Doctoral students at Boston University could be forced to take a leave of absence and lose their health insurance if they do not comply with new guidelines requiring them to return to campus in the fall.

The guidelines, announced on Friday, mandate that “continuing students with teaching service appointments for fall 2020 who are unable to return to Boston University by September 1 should be expected to take a leave of absence,” according to a memo released last week by University Provost Jean Morrison and Associate Provost for Graduate Affairs Daniel Kleinman. “Alternatively, at the discretion of the program and school/college, the student may attend classes remotely without stipend support.”

PhD student Lena Brucia Breitenfeld now has to make a decision: come to campus in-person and continue work as a teaching fellow, or lose her salary and health insurance.

“This policy is threatening to leverage people's insurance coverage against them and forcing them to choose between their safety and their health care coverage,” she said. “It would be really, really dangerous to make people choose between life saving health care and their safety.”

For Breitenfeld, a transgender woman, this could mean a choice between continuing to have access to life-affirming hormones and other medical needs, or giving up health insurance and exposing herself to the public during a pandemic. According to the guidelines, she has until August 1 to let her program know if she will be returning, which she said could affect her housing situation too.

“A couple of my possible living situations are to live with a friend of mine who is immunocompromised, or to live with my parents, one of whom is a senior citizen,” Breitenfeld said. “I don't know if it's going to be safe at all for me to go in and thus expose members of my family and my friends.”

Boston University suggested that it may not be possible for students with positions as research assistants to carry out their jobs remotely, according to a “Frequently Asked Questions” section on the school’s website regarding the policy.

“Many of the service responsibilities of PhD students, particularly those with teaching service appointments, cannot be readily done remotely,” the post reads. “BU cannot provide stipends to students who are unable to complete their service responsibilities.”

In a statement to WGBH News, a spokesperson for the university said there are some exceptions: namely if a student is able to enroll in courses remotely, the university will continue to cover their health insurance but not their salary.

“BU cannot pay PhD students who are unable to do their 'service;' generally, PhD students must be in the Boston area and able to be on campus in order to complete their service responsibilities,” the spokesperson said. “Generally speaking, we expect PhD students to be on campus to receive stipends… For a PhD student who cannot return to campus in the fall and who believes they can effectively do service work off campus, they may contact their program director of director of graduate studies to discuss what options are available.”

Alicia Matz, a PhD student in the university’s Classics department, has Type-1 diabetes, and has applied for a “workplace readjustment” in the hopes that she will be able to continue her work remotely as an exception to the new rule.

“If I'm not granted it and I have to go into campus, I would probably have to do that,” she said, “in order to keep myself insured and have the ability to buy insulin and other medical supplies I need.”

The policy also means international students who are unable to travel to campus by September will also forgo their insurance and salaries, according to the school.

“Unfortunately, tax laws and payroll surcharges in both the United States and within a student’s home country, make it financially and operationally infeasible to provide stipend support to international PhD students who are not able to come to the U.S.,” the school’s website reads. “There are additional regulatory complexities with respect to paying new international students who are unable to come to the U.S. by the beginning of the semester.”

Ian Chandler-Campbell, a doctoral student in Education and Human Development, said he’s particularly concerned about the impact this policy will have on Black and Indigenous people of color, who have been disproportionately affected by COVID-19.

“This policy is forcing these students to choose between being able to financially survive and have medical insurance during a global pandemic and protecting their physical well-being against a disease that disproportionately affects these underserved communities," he said.

“This is not ethical to force us to make that choice,” Chandler-Campbell continued. “BU talks a great deal about supporting us — we literally want them to put their money where their mouth is.”

Ana Reboredo Segovia, a PhD student and research assistant, said she finds the communication around the policy to be vague and confusing.

“They haven’t answered questions about how proper ventilation in classrooms will be provided. How will they measure that? If a teaching fellow becomes sick, are they just expecting us to trade off duties? That’s not how it works,” she said. “Personally, I don't relish the idea of having to go back to a classroom, especially when the administration isn't providing personal protective equipment to the students or to the teaching staff.”

Students and teachers will be expected to wear face coverings while on campus and required to provide their own personal protective equipment, according to the university’s website.

Chandler-Campbell, who said he plans to return in the fall, finds this policy concerning.

“They've specifically refused to provide PhD students who are working as staff with any type of PPE,” he said. “And what am I going to do if a student forgets to or refuses to wear a mask?”

Breitenfeld echoed this concern, not just for the PhD students returning to campus but for the larger community surrounding the school.

“It's not just putting graduate workers, faculty, staff and students at Boston University at risk, it's also putting the general community of Boston at risk because the university is asking us to go out into the world,” she said. “This isn't just a concern for people in the Boston University community. It's it's a concern of everybody that lives nearby.”

CORRECTION: An earlier version of this article stated that the policy applies to graduate students, it exclusively applies to PhD students. WGBH News apologizes for the error.