Supervision of Medical Students

Purpose

To ensure safety of patients and learners, and a supportive environment for student learning and growth in the clinical setting.

Overview

In keeping with our combined duties to patient care/safety and education of students in the practice of medicine, and in keeping with accreditation requirements, this policy describes the requirements to meet the standard of appropriate supervision in the clinical environment.

Related LCME Standards

9.2: Faculty Appointments

9.3: Clinical Supervision of Medical Students

Principles

At UCSF, we value the role of learners in the provision of excellent clinical care. We also embrace the educational principle of graded responsibility to maximally support learners in their development of clinical expertise. We believe that appropriate supervision is also critical to performing assessments of the learner and providing meaningful feedback.

Policy

Students of the UCSF School of Medicine must be appropriately supervised when participating in required or elective clinical activities.

  1. Medical students may not provide care in an unsupervised fashion.
  2. Supervisors must either hold a faculty appointment or be supervised in their teaching and assessment role by an individual who has a faculty appointment and may include physicians, residents, fellows, and other licensed health professional faculty supervising an activity within their scope of expertise or practice.
  3. Students may be supervised at one of two broad levels as determined by the supervisor:
    1. Direct observation: the supervisor is present with the student and the patient
    2. Immediately available Indirect Supervision: the supervisor, while not in the presence of the student and/or patient, is immediately available to the learner and/or at the site of care to provide direct supervision
  4. Determination of appropriate level of supervision is made by the supervisor, based on many factors, including:
    1. Level of training of the student
    2. Previous experience and skill of the student with the clinical activity and setting
    3. Familiarity of the supervisor with the abilities of the student
    4. Acuity of activity and level of risk to patient
  5. Students may not perform procedures without direct supervision.

Accountable Dean or Director

Associate Dean for Curriculum

Director of clerkship or course

Procedures

  1. The supervisor reviews and independently verifies all student findings, assessments, and care plans, and documents this review.
  2. It is the faculty supervisor’s role to ensure that any non-physicians who are engaged in clinical teaching for supervising any student are acting within their scope of practice.
  3. The director of the clerkship or course is responsible for communicating policies and procedures related to supervision to faculty and students participating in their curriculum, and for monitoring compliance with the policies and procedures with a report to the relevant governance committee.
  4. The director of the clerkship or course is responsible for developing and communicating standard procedures through which students can report concerns regarding adequate and appropriate supervision of what they may deem a violation of this policy. Procedures may include, but are not limited to SAFE reporting (to report mistreatment or negative learning environment), direct reporting to a clerkship or course director or coordinator, and documenting concerns in course or clerkship evaluations at the end of the course or clerkship.

Related Policies

  1. Medical Student Documentation Policy

Approval Date and Governing Body: August 14, 2008, CCEP

Last Updated: October 22, 2018