Unit Policy
Title
School of Medicine: Policy on New Child Adjustment
Introduction
Purpose
This Policy provides guidance for University of North Carolina at Chapel Hill ("University") School of Medicine ("SOM") Medical Doctorate (MD) degree program students ("Student/s") taking time away from the MD degree program curriculum to care for a New Child.
Scope
This Policy applies to all Students in the MD degree program and deans, faculty, and staff who are responsible for its implementation.
Policy
Policy Statement
Students can take New Child Adjustment ("NCA") Leave to care for a New Child while remaining enrolled in the SOM and maintaining their Student benefits (e.g., student health insurance, and financial aid). To maintain healthcare insurance, library, and financial aid benefits, a Student must be enrolled in at least six (6) credit hours per semester.
While the NCA Leave option exists to accommodate Students wishing to graduate and match with their original class, Students who choose the NCA Leave option are not guaranteed to graduate on time, and Students are still responsible for completing their full graduation and course requirements, consistent with their year of graduation. Certain external policies are outside the control of SOM, which may affect the extent of flexibility offered. For instance, National Board of Medical Examiners ("NBME"), United States Medical Licensing Examination ("USMLE"), National Residency Match Program ("NRMP"), Electronic Residency Application Service ("ERAS") and other organizations have policies regarding eligibility and timing. Additionally, healthcare entities require a Student to be enrolled in order to engage in any clinical activities and thus, be covered by malpractice insurance.
Any NCA Leave that is significant enough to shift timing of courses and/or enrollment status may be reflected on official transcripts. The NCA Leave will be noted in the Medical Student Performance Evaluation ("MSPE"), and the Student may choose to list the leave as parental, medical, or personal.
An NCA Period is designed with the Student's success in mind. Staff and faculty will work with Students to explore all possible options, including involving the Student in personalizing the options available to them. An NCA Period is intended to be:
- Flexible
- A Student's NCA Leave plan will be individualized to address the unique needs and goals the Student and to allow for the greatest flexibility in formulating an NCA Period. The Student's wishes to graduate on time and meet specific academic goals will be honored whenever possible and consistent with University policy.
- Individualized
- If Students desire to take NCA Leave and want to graduate on time, there are a number of options available to make up time and achieve on-time graduation, including:
- Electives – SOM is open to Students completing academic electives during their NCA Period provided that the objectives, rigor, and criteria of evaluation are approved by the electives course director. Students must send requests to complete electives during an NCA Period to the electives course director via email. Students must be actively enrolled to receive credit for an elective.
- Banking Time – Whenever possible, Students completing a clinical course may be allowed to "bank" the time they completed within that course depending on capacity, timing, amount of course completed before leave, and amount of course needed after leave. Depending on the preceding factors, Students may re-enter that course at the conclusion of their leave. SOM reserves the right to have Students restart a course should circumstances require (e.g., a Student needs to finish a course at another site, a Student's performance on a course up to that point is not satisfactory, or there is significant lag between the beginning of a course and the time when the course will be finished). If the NCA Period taken by a Student is greater than six (6) months, credit for banked time will need to be specifically evaluated by the Office of Student Affairs upon the Student's return from the NCA Period. Office of Student Affairs leadership (i.e., a Dean or the Senior Director) will communicate its determinations of credit that will be granted to Students via email.
- Moving Flexible Time from the Individualization Phase – No matter when in the MD Program a Student's NCA Period takes place, "time off" that would otherwise be used during Individualization Phase, if not already used, will be allowed to be moved to accommodate the Student. Examples include time off for interviews and time off dedicated for USMLE Step 2 Examination ("Step 2") preparation.
- Holidays – Students' ability to finish requirements during holidays will be reviewed by course directors on a case-by-case basis.
Curricular Phase Considerations When Pursuing an NCA
Foundation Phase
For any Student taking an NCA Period during Foundation Phase, makeup work can be completed during the summer between MS1 and MS2 year, spring break, the winter holiday of either year, or dedicated study period for the USMLE Step 1 Examination ("Step 1"). Since these periods of time are limited, there is also a limit to how much makeup work can be completed during these times. Course directors, curricular affairs staff, and curricular deans will work with those in the Office of Student Affairs to create plans that optimize Student success as well as Student personal goals and to communicate plans to Students.
Application Phase
- To ensure Students do not miss important information provided at orientation, a Student cannot enter a course or rotation after it has started. An exception may be made, depending on individual circumstances, if a Student is willing to attend the orientation and then continue their NCA Period, making up missed work later. Students may request such an exception by emailing the Office of Student Affairs at SALeadership@listserv.med.unc.edu. Requests are reviewed by the Student Support Committee.
- A Student who takes NCA Leave in the middle of a course will receive an Incomplete Grade, which is a temporary grade and will be replaced with a final grade once the coursework is completed.
- It cannot be guaranteed that a Student will receive the same placements (site or specific clinical service) for a course or rotation if completing makeup work. All course/rotation assignments are based on capacity at the time of a Student's return.
- Consideration should be given to optimize the Student's learning curve, i.e. there may be a portion of the course or an assessment that is intentionally conducted towards the end of course because success requires previous elements of the course. Summative assessments (e.g., OSCE, NBME) should be scheduled after the Student has completed, as determined by their course director, the majority of the course.
- Plans for NCA Periods which fall in two (2) separate courses will need to be developed with input from both course directors to ensure that coursework is completed in a way that meets the objectives of each course and in an efficient manner.
- Students completing one (1) or more of the clinical phases at a Regional Campus need to discuss the specifics of their schedule with their campus' leadership (i.e., Regional Campus deans and/or Directors of Curricular and Student Affairs) because of the unique considerations of scheduling makeup work at a specific campus or for a Longitudinal Curriculum.
Individualization Phase
- Students taking an NCA Period during the Individualization Phase should also account for the Application Phase considerations listed above.
- Individualization Phase has more flexibility as Students generally have more input into the course scheduling.
- Individualization Phase has flexible courses built in for completing Step 2 and for interviewing. These can be shifted into Application Phase. However, these shifts may only be minimally beneficial depending on the Student's residency application, interview and Match timeline, as well as timeline to complete Step 2.
- Some Individualization Phase courses are non-clinical, offering some flexibility to Students and allowing them to complete them during an NCA Period if also enrolled.
- Many Individualization Phase courses have elements that require in-person attendance and other factors that do not allow sufficient flexibility for taking these during an NCA Period.
- Individualization Phase also allows for electives which are created by a Student and a preceptor. These are created using the Special Elective Form and must have learning objectives as well as evaluation methods. These also offer flexibility.
Definitions
New Child: A dependent child, newborn biological child, or a newly placed adopted, foster or otherwise legally placed child under the age of eighteen (18) whose Parent/Guardian is a Student.
Parent/Guardian: Either (a) the parent of a child through birth or legal adoption, or (b) an individual who cares for a child through foster or other legal placement under the direction of a government authority.
New Child Adjustment (NCA) Period/Leave: Time away from the curriculum due to an NCA.
Course: A unit of study for which a final grade is administered. (e.g., The Patient, Community Based Primary Care).
Rotation: A unit of study that takes place within a clinical course (e.g., Labor and Delivery rotation in the Obstetrics and Gynecology course).
Regional Campus: An instructional site that is distinct from the central/administrative campus of the SOM where some Students spend one or more of an entire curricular year.
Foundation Phase: The first eighteen (18) months of the medical school curriculum comprised of:
- Nine (9) Medical Science courses (three per semester)
- Three (3) semesters of Patient Centered Care (PCC)
- Three (3) semesters of Social and Health Systems (SHS)
Application Phase: The twelve (12) month phase of the medical school curriculum dedicated to core clinical experiences, beginning in March and ending in February of the following year consisting of:
- Six (6) clinical courses:
- Community Based Primary Care
- Pediatrics
- Medicine
- Surgery
- Psychiatry
- Obstetrics and Gynecology
- One (1) longitudinal course
- Social and Health Systems 4
Individualization Phase: The final fourteen (14) months of the medical school curriculum dedicated to the completion of graduation requirements and electives tailored to a Student's career interest, beginning in March and ending in May of the following year consisting of:
- Two (2) Acting Internships
- One (1) Critical Care Selective
- One (1) Advanced Clinical Selective
- Four (4) Electives
- Two (2) Longitudinal Courses:
- Science of Medicine and Social and Health Systems 5
- Transition to Residency (to be completed at the end of the phase)
Longitudinal Curriculum: Refers to a clinical training model in which Students care for patients over time across multiple specialties simultaneously, integrating learning across disciplines.
Related Requirements
External Regulations
Unit Policies, Standards, and Procedures
Contact Information
Primary Contact
Title: Senior Director for Student Affairs
Name: Valerie Glassman
Email: valerie_glassman@med.unc.edu
Publication Details
Issuing Officer: Alice Chuang, Associate Dean for Student Affairs, alice_chuang@med.unc.edu
Effective Date: October 1, 2025
Review Cycle: The Education Committee will review this Policy on an as-needed basis with input from SOM Students Affairs and the University Compliance Office.
Next Review Date: September 30, 2027