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Medical Education
Medical Student Education

Medical Student Duty Hours on Clinical Rotations

Learning and Working Environment Principles
  1. A supportive educational environment with a commitment to patient safety and student well-being should be in place for the rotation.
  2. Accomplishment of the core clinical objectives (see core clinical experience card and website for the particular rotation) should be reasonable within the designated time frame of the rotation.
  3. Didactic and clinical education have priority in the allotment of students’ time and energy.
  4. The rotation must ensure that qualified residents, staff and faculty provide appropriate supervision of the medical students.
  5. The student duty hour guidelines should be flexible to address site variation and the difference in roles between students and residents, and to achieve the best possible balance between learning opportunities and student well being.
Duty Hours Policy for Third and Fourth Years

Duty hours are defined as all clinical and academic activities related to the rotation; i.e. patient care (both inpatient and outpatient), out-of-hospital/clinic time spent on patient notes, administrative duties related to patient care, time spent in-house during shift activities, and scheduled activities, such as conferences.

  • Duty hours must be limited to 80 hours per week, inclusive of all direct patient care activities (whether completed in-house or at home). Such activities may include writing patient notes and research specifically aimed at writing those notes, as well as preparing to present during daily rounds. Duty hours also include didactic teaching sessions and longitudinal clinic. Duty hours do not include time spent studying for exams or for preparation for formal presentations (such as journal clubs, handout development).
  • Medical students must be provided with 24 hours off within seven days of duty, averaged over 4 weeks, free from all educational and clinical responsibilities.
  • Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours per day for patient care, plus 4 additional hours for educational activities (e.g. transition of care, conferences).
  • At-home call must not be so frequent as to preclude rest and reasonable personal time for each student. When the student is called into the hospital, the hours spent in-house are counted toward the 80-hour limit.
  • Night float rotation should not exceed 6 nights in a row; at a minimum there are 8 hours off between shifts.
  • The student duty hour guidelines will be communicated to students and supervising physicians (including residents, fellows and faculty) in writing as well as to students verbally at each clerkship orientation.
  • If a student is concerned about a violation of the duty hours policy at a site, the student can fill out the confidential duty hours form (see below), which will go to the clerkship director anonymously.

If you have encountered a violation of the duty hours policy as described above:

  1. Use the “SAFE” (Supporting a Fair Environment) reporting mechanism—a single form for you to confidentially report duty hours violations. This reporting mechanism supports the RESPECT questions distributed through our course evaluation system and managed by your course curriculum team.

Effective October 10, 2009. Revised September 1, 2017.