Policy Number: 410
Date Approved: 03/26/2025
Executive Responsibility: Faculty Curriculum Committee
References: LCME Element 6.3; LCME Element 8.8
410.1 Purpose
In accordance with LCME Element 8.8:
"The medical school faculty committee responsible for the medical curriculum and the program’s administration and leadership ensure the development and implementation of effective policies and procedures regarding the amount of time medical students spend in required activities, including the total number of hours medical students are required to spend in clinical and educational activities throughout the curriculum."
This policy also ensures that students have sufficient time for independent study, self-directed learning, and development of lifelong learning skills in accordance with LCME Element 6.3.
410.2 Foundations Phase Duty Hours Policy
The general structure of Foundations modules is defined by the module director(s) and steering committee members in collaboration with the Department of Medical Education (DME) and approval by the Faculty Curriculum Committee (FCC). Content may be delivered in a variety of modalities, including required in class and out of class activities. The total duration of required in-class activities (inclusive of clinical skills activities) shall not exceed 20 hours per week when averaged over the length of each module. The total duration of all required activities (inclusive of required readings and preparatory activities) shall not exceed 80 hours per week when averaged over the length of each module.
Self-directed learning must be a component of the Foundations curriculum. Students must be involved in formal self-directed learning activities within the Foundations curriculum, in the form of WrightQ.
The FCC will regularly review contact hours within each of the Foundations modules as a part of the formal module evaluation process. Student contact hours are also monitored by DME and reviewed with module directors prior to the beginning of each module.
410.3 Doctoring Phase Duty Hours Policy
Medical students engaged in clinical activity shall not be on duty more than 80 hours per week (averaged over a four-week period). For the purposes of this policy, duty hours are defined as time spent in the hospital or clinics directly related to patient care, on-call time (even if spent sleeping), and any required didactic sessions. Required preparation for patient care and educational activities, such as required didactic sessions, are considered part of duty time. Non-required preparation for patient care or examination study are not considered toward the 80-hour per week limit.
Medical students shall not spend beyond 28 consecutive hours in the clinical setting while on duty. This allows students to remain in the hospital post-call for a few hours in order to complete on-call notes, patient care, and for the educational experience related to their on-call activities that may take place during the morning post-call.
Medical students shall be provided with an average of 1 day in 7 free from all required educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One “day” is defined as one continuous 24-hour period free from all required clinical and educational activities.
Medical students shall not be required to take overnight “call” two evenings prior to the end of clerkship rotation final examination, where applicable.
Students must have adequate sleeping facilities at every teaching site in which 24-hour call activities occur. These facilities must be available to the student 24 hours a day.
The FCC will regularly review duty hours compliance as reported on the end of clerkship evaluations.
410.3.1 Impairment Due to Fatigue
- If a student feels that they may be at risk when operating a motor vehicle because of fatigue or sleep deprivation, they should obtain sleep at the on-site call room before departing the premises or ask someone to take them home.
- Faculty (and residents) shall monitor students for symptoms and signs suggestive of impairment (including learning impairment) due to sleep deprivation and/or emotional fatigue. The faculty must advise the student appropriately if such observations are confirmed.
- Faculty must notify the Clerkship Director of any student who suffers continued, persistent signs of sleep deprivation or emotional fatigue. If the situation persists, then faculty must notify the Associate Dean of Student Affairs.
- Students should notify the Clerkship Director if they feel their learning is impaired due to sleep deprivation or emotional fatigue.
410.4 Duty Hours Violation Reporting
Students can directly report the violation to the appropriate Module/Clerkship Director or Assistant/Associate Director, the BSOM ombudsperson, the Associate Dean for Student Affairs and Admissions, and/or the Associate Dean for Medical Education, who will investigate the report.
At the end of each clerkship, students will be asked about compliance with the Doctoring Duty Hours Policy on the clerkship evaluation. Any reports of duty hours violations will be identified by the Director of Assessment & Evaluation, who will investigate the report.