must notify the Office of Student Affairs in the School of Medicine immediately. Failure to do so may jeopardize any insurance coverage otherwise available.

Students are provided liability coverage when engaged in patient care as part of their educational program and when supervised by a licensed clinical faculty member.  Such coverage extends only while officially registered as students and not during vacations, leaves of absence, or other periods of non-student status.  Coverage does not extend to activities undertaken outside of the educational program.  Any questions concerning liability issues involving patients should be directed to the Office of Student Affairs.

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Published and maintained by the Office of Student Affairs and the Academic Societies
Revised 3/03/17