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 student well-being and patient safety.

Pre-clerkship Workload Policy

All efforts are made to ensure that students are provided sufficient time each quarter to prepare for the required MD curriculum, explore elective and scholarly activities, and maintain wellness and self-care.

The anticipated student weekly workload should not exceed 66 hours of in-class and advance preparation for sessions in the required MD program curriculum. The 66-hour limit is based on 60 hours for required courses within that quarter and assumes that students will enroll in 2 units/quarter to meet their Scholarly Concentration requirement.

The total hours are based on the Stanford University unit policy that states: "Every unit for which credit is given is understood to represent approximately three hours of actual work per week for the average student.” Note that the School of Medicine MD Program Autumn Quarter for both first- and second-year medical students is extended beyond the typical quarter length and therefore the unit count is higher though the weekly workload still adheres to the 66 hours/week guidance.

The anticipated weekly workload may vary by student depending on attendance and engagement in courses (i.e., viewing lecture videos) and student learning styles. All efforts are made to ensure that the total weekly hours do not exceed the 60 hours and data will be collected by students as part of end-of-quarter course evaluations to continually monitor the workload based on student experience.

To further ensure that students have enough open time in their weekly schedule, Wednesdays are left free from required curriculum. There are exceptions to this policy made for clinical skills baseline exam in the Mini-Quarter, during final exam week, and Q6 (MS2 Spring Quarter). Any additional exceptions must be submitted to the Committee on Curriculum and Academic Policy for approval.

In addition, students must adhere to the quarterly curriculum policy, Section 4.15: Curriculum and Assistantship Limits, that states any student undertaking 100% MD curriculum effort may obtain up to an additional 25% appointment effort.

Concerns about violations of this policy can be shared with the Assistant Dean for Preclerkship Education.

Clerkship Duty Hours Policy

  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. Students must have a minimum of 8-hours free of duty between scheduled duty periods.
  3. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.
  4. 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, academic, and administrative activities.
  5. All patient care must be supervised by qualified residents and/or faculty.
  6. 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.

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 14-hours free of duty after 24-hours of in-house duty.

Concerns and incidents related to a violation of student duty hours can be reported directly in Qualtrics and this can be done anonymously. Dr. Tracy Rydel, Assistant Dean for Clerkship Education will receive the report.

updated August 2021