Paid Time off & Leaves of Absence

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NEW YORK-PRESBYTERIAN HOSPITAL
GRADUATE MEDICAL EDUCATION
POLICIES AND PROCEDURES

REFERENCES:

In accordance with Section 4.8 of the Accreditation Council for Graduate Medical Education (ACGME) Institutional Requirements, NewYork-Presbyterian Hospital (NYPH) as the Sponsoring Institution has a policy for paid time off and leaves of absence, consistent with applicable laws. Pursuant to this policy residents and fellows in each of NYPH’s ACGME- and Commission on Dental Accreditation (CODA)-accredited programs (Graduate Staff) will receive paid time off entitlements for certain qualifying conditions. This policy also requires NYPH to provide these residents and fellows with accurate information regarding the impact an extended leave of absence could have upon their satisfactory or timely completion of a program, and their eligibility to participate in examinations administered by relevant certifying board(s).

POLICY:

APPLICABILITY

All NYPH employed Graduate Staff in ACGME-accredited and CODA- accredited training programs may request paid time off starting the day the Graduate Staff is required to report.

PAID TIME OFF

At the beginning of each academic year, Graduate Staff are eligible for, and will be provided (i.e., front loaded), the following days of paid time off:

20 vacation days
- Up to 7 Sick Days, totaling no less than 56 hours of paid sick time in accordance with New York State’s Sick Leave Law (NYSLL) and New York City’s Earned Safe and Sick Time Act (ESSTA) (collectively referred to as the “Leave Laws”). This time can be used for the following:
- Personal illness and routine medical appointments on a regularly scheduled workday.
- To care for a family member who is ill or if a Graduate Staff member’s child’s school or childcare provider, or the Hospital, are closed due to a public health emergency.
- To address exposure to a communicable disease – whether their own or their family members’ – when it has been determined by the public health authorities that the exposed person’s presence in the community may jeopardize the health of others. This is true whether or not the exposed individual has actually contracted the communicable disease.
- o For “Safe Time” which allows Graduate Staff who have suffered acts or threats of domestic violence, a family offense, sexual offense, stalking or human trafficking, against themselves or family members, to use this time to address issues that may come up in connection with such actions or threats.
- For the purposes of this policy, “family member” is an individual related by blood and any individual whose close association is equivalent of a family relationship, including but not limited to spouse, domestic partner, parents or legal guardians, children, grandparents, grandchildren, sibling (i.e., a Graduate Staff member’s brother or sister, half-sibling, step-sibling and siblings related through adoption); and the child or parent of a Graduate Staff member’s spouse, domestic partner or household member.
- A “household member” is (i) people related by blood or affinity; (ii) people legally married to or in a domestic partnership with one another; (iii) people formerly married to or in a domestic partnership with one another regardless of whether they still reside in the same household; (iv) people who have a child in common, regardless of whether they have been married or domestic partners or have lived together at any time; and (v) people who are not related by blood or affinity and who are or have been in an intimate relationship, regardless of whether such people have lived together at any time.
3 bereavement days
1 Cultural Heritage Day, which is intended to allow Graduate Staff an opportunity to celebrate a day that is meaningful to them and their cultural heritage. Subject to review and approval by program leadership
Up to 103 Paid Leave Days, which may be used for medical, parental, and/or caregiver leave(s) for qualifying reasons that are consistent with this policy and applicable laws at least once and at any time during an ACGME-accredited or CODA-accredited program, starting the day Graduate Staff are required to report. The sections below on medical, parental, and caregiver leave provide additional information on leave time and pay. Also, please see Procedure for Requesting a Leave of Absence below for details on how to apply for a leave.
Professional Development: in addition, up to five (5) Paid Leave Days can be used for conferences, interviews, or other professional development activities, subject to approval by program leadership. If additional Paid Leave Days are needed for interviews, such time may be provided at the discretion of program leadership.

Graduate Staff will not be compensated for unused PTO at the conclusion of the academic year and may not carry over unused days into the next academic year, unless otherwise required by law. These days are replenished annually, according to the start date listed on the Graduate Staff member’s contract.

LEAVES OF ABSENCE

A leave of absence is an excused absence from work for an approved reason with supporting medical documentation and/or other applicable forms. Graduate Staff may request leaves of absence for all the reasons enumerated in the Family & Medical Leave Act (FMLA), including the military family leave entitlements, as well as personal reasons or as medical accommodations. NYPH may also provide additional leave time and continuation of benefits for Graduate Staff as defined by current Hospital policy and applicable state, city and federal laws such as the Americans with Disabilities Act (ADA) and New York State Paid Family Leave Law (PFL).

The FMLA provides eligible Graduate Staff with up to 12 weeks of unpaid leave in a rolling 12-month period for their own illness or injury; or to care for a family member. Leave to care for a covered injured or ill service member can be taken for up to 26 weeks in a rolling 12-month period. To the extent permitted by law, FMLA will run concurrently will all qualifying leaves of absence, including the PFL.

Leaves of absence should be requested as soon as the need for leave is known, even if the exact date(s) of leave is not yet known. Graduate Staff may contact the GME Office for additional information. Requests for personal leaves of absence, including leaves of absence for non-ACGME related activities, will be carefully considered in accordance with applicable laws and the operational needs of NYPH.

PROCEDURE TO REQUEST A LEAVE OF ABSENCE
In order to request a leave of absence, or extend an existing leave of absence, Graduate Staff should notify the GME Office at GMEoffice@nyp.org. In addition to submitting the leave of absence request to the GME Office, the Graduate Staff must contact the Hartford either by phone (888-899-2374) or online (mybenefits.thehartford.com/login). Additional forms may need to be completed as requested by the Hartford for leave related to medical, caregiver, parental, and military leaves. When reasonably foreseeable, Graduate Staff members should provide up to 30 days advance notice to their program leadership and the GME Office when requesting a leave of absence.
MEDICAL LEAVE
Medical leave is available to support Graduate Staff needs for time away from work to recover from a serious health condition that renders them unable to perform the essential functions of their position. A ‘serious health condition’ is an illness, injury, impairment or physical or mental condition that requires inpatient care or continuing treatment by a health care provider.
CAREGIVER LEAVE:
Caregiver leave is available to provide care to an Eligible Family Member with a Serious Health Condition. A Serious Health Condition is an illness, injury, impairment, or physical or mental condition that involves Inpatient Care or continuing treatment by a Health Care Provider.

ELIGIBLE FAMILY MEMBERS – DEFINITIONS
For purposes of caregiver leave, Eligible Family Members are defined as follows:
1. Spouse: A Spouse is an employee’s husband or wife or spouse as defined or recognized under New York State law for purposes of marriage.
2. Domestic Partner: A Domestic Partner (DP) is the employee’s same-sex or opposite-sex partner named in a Domestic Partnership as permitted under the laws of New York State and the City of New York for couples that have a close and committed personal relationship.
3. Parent: A Parent is the employee’s biological, step, foster or adoptive parent when the employee was a child.
4. Parent-in-Law: A Parent-in-Law is the biological, step, foster or adoptive parent of the employee’s Spouse/DP when the Spouse/DP was a child.
5. Child: A Child is the employee’s biological, adopted, step or foster child, or a Legal Ward, who is under age 18. A child may be covered under the NYSPFL Law even if the child is over age 18 if they are incapable of self-care because of a physical or mental disability.
6. Grandparent: A Grandparent is the parent of the employee’s biological, step, foster or adoptive parent when the employee was a child.
7. Grandchild: A Grandchild is the biological, adopted, step or foster child, or a Legal Ward who is under age 18, of the employee’s Child.
8. Sibling: A sibling is a Graduate Staff member’s biological or adopted sibling, a half sibling or stepsibling.
PARENTAL LEAVE:
Parental leave is available to parents for the birth, adoption or surrogacy of a child (for birthing parent or the receiving). Graduate Staff are eligible for up to 26 weeks of Parental Leave, a portion of which will be paid.

Parental leave time must be taken consecutively and within 52 weeks after the birth, adoption or surrogacy of the child.

DEFINITIONS: For purposes of this policy, the Parent is defined as the person who
will be responsible for regularly providing the child with the majority of its care during the entire period of parental leave. When requesting leave, Graduate Staff must certify that they will be the child’s Parent in accordance with this definition—(a) biological; (b) adoption; (c) surrogacy (for birthing parent or the receiving).
PAY DURING MEDICAL, CAREGIVER & PARENTAL LEAVE
In accordance with ACMGE Institutional Requirement IV.H.1.a, each Graduate Staff member shall be permitted a total of (6) weeks of paid medical, parental, and caregiver leave(s) of absence for qualifying reasons that are consistent with the applicable state and federal laws, at least once and at any time during the Graduate Staff program, starting on the day the Graduate Staff member is required to report (ACGME Leave Time). The first (6) weeks of the first approved medical, parental, or caregiver leave shall be provided to the Graduate Staff member at an equivalent of 100 percent of their salary. One (1) week of paid time off shall also be reserved for use outside of the first six (6) weeks of paid leave during the academic year that a Graduate Staff member takes his/her first paid medical, parental, or caregiver leave.
The Paid Leave Days and Vacation days provided by NYPH meet this ACGME requirement.
- DURATION AND PAY DURING MEDICAL AND CAREGIVER LEAVES
  - Medical and Caregiver Leave time will run concurrently with all applicable NYP leave policies, NYS and federal Leave Laws such as FMLA, and ACGME requirements, unless otherwise required by the Leave Laws.
  - As mentioned above, Graduate Staff covered under this policy will receive 6 weeks of paid ACGME Leave Time. This may be used for Medical and/or, Caregiver leave and will run concurrently with the FMLA, the Leave Laws and other applicable leave-related laws (i.e., short-term disability, etc.), as may be applicable These 6 weeks will be taken from the Graduate Staff member’s Paid Leave Days’ bank.
  - After utilizing the 6 paid weeks of ACGME Leave Time, Graduate Staff may be entitled to additional paid leave time using Paid Leave Days and/or sick time.
  - For Graduate Staff members on Medical leave who qualify for FMLA time, the 6 weeks immediately following the ACGME leave time would be protected under the FMLA. If a Graduate Staff member is not eligible for FMLA or has exhausted their FMLA entitlement, they may also be eligible for a leave of absence as a reasonable accommodation in accordance with applicable federal, state and local laws (i.e., the Americans with Disabilities Act, the New York State Human Rights Law and/or the New York City Human Rights Law). Additional leave time approved will be paid using available Paid Leave Days and/or sick time.
  - For Graduate Staff members on Caregiver leave who qualify for FMLA, the 6 weeks immediately following the ACGME leave time would be protected under the FMLA. Where applicable, Graduate Staff members may be eligible to receive partial wages under the New York State Paid Family Leave Law (NYS-PFL) for additional time approved under FMLA.
  - Graduate Staff who are not eligible for Paid Family Leave, or exhaust their Paid Leave Days and Sick days, but are approved for additional leave of absence will be unpaid, but will have the option to use available vacation days. Graduate Staff must provide written notice to the GME Office should they choose to be paid using vacation time.
- o DURATION AND PAY DURING PARENTAL LEAVES
  - Birthing Parent
    - During the disability period of the Graduate Staff member’s leave, which covers the time needed to miss work due to their own serious health or pregnancy-related condition, in addition to the 6-8 weeks post-partum period (Normal deliver: 6 weeks, C-section: 8 weeks if medically certified), Graduate Staff will be paid from their Paid Leave Days bank. Note that this paid time fulfills the minimum 6 paid weeks required under ACGME Institutional requirement IV.H.1.a.
    - After the disability period, Graduate Staff may be eligible for partial wages for an additional 12 weeks under the PFL.
    - Once Paid Family Leave is exhausted, Graduate Staff can choose to use available vacation time to receive full pay for additional time taken.
    - Graduate Staff that are not eligible for Paid Family Leave or wish to receive full pay can choose to use available vacation time. Graduate Staff must provide written notice to the GME Office should they choose to use vacation time.
  - Non-Birthing, Adoptive, or Surrogacy Parents
    - Graduate Staff covered under this policy will receive 6 weeks of paid time for Parental Leave, which fulfills the minimum 6 paid weeks required under ACGME Institutional requirement IV.H.1.a. This time will come from your Paid Leave Days bank.
    - In addition, Graduate Staff may also be eligible for partial wages for an additional 6 weeks under the NYS Paid Family Leave Law.
    - Once Paid Family Leave is exhausted, Graduate Staff can choose to use available vacation time to receive full pay for additional time taken.
    - Graduate Staff that are not eligible for Paid Family Leave or wish to receive full pay can choose to use available vacation time. Graduate Staff must provide written notice to the GME Office should they choose to use vacation time.
    - Additional Considerations
      - Graduate Staff who choose to delay their parental leave start date are only eligible for the leave duration up to 26 weeks within 52 weeks of the date of birth, adoption or placement. Any delayed Parental Leave start dates are subject to the discretion and approval of the Program. Graduate Staff should contact the GME office and the Hartford to discuss any delays or changes to their leave. See Section A for additional information.
      - Graduate Staff who choose to return to work before their 26 weeks are exhausted, will forfeit the remainder of the Parental Leave duration.
      - To the extent permitted by law, all paid parental leave time will run concurrently with all applicable NYP leave policies, New York State and federal leave laws, and ACGME requirements.
NEW YORK STATE PAID PRENATAL LEAVE Eligible Graduate Staff can use protected time off for prenatal care for up to 20 hours of healthcare services received during a pregnancy or related to a pregnancy. Under Hospital policy, all Graduate Staff who are the birthing parent, defined as the parent directly receiving the healthcare services, are eligible to use up to 20 hours of paid prenatal time during any 52-week period for the reasons set forth below:
- Physical examinations
- Medical procedures
- Monitoring and testing
- Abortion care or post miscarriage examinations
- Fertility treatment or care appointments, including in vitro fertilization
- Or discussions with a healthcare provider related to pregnancy.
  
  Eligibility: Graduate Staff who are the birthing parent are eligible to use paid prenatal leave from their date of hire. There is no waiting period. Paid prenatal leave is for prenatal care appointments only and cannot be used for post-natal care or during leave of absence for birth.
  
  Procedure: To receive paid prenatal time, please notify your program director and program coordinator. Please note, Graduate Staff are not required to disclose or provide written medical information. Once requested, this time can be coded as
  “prenatal” by your program director or coordinator. Graduate Staff do not need to contact the Hartford to utilize paid prenatal time.
  
  Pay & Use: Paid prenatal leave pays up to 20 hours at the Graduate Staff member’s regular rate of pay and is pulled from a separate bank. This time does not impact Graduate Staff’s vacation, sick, or paid leave days. Prenatal time may be taken in one hour increments up to a total of 20 hours. Once paid prenatal time is exhausted, team members can choose to use any remaining sick or vacation time to receive pay for a prenatal appointment.

BENEFIT COVERAGE WHILE ON LEAVE OF ABSENCE:

During a medical illness or injury leave of absence, NYP will ensure the continuation of health and disability insurance benefits for residents/fellows and their eligible dependents during any approved medical, parental, or caregiver leave(s) of absence. In addition, group benefit coverage will continue under any approved statutory disability plans.

Group Benefits will be suspended if the Graduate Staff member is not receiving payments via Hospital policy or statutory disability benefits. Once Group Benefits are suspended, the Graduate Staff member must remit the appropriate premiums on a monthly basis directly to NYP’s vendor, Inspira, to continue benefit coverage through NYP. Graduate Staff members may choose to continue or discontinue all or some benefits for the duration of their leave, by contacting Inspira directly and specifying which services they wish to continue or discontinue. Group benefits are reinstated the day the Graduate Staff member returns to work and payment will resume through payroll deductions. Inspira can be reached at the information below:

Phone | (888) 678-7835
Email | directbilling@inspirafinancial.com
Inspira Mailing address
PO Box 953374
St. Louis, MO 63195-3374s

GRADUATE STAFF RESPONSIBILITIES:

Graduate Staff should provide reasonable advance notice to the GME Office and the Program Director when the need for leave is foreseeable. If it is not foreseeable, notice must be given as soon as the need for leave is known, even if the exact dates are not yet known. Graduate Staff are also required to comply with all applicable call-in procedures for reporting an illness. Requests for leave may be denied if notice is not provided as required.

While on medical or caregiver leave, Graduate Staff are required to provide recertification of the medical condition as requested by NYPH and permitted by law.

Graduate Staff who are absent for 1 scheduled workweek or more, for their own personal illness or injury (including maternity and work-related incidents) must be medically cleared to return to work by Workforce Health & Safety (WH&S) prior to returning to work. Graduate Staff who are on a leave of absence for any reason other than their own personal illness or injury must notify their Program Director and the GME Office to discuss expected return to work date and scheduling.

Graduate Staff are not permitted to perform any gainful employment during a leave of absence.

LEAVE OF ABSENCE FOR NON-ACGME ACTIVITIES:

It is the policy of some programs to allow Graduate Staff to take extended time off from their training program to participate in academic, educational, leadership, or research activities that are not part of the program’s standard curriculum in order to further their clinical career. For example, Graduate Staff may intend to participate in scholarly activities, obtain a Masters of Public Health, participate in a leadership fellowship, or conduct NIH-funded bench or clinical research. Please note, however, that this is separate and apart from any medical, caregiver, parental or prenatal leaves discussed above.

While on leave for non-ACGME activities, the Graduate Staff will be listed in the ACGME program roster as “In Program but Doing Research/Other Training (intended to resume accredited training in this program).”

The institution is under no obligation to approve a leave of absence for non-ACGME activities; if the request is denied it cannot be appealed.

PROCEDURE FOR REQUESTING LEAVE FOR NON-ACGME ACTIVITY:

The Graduate Staff member must notify the program and the GME office at GMEoffice@nyp.org at least 120 days in advance of leaving the program.

The Graduate Staff must obtain prior written approval from the Program Director.

For activities that will take place at a location/institution external to NYP, the Graduate Staff must also obtain prior written approval from the DIO.

The request for leave must include the following:

The purpose of, and the rationale for, the leave;
The duration of the leave and the dates of the proposed leave;
The location where activities will take place (name of institution, program, supervisor/director);
Whether the Graduate Staff will require an extension of training;
Note: In situations where the leave results in an extension of training, and further results in the program exceeding the approved resident/fellow complement, when the Graduate Staff returns, the program must request from the ACGME a temporary increase in program complement.
Whether the Graduate Staff may need to repeat any rotations prior to returning to residency/fellowship; and
The anticipated graduation date of the Graduate Staff.

BENEFITS DURING A LEAVE OF ABSENCE FOR NON-ACGME ACTIVITIES:

NYPH benefits will be discontinued for the duration of the unpaid leave of absence. In accordance with applicable laws, COBRA-eligible Graduate Staff will be given the opportunity to continue coverage. Graduate Staff should contact HR connects at hrc@nyp.org or 646-697-4727 regarding continuation of benefits under COBRA.

NOTIFICATION TO GRADUATE STAFF OF IMPACT ON TRAINING & CERTIFICATION:

CERTIFICATION

A Graduate Staff may be required to extend their training in order to fulfill all program requirements. A leave of absence may affect a Graduate Staff member’s eligibility for promotion, ability to complete their training within expected time frames or eligibility for specialty board examinations. This determination as to whether a Graduate Staff member’s leave affects their eligibility for promotion or extends their training time frame to fulfill all program requirements is made by the Graduate Staff’s Program Director, in coordination with the GME Office, and in accordance with Program, ACGME Review Committee, and specialty/subspecialty board requirements and policies.

Prior to taking such leave, the program must provide the Graduate Staff with information regarding the impact of such leave on the criteria for satisfactory and timely completion of the program and the Graduate Staff’s eligibility to participate in examinations by the relevant certifying board(s).

REQUIREMENTS FOR RETURNING TO THE PROGRAM:

In order to return to the program, the returning Graduate Staff may need to complete the onboarding process prior to rejoining the program. Additionally, the Graduate Staff may be required to repeat some rotations as determined by the program.

COMPLEMENT CHANGES:

In situations where a leave of absence results in an extension of training or results in non-promotion, and further results in the Program exceeding the approved Resident complement, when the Graduate Staff member returns, the Program must request a temporary increase in Program complement from the ACGME (with prior GMEC approval).

REVIEW/OVERSIGHT

This policy must be available for review to Graduate Staff members at any time in the GME office and can also be accessed on the NYP Graduate Medical Education page. In fulfilling institutional oversight responsibilities, the GMEC will provide oversight and monitor implementation of this Policy by programs and requests for leave of absence, including medical, parental, or caregiver leaves of absence, on at least an annual basis.

APPROVAL DATES:
Approved by GMEC: April 2010
Approved by The Medical Board: May 2010
Reviewed by GME Office: September 2014
Reviewed by GME Office: May 2019
Approved by GMEC: September 2020
Approved by The Medical Board: October 2020
Approved by GMEC: September 2021
Approved by The Medical Board: September 2021
Approved by GMEC: July 2022
Approved by The Medical Board: October 2022
Approved by GMEC: August 2025
Approved by The Medical Board: October 2025