3.18: Student Duty Hours and Work Environment

Providing students with a sound academic and clinical education must be carefully planned and balanced with concerns for patient safety and student well-being.

Supervision of students

  1. All patient care must be supervised by qualified physicians or non-physician designees operating within their scope of practice.
  2. Faculty, residents and students must be educated to recognize the signs of fatigue, and adopt and apply policies to prevent and counteract the potential negative effects.

Duty hours

  1. Duty hours are defined as all clinical and academic activities related to the students, i.e., patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.
  2. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.
  3. Students must be provided with one day in seven free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.

In-house call activities
The objective of all call activities is to provide students with continuity of patient care experiences throughout a 24-hour period. In-house call is defined as those duty hours beyond the normal workday when students are required to be immediately available in the assigned institution.

  1. In-house call must occur no more frequently than every third night, averaged over a four-week period.
  2. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours.
  3. Students must have a minimum of 8-hours free of duty between scheduled duty periods. Students must have a minimum of 14-hours free of duty after 24-hours of in-house duty.      

    updated September 2013

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