I. Purpose of policy
To define the types of time away from the training program, the process for requesting each, and the effect on Graduate Medical Education training.
Dartmouth Hitchcock recognizes the need for, and importance of, providing Residents with time away from their training program for vacation, sickness, or other personal reasons. Residents in Graduate Medical Education (GME) shall be allowed time away under this policy, subject to any applicable federal and state leave laws, Dartmouth Hitchcock policy, and the requirements of each Training Program. A leave of absence might not be credited as training time and may result in program extension as described herein, and/or as required by the particular Training Program, Review Committee (RC), and/or Specialty Board.
II. Policy scope
This policy applies to all Residents participating in ACGME-accredited Graduate Medical Education programs at Dartmouth Hitchcock.
III. Definitions
Caregiver Leave: Leave to care for a spouse, child, or parent with serious health condition.
Flex Days: Time off for the Resident to deal with brief, and unexpected life, and/or personal issues, such as health or family emergencies.
Medical Leave: Leave for the Resident’s serious health condition that makes the Resident unable to perform the functions of their job.
Parental Leave: Leave due to the birth of a child or placement of an adopted/fostered child including to bond with the said newborn or placed child within one year of birth/placement.
Resident: Any physician in an ACGME-accredited Graduate Medical Education program, including residents and fellows.
Training Program: A Graduate Medical Education, ACGME-accredited residency or fellowship program.
IV. Policy statement
- Types of Time Away from Residency
- Vacation Time
All Residents receive 15 paid vacation days per academic year. Unused vacation days do not carry over to the following year. Vacation in the final two weeks of training is strongly discouraged, yet left to the discretion of the Program Director.
Requests for vacation must be submitted in advance to the Program Director or designee, and scheduled by mutual agreement. Each program must outline the process for vacation requests in their program-specific Time Away Policy, and must include any limitations on when vacation may be taken. - Flex Time
All Residents receive 5 paid Flex Days per academic year. Unused Flex Days do not carry over to the following year. Flex Days cannot be used in increments of less than one full day.
Flex Days are intended to assist Residents in dealing with brief and unexpected life and personal issues (such as health or family emergencies). Flex Days are not intended to extend approved vacation time or holidays, to substitute for unapproved vacation time or holiday requests, to avoid work assignments (such as night or weekend shifts), or to replace the use of any other leave covered in this policy for which the Resident is eligible.
Each program must outline the process for Flex Day requests in their program-specific Time Away Policy. Flex Days may be scheduled in advance via written request to the Program Director or designee. If the Flex Day cannot be planned in advance, the Resident must follow the program’s process for notification as listed in the program-specific Time Away Policy. A written request to designate the time missed as a Flex Day must be submitted as soon after the absence as possible.
A Resident is not required to reveal why they wish to use a Flex Day; however, a Resident may voluntarily choose to share why they wish to use the Flex Day, and the Program Director or designee can factor this voluntarily self-disclosed information into the decision whether or not to approve use of Flex Day. Generally speaking, Program Directors or designees will approve in writing all requests for the use of a Flex Day unless a request is not consistent with the intended purposes of Flex Days or the program cannot accommodate the time away due to patient care
needs. If a Program Director or designee denies a Resident’s request to use a Flex Day, the Program Director or designee will notify the Resident in writing of the reason for the denial and will courtesy copy the GME office on that communication. - Family and Medical Leaves of Absence
- Paid Medical, Parental and Caregiver Leave
Residents are entitled to a total of 6 weeks of Paid Medical, Parental, and Caregiver Leave once during their Training Program. This paid leave is in addition to the above annual vacation and flex time and will be paid at 100% of pay.
Paid Medical, Parental, and Caregiver Leave is available beginning the first day of the Resident’s signed Agreement of Appointment and can be taken intermittently or consecutively, in consultation with their Program Director. Leave can be taken for the following reasons:- The birth of a child and to bond with the newborn child within one year of birth.
- The placement with the Resident of a child for adoption or foster care and to bond with the newly placed child within one year of placement.
- A serious health condition that makes the Resident unable to perform the functions of their job.
- To care for the Resident’s spouse, child, or parent who has a serious health condition.
Residents requesting Paid Medical, Parental, and Caregiver Leave must follow the Leave of Absence Application Process outlined below. - Family and Medical Leave Act (FMLA) Leave
Residents who have been employed with Dartmouth Health for at least twelve months and have worked at least 1,250 hours during the 12-month period immediately preceding the commencement of the leave are eligible for qualified family and medical leave under provisions of the federal Family and Medical Leave Act (FMLA).
FMLA provides eligible Residents up to 12 weeks of unpaid, job-protected leave per rolling 12-month period for the following reasons:- The birth of a child and to bond with the newborn child within one year of birth.
- The placement with the Resident of a child for adoption or foster care and to bond with the newly placed child within one year of placement.
- A serious health condition that makes the Resident unable to perform the functions of their job.
- To care for the Resident’s spouse, child, or parent who has a serious health condition.
- For any “qualifying exigency” arising from the foreign deployment of the Resident’s spouse, son, daughter, or parent with the Armed Forces.
Although leave under the FMLA is unpaid, Residents may be entitled to concurrent paid leave (such as Paid Medical, Parental, and Caregiver Leave; Paid Parental Leave) or other wage replacement benefits (such as Short Term Disability).
For more information, please refer to Dartmouth Hitchcock’s Family and Medical Leave Act (FMLA) and Service-member Leave Policy, which can be found on PolicyTech.
Residents requesting FMLA Leave must follow the Leave of Absence Application Process outlined below. - Parental Leave
In addition to Paid Medical, Parental, and Caregiver Leave and FMLA Leave, Residents may be eligible for parental leave as follows:- NH Pregnancy and Maternity Leave
Pregnant Residents working in New Hampshire are entitled to leave under NH law for any period of incapacitation due to pregnancy or childbirth. NH Pregnancy and Maternity Leave can be taken pre-partum with supporting medical documentation of disability based upon the pregnancy. It can also be taken postdelivery, the typical period for which is six weeks, unless supporting medical documentation is submitted demonstrating continuing disability, such as due to complications of childbirth. - Paid Parental Leave
Dartmouth Hitchcock provides two consecutive weeks of Paid Parental Leave to eligible Residents following the birth or adoption of a child.
For more information, please refer to D-H’s Paid Parental Leave Policy, which can be found on PolicyTech.
Residents requesting Parental Leave must follow the Leave of Absence Application Process outlined below. - NH Pregnancy and Maternity Leave
- Military Leave
Military Leave is governed by Dartmouth Hitchcock policy and subject to USERRA, a federal law protecting the rights of employees, including Residents, with military duty. Please refer to Dartmouth Hitchcock’s Military Leave Policy, which can be found on PolicyTech.
Residents requesting Military Leave must first discuss the leave of absence with their Program Director, and then contact the Benefits Administration Office at 603-650-1400 (Monday through Friday, 8:00 am to 5:00 pm ET) or dhleaves@hitchcock.org. - Personal Leave
Residents with at least 12 months of continuous employment who have exhausted all Vacation and Flex time, and all other eligible leave options, may apply for a personal leave of absence. Please refer to D-H’s Personal Leave Policy, which can be found on PolicyTech.
Residents requesting Personal Leave must first discuss the leave of absence with their Program Director, and then contact the Benefits Administration Office at 603-650-1400 (Monday through Friday, 8:00 am to 5:00 pm ET) or dhleaves@hitchcock.org. Program Directors have the ultimate authority to approve or deny a request for Personal Leave.
- Paid Medical, Parental and Caregiver Leave
- Other Leave Types
In addition to the leave types outlined above, the additional leave types listed below may also apply to Residents:- Bereavement
- Blood Donation
- Court Service
- Crime Victim
- Educational Leave
- Jury Duty
- Pregnancy Disability Leave
- Vermont Parental and Family Leave
- Vacation Time
- Benefits While on Leave
- Health Insurance
Residents’ health benefits will be maintained during any period of approved leave under the same conditions as if they continued to work. If a Resident goes into an unpaid status, their benefits premiums will go into arrears, which will be recovered by double deductions upon their return to work. - Short Term Disability
Dartmouth Hitchcock offers Residents Short Term Disability (STD), a wage replacement benefit available when a physical or mental condition sufficiently incapacitates the Resident, requiring that they temporarily suspend participation in the Training Program. Residents are eligible for STD benefits equivalent to 100% of their pay for up to 90 days upon certification of the disabling condition by their health care provider.
Residents must follow the process set forth below to apply for STD benefits through Sun Life.
- Health Insurance
- Responsibility of Training Program
Each specialty review committee (RC) and/or board has its own unique requirements related to time required for program completion or board eligibility. Programs are responsible for understanding the specific requirements of these bodies so that they can advise Residents about any impact there might be to board eligibility, program extension or completion.
Programs must discuss with Residents any impact taking a leave will have on their program completion and board eligibility.
Each program’s time away policy must include these details as they relate to Resident leave:- The specific time away from training requirements allowed by the specialty board and/or RC.
- The process to ensure the availability of resources to support Residents’ well-being and education by minimizing impact to clinical assignments resulting from leaves of absence.
- Dartmouth Hitchcock GME has an Optional Extra Shifts Within a Training Program Policy (located in PolicyTech), that may be implemented by programs as necessary and reasonable.
Time away from the program, including but not limited to vacation, flex days, and all types of leave, must be tracked in the residency management system, MedHub. MedHub is the system of record for Resident time away from the program; no other tracking system should be used.
The Program Director or designee is responsible for being in contact with the GME Office, specifically with the Business & Reporting Specialist, upon receipt of a Leave of Absence form from a Resident. The GME Office will be in contact directly with Leaves Administration (dhleaves@hitchcock.org) upon receipt of the form. - Responsibility of Resident
Residents are responsible for communicating early with their Program Director and/or designee about the possibility of taking leave, the duration, and timing.
They must initiate the request for leave of absence by taking the following actions:- Discuss the leave of absence with their Program Director, and submit the completed GME Leave of Absence (LOA) Request form to their Program Coordinator.
- Contact Sun Life to begin the Leave of Absence (LOA) and Short Term Disability (STD) claim process. Sun Life administers Dartmouth Hitchcock’s leave of absence process and short term disability benefits. Sun Life will determine eligibility, collect the required medical documentation, make the decision to approve or deny the request, and send the decision letter.
To apply for a leave of absence and/or short term disability benefits, contact Sun Life online, by phone, by e-mail, or through the Sun Life Absence Management Services mobile app:
Sun Life website
Phone: 844-236-5180 (Monday through Friday, 8:30 am to 10:30 pm ET)
Email: absence@sunlife-ams.com
Leave of absence requests require a 30-day notice whenever an absence is foreseeable.
Unless and until Sun Life approves a leave, Residents are obligated to follow the department’s call-out procedures for any day missed, or as soon as practicable in the event of a medical emergency.
- Questions
Please direct questions about this policy to the GME Office at gme.office@hitchcock.org.
V. References
Institutional Requirements. (2022). Retrieved from ACGME.org: Institutional Requirements (acgme.org).
Dartmouth Hitchcock Policy ID: 27501