Subject:
Scope:
Supersedes:
Effective:
Requirements of:
Approved:
SYSTEM-WIDE MEDICAL EDUCATION POLICY
No. 210
Leaves of Absence
Interns, Residents & Fellows (House Officers)
All previous policies and procedures regarding this subject and scope
12/6/09
Accreditation Council for Graduate Medical Education (ACGME)
American Osteopathic Association (AOA)
Council on Podiatric Medical Education (CPME)
Medical Education Shared Governance Team
Date:
7/6/12
Purpose
To ensure appropriate and consistent guidelines for leaves of absence for all individuals enrolled
in the Henry Ford Health System (HFHS) graduate medical education programs, including
interns, residents and fellows (house officers). The purpose of this policy is to establish and
communicate the guidelines for leaves of absence.
Policy
It is the policy of Henry Ford Health System (HFHS) to comply with Federal, State and local
rules and regulations related to the administration and implementation of leaves of absence
programs and to be consistent in the communication and application of such programs.
Medical Education programs adhere to the following HFHS policy, located in the System Human
Resource Policies Manual: No. 7.02 Leaves of Absence Policy.
Family and Medical Leave Act (FMLA): FMLA is designed to help employees balance their
work and family responsibilities by allowing them to take reasonable unpaid leave for certain
medical and family reasons. It also seeks to accommodate the legitimate interests of employers
and promote equal employment opportunity for men and women.
 House officers are eligible for FMLA leave if they have worked for HFHS at least 12
months and a minimum of 1,250 hours.
 FMLA provides employees with up to 12 weeks of unpaid, job-protected leave per year.
The rolling period is measured backwards from the date a FMLA leave commences. This
means that the 12 months prior to the beginning of the requested leave are reviewed to
determine if less than 12 weeks have been used in that period If less than 12 weeks have
been used, additional leave may be granted up to the 12 weeks.
 It also requires that group health benefits be maintained during the leave period.
 The house officer’s position is guaranteed for the total 12 weeks of a qualified FMLA
leave; the house officer is restored to the same position vacated when the leave
commenced.
Medical Education Policy #210: Leaves of Absence
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HFHS recognizes the interns’ residents’ and fellows’ (house officers) unique and multiple roles
as a student, a physician and an institutional employee. HFHS aims to balance house officers’
personal responsibilities, medical situations, educational needs and military service commitments
with the requirements of their graduate medical education program and the department’s,
hospital’s and system’s operations and policies. Additional requirements and benefits specified
in this Medical Education policy are designed to support the house officer in successfully
completing the required training period.
Medical Leave: Leave covering the house officer’s serious medical condition (illness, injury,
impairment or physical or mental condition that requires inpatient care or a regimen of
continuing treatment by a healthcare provider; pregnancy), when the individual is unable to
perform the essential functions of his or her position, regardless of length of service and hours
worked.
 Requires physician documentation after three days of absence.
 House officers who have more than two weeks accrued vacation time must use accrued
vacation time down to two weeks.
 Salary is continued for the duration of the physician-documented medical leave or a
maximum of six months. If the medical condition continues, the house officer may be
eligible for Long-Term Disability (LTD) benefits (claim must be submitted prior to end
of six month paid leave).
 Group health benefits continue for a maximum of six months.
Medical Leave of Absence Related to Pregnancy:
 Female house officers requesting a medical leave of absence related to pregnancy are
provided to up to six weeks after date of delivery for a vaginal delivery and up to eight
weeks after date of cesarean delivery with salary continuation and benefits. The house
officer is not required to use any vacation during this period. Female house officers may
use their available vacation in addition to the six or eight weeks of medical leave of
absence related to pregnancy. Total time away may not exceed 12 weeks, unless there is a
physician-documented medical need.
 If there is a physician-documented need for beginning a medical leave before delivery or
continuing it after the six or eight specified weeks, the mother must use accrued vacation
down to two weeks before being eligible for medical leave in addition to the six or eight
weeks.
 Male house officers shall be entitled to use vacation for three days upon immediate
notification of delivery of a newborn child.
 Female and male house officers who request additional time off related to the birth of
their newborn may request a Family Leave if they qualify for FMLA or a Personal Leave
if they do not qualify for FMLA.
Family Leave:
House officers who meet FMLA requirements are entitled to Family Leave for the following
situations:
1. Birth of a house officer’s newborn child and the care of said child;
2. Placement with a house officer of a child by adoption or foster care and care of said
child;
3. To care for an immediate family member (parent, spouse or child) with a serious medical
condition.
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An individual of the same sex, who currently resides with the house officer in a mutual
commitment, similar to marriage, shares financial responsibility, is not legally married to
another individual and is not a blood relative will also be considered an immediate family
member for family leave.
House officers must use accrued vacation down to two weeks and may exhaust vacation
time to zero as part or all of their family leave. The remainder of the approved family
leave is without pay.
Total time away may not exceed 12 weeks, including time used during the adoption
process and intermittent time off.
Group health benefits continue.
Personal Leave: The granting of a personal leave of absence is determined on a case-by-case
basis by the Program Director, in consultation with the Director of Medical Education. Personal
leaves are not covered by FMLA.
 House officers requesting personal leave must exhaust vacation time to zero. The
remainder of the approved personal leave is without pay.
 House officers granted personal leaves are not eligible to receive benefits or
reimbursement funds. Benefits continue through the end of the month in which the leave
commences. House officers may be eligible for continuation of benefits coverage
through COBRA.
 If HFHS requires the personal leave, pay and benefits are continued.
 Personal leaves are limited to six months.
Military Leave: A house officer who is a member of the National Guard or organized reserves
of the United States Military Service and who is ordered to active duty or an annual training
period will be granted a leave of absence for the duration of the duty or training period.
 Notification to Program Director upon receipt of order or notice to appear for duty is
required.
 Medical procedures or activity provided while on military leave is not included in activity
logs or counted towards educational objectives within the GME program.
 House officers on military leave are not required to use vacation time.
Active Duty.
 House officers performing military duty for more than 30 days may elect to
continue HFHS group health benefits up to 18 months through COBRA.
 A house officer on military leave, whose military pay is lower than his/her civilian
pay rate, may request to use paid vacation time off to compensate for the difference.
The house officer must first submit a leave and earnings statement to request this
compensation.
 Upon return from a military leave of absence, the house officer is restored to the same
pay as if he or she had not left.
Annual Military Training.
 House officers who take a leave of absence to fulfill annual two-week training
requirements retain their benefits.
 Upon presentation of the statement of training wages received, HFHS shall pay the
difference between their regular rate and training wages.
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Funeral Leave:
 House officers may take up to three days off with full compensation and benefits if a
death occurs in the family (parents, spouse or same sex partner, child, father-in-law,
mother-in-law, brother, sister, brother-in-law, sister-in-law, and grandparents). If
additional time is needed because of foreign travel, it is at the discretion of the Program
Director.
 If the funeral leave conflicts with, or is required during a previously scheduled vacation
or holiday time, the days absent will be counted as funeral leave or the vacation may be
extended by three days to accommodate the funeral leave.
Jury Duty:
 House officers called to serve on jury duty will be scheduled off and paid by the
court in addition to their regular pay. Documentation must be provided.
 Benefits are not affected by serving on jury duty.
 Vacation time is not used for this purpose.
Procedures
Leave Request. To initiate a leave, the house officer must:
1. Discuss the need for leave with the Program Director. In the case of foreseeable leaves, a
house officer must give 30-days notice to his or her Program Director. In situations where
the need of a leave is not foreseeable, house officers are required to give written notice to the
Program Director as soon as practical. In a medical emergency, a verbal notice may be
acceptable, with written Physician’s Certification Form submitted within 15 days of
commencement of leave.
2. Contact the Medical Education Department to discuss procedures. The Human Resources
Department does not monitor house officer leaves.
3. Complete the Leave Request Form and provide required documentation.
4. The Medical Education Department, not Human Resources, will maintain leave
documentation and track medical leaves for house officers to qualify for Long-Term
Disability (LTD); the Program Director will track absences to ensure that all program
requirements are met.
Intermittent or Reduced Schedule Leave. A house officer may request a FMLA-qualified
leave on an intermittent or reduced schedule basis, for medical circumstances. If operations will
be significantly affected by the intermittent schedule, HFHS reserves the right to temporarily
reassign the house officer to an alternate position during the course of an intermittent or reduced
schedule leave. If the reassignment does not meet regulatory or educational requirements of the
program, the Program Director will determine the impact upon the house officer’s training
program.
Compensation and Benefits.
 House officers receive salary continuation for six months during physician-documented
medical leaves. Short-Term Disability (STD) is not provided.
 After six months of an approved medical leave, house officers may be eligible for Long
Term Disability (LTD) through an insurance policy purchased for each house officer by
HFHS.
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House officers on approved medical, family and annual military leaves maintain all
benefits including medical, vision, dental, life and disability during the approved leave
period, for six months. While on unpaid leave, deductions are not collected. Upon
conclusion of the leave the house officer is responsible for paying to HFHS all insurance
premiums and other amounts that are in arrears (i.e., unpaid obligation for coverage while
on leave). Upon return, house officers must contact payroll to initiate repayment plan.
Returning from a Leave of Absence. To return from leave, the house officer must:
1. Contact the Program Director to plan for return to the program. The Program Director will
evaluate the house officer’s training status upon return from a leave and at his/her sole
discretion, will determine the amount of time that the house officer must make up to
complete the requirements of the program. (See below: Effect Upon the Graduate Medical
Education Program.)
2. Notify the Program Director as soon as the treating physician has given clearance to
return to work from a medical leave. The house officer will be required to provide
documentation from the physician stating the employee is able to return to work, the
date of the return and any restrictions that may apply.
3. Contact the Medical Education Department to discuss procedures.
4. Provide required documentation.
Effect Upon the Graduate Medical Education Program. Promotion or program completion
of a graduate medical education program may be affected by leaves of absence, based on the
length of the leave and the educational requirements of the program. The Program Director, at
his/her sole discretion, will determine the amount of time that the house officer must make
up to complete the requirements of the program. Accreditation agencies and specialty
colleges may have specific requirements regarding the amount of time an intern, resident or
fellow must be engaged in training in order to qualify for promotion, program completion or
board certification. Information related to eligibility for specialty board examinations is available
through each specialty college and may be accessed through the American Board of Medical
Specialties (www.abms.org) or the American Osteopathic Association (www.osteopathic.org).
The Program Director must inform the trainee of any specialty-specific board requirements that
may be impacted by any leave of absence.
Effect Upon Employment. Upon return from a leave, the house officer will be restored to the
same position vacated and salary when the leave commenced.
 If a house officer becomes eligible for a pay increase while on leave, the increase will
become effective at the beginning of the first full pay period upon the house officer’s
return to work.
 Promotion may be affected by a leave if all educational and time requirements have not
been met.
 The Program Director will evaluate each house officer’s training status upon return from
a leave.
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Termination. House officers on leave for six consecutive months (excluding military active
duty) are automatically terminated. The total of all leaves taken under this policy, when added
together, shall not exceed 12 months during the training program. House officers who exceed
the 12 month leave limitation (excluding military active duty) during the training program are
automatically terminated.
A terminated house officer may petition the Program Director to return to the graduate medical
education program. The Program Director may reinstate the former house officer at his/her sole
discretion, and will determine the amount of time that the house officer must make up to
complete the requirements of the program.
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