|Medical Student Education Hours Policy (AKA Duty Hours)|
The ACGME has established limits on the work hours of interns and residents to help prevent stress, burnout, injury or even medical errors. This medical student policy was developed in accordance with and modeled after the new 2011 ACGME standards for resident duty hours. Medical students need to learn healthy and appropriate strategies for managing potentially long duty hours even at this stage of training. Patient safety, student wellness, and learning lifelong practice habits are an important focus of our medical training at MUSC.
The College of Medicine Clinical Sciences Curriculum Planning and Evaluation Subcommittee considered the issue of student duty hours and initially adopted guidelines (May 2011). The recommendations of the Institute of Medicine (IOM) were used as a guide and modified to apply to our students encouraging wellness without comprising the quality of the education. The guidelines were revised and expanded to consider “education hours” and not merely clinical duty hours and were approved by the College of Medicine Undergraduate Curriculum Committee on January 20, 2012.
Education hours are defined as prescribed education activities/events, including but not limited to patient care, seminars, lectures, rounds, labs, small group activities, etc. Education hours do not include individual study time, individual preparation for planned activities, time spent in additional elective or extracurricular activities (ex. longitudinal electives) or self-directed learning activities.
Policy for Student Education Hours
Years 1 and 2
- In years 1 and 2, scheduled student education hours should not exceed more than an average of 40 hours per week over each block in order to allow time for independent student study and preparation.
Years 3 and 4
- The maximum number of hours that a student may be engaged in education activities in one week is 80 hours, averaged over 4 weeks.
- The maximum shift length is 26 hours. Rotations must encourage the use of alertness management strategies in the context of patient care responsibilities. Call rooms will be provided when the rotation requires overnight call.
- Students on occasion and of their own initiative may remain beyond their scheduled period of duty to continue to provide care to a single patient (e.g. required continuity, academic importance, or humanistic needs of a patient or family).or, for example, to take advantage of a procedural training opportunity, but should still adhere to the weekly hour maximum.
- The maximum frequency of in-hospital call is every third night.
- The minimum time off between scheduled shifts is 8 hours.
- The maximum frequency of in-hospital night shifts is 6 night shifts sequentially.
- As a minimum, a student must have the following time off duty: 1 day (24 hours) per week averaged over 4 weeks.
In the case of clerkships and clinical courses, where hospital team members create the violation of the Student Education Hours guidelines, students may make a direct report to the clerkship/course director or make a direct report to the Associate Dean or Assistant Dean for Students Affairs or designee. If a student reports the violation directly to the course or clerkship director, the course or clerkship director is required to investigate the situation and attempt to remedy it. If the situation is not remedied, the student must report the situation to the Associate Dean or Assistant Dean for Student Affairs.
Students are made aware and reminded of the education hours policy at orientation to each academic year. The portion of the policy relevant to each academic year is included in each syllabus and posted online for reference. In the clinical years, students are asked to report their perception of workload in each required course in addition to reporting any education hours policy violation in Evalue. Evalue notification of an education hours’ violation is sent directly to each clerkship director; each clerkship director is responsible for collecting and reviewing Evalue data on the frequency and nature of education hour violations, and for providing an update to the Clinical Sciences Curriculum Planning and Evaluation Committee twice a year. In addition, student representatives on each of the curriculum planning and evaluation committees (years 1-4) are asked to inquire of peers and report any student concerns to the committee. Clerkships meet with students for feedback sessions (except Family Medicine); the education hours policy is addressed at this time as well.
Revised January 2012