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Health Provider and Education Roles for Faculty Supervising Students

 

Duality of Interest: Health Provider & Education Roles for Faculty Supervising Students

 

Purpose

To provide expectations and requirements regarding the potential duality of interests concerning the education and health care of UCSF medical students.

 

Background

Faculty physicians, fellows, residents, and other non-faculty instructors & supervisors as well as clinical staff in academic medical centers serve major roles in both teaching and clinical care. From time to time, medical students -­‐ by virtue of illness or learning difficulties -­‐ may need to seek advice, assessment, and/or clinical care from faculty who teach in the medical school. When a student seeks care from a faculty member in the institution in which the student is enrolled, a duality of interest may be created. This policy is established to address the potential duality of interests that arise in these circumstances, in the interests of:

  1. Maintaining the rights of the student to confidentiality with treating providers.
  2. Avoiding the potential that assignments, assessments, grading, and progress could be impacted by a faculty member’s knowledge of a student’s illness or disability status.
  3. Minimizing concerns about favoritism related to special relationships between a faculty and a student.
  4. Ensuring compliance with LCME standards, specifically standard 12.5: Non-Involvement of Providers of Student Health Services in Student Assessment/Location of Student Health Records (Appendix A)

 

Definitions

 

Duality of Interest

A situation in which an individual has multiple responsibilities which may result in conflicts of interest, real or perceived.

May

Allowable in all circumstances; at times with limitations

Must not

Prohibited from engaging in the activity

Should not

It is preferred that the individual not engage in this activity; however, circumstances may occur in which the individual may engage in this activity

Familial or intimate relationships

Close family relationships (first and second-degree relatives, including those by marriage) and social relationships (close family friends.)  Please also refer to the UC policy APM-015 that prohibits romantic and sexual relationships between faculty and students.

 

 

Principles

  1. The physician has a primacy of duty to their patient and is professionally obligated to act in the best interests of their patient.
  2. The student has the right to strict confidentiality of their health and medical conditions, inclusive of both physical and mental health or learning disability.
  • The student may waive their right to confidentiality if the student believes it is in their best interest.
  • Further, limits to strict confidentiality may be necessary to ensure patient safety.  
  1. Faculty and staff are responsible for approaching and working with each student without bias and without favoritism.
  2. Faculty and students must recognize that the appearance of a duality of interest may interfere with the learning environment for both the involved student as well as the student’s peers and must be considered regardless of whether a conflict of interest is truly present.

 

 

Policy

  1. UCSF Faculty and Staff Providing or  who Have Provided Clinical Care Services for a Student
  1. Must not serve in any academic (small group, clinical, or research) supervisory or mentoring role for that student. They specifically must not supervise the student in the clinical setting, provide an academic assessment of the student, participate in assigning grades for that student or participate in making decisions about academic advancement or lack thereof for that student. In the event that no other faculty member is available to supervise a relevant clinical experience that a student requests, the Associate Dean for Students must review the circumstances and may provide a limited waiver to this policy. 
  2. May function as a large group classroom teacher for that student at any time, and may function as a small group teacher for that student as long as they do not participate in assessment or grading activities and may provide general support for classroom-based learning experiences for that student that requires their expertise.
  3. Must not provide written or verbal statements regarding their involvement in the student’s care or the nature of the student’s condition to the School of Medicine administration or other bodies unless specifically requested by the student under their care and after the appropriate consent has been provided. Exceptions to the requirement of consent include the presence of life-threatening physical or mental conditions or other legally covered limits of confidentiality.
  4. The School of Medicine Medical Student Well-Being Program staff may, for continuity purposes, continue to care for a student after university limits on number of visits for that student has been reached. They may not serve in any academic, supervisory, mentoring or assessment role for a student who is are has been under their care.

 

  1. UCSF Faculty who have participated in supervision, assessment, grading, and academic advancement decisions for a student:
  1. Must not solicit that student as a patient in their clinical practice.
  2. May accept a student request for medical care with the understanding that they will adhere to the directives in section A.
  3. Faculty may not provide medical advice or care to their students while they are supervising that student.

 

  1. UCSF Faculty and Staff with Familial or Intimate Relationships with an Enrolled Student
  1. Must not serve in any academic supervisory role for that student. They must not supervise the student in the clinical setting, lead small group sessions involving the student, provide an academic assessment of the student, participate in assigning grades for that student or participate in making decisions about academic advancement or lack thereof for that student.
  2. May serve in a mentoring capacity for situations that do not formally contribute to decisions about academic progress.

 

Policy Limitations

This policy is not intended to prevent the timely intervention by a qualified clinician in case of a medical emergency (e.g., cardiopulmonary arrest, suicidality, homicidality).  Once the student has been stabilized or transferred to the appropriate care site, the faculty member with a duality of interest should relinquish care.

 

In the event a faculty-student relationship specifically or not specifically described in this policy presents a conflict of interest, it is the expectation that the faculty member takes responsibility for managing the relationship based on the best interest of the student patient. Consultation regarding potential or actual conflicts of interest may be sought from the Associate Dean for Students or Medical Student Well-Being. Please also refer to the UC policy APM-015 that prohibits romantic and sexual relationships between faculty and students.

 

In the case of disagreement about the application of any elements of this policy, the default arbiter will be the Associate Dean for Students. Waivers of this policy require consultation and approval of the Associate Dean for Students.

 

Policy Approval

 

UCSF School of Medicine Committee on Curriculum and Educational Policy

Date: 8/1/2017

 

Next Renewal Date:  8/1/2022

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