CLINICAL MEDICINE COMMITTEE
April 18, 2011
Attending: Heald, Buer, A. Innes, D. Innes, Potter,
Jackson, Ham, Herrington, Ms. Newberry, Mr. Zhao, Wilson
The meeting was called to order at 5:02 PM.
Dr. Don Innes presented the new medical student work hour/duty hour standard that has been adopted by the curriculum committee:
Medical students rotating on clinical services (clerkships, selectives and electives) should be subject to the same principles that govern the 80-hour work week for mid-level residents (a maximum of 80 hours of required clinical duties per week averaged over a four week period, no more than 24 consecutive on duty hours with at least 10 hours off between shifts, and on average one day in seven free from all required clinical duties). Four additional hours for the handover of patients (no new patients) after 24 hours is allowed for feedback on clinical decisions and for continuity. Clerkship, electives and selectives directors are responsible for monitoring and ensuring that duty hours are adjusted as necessary. Student duty hours should be set taking into account the effects of fatigue and sleep deprivation on learning and patient care. In general, medical students should not be required to work longer hours than mid-level residents*. (Curriculum Committee 9/9/2004; modified 04/14/2011)
This will be included in the medical student director, which is
available on the SOM website. Each clerkship director should make
sure that their faculty and residents are aware of the new standard,
which is consistent with recommendations of the LCME. Dr. Innes stated
that Dr. Cynthia Brown will be speaking to the rising 3rd
year medical students about sleep and fatigue during the transition
Dr. Innes presented a draft of the new “pay for teaching” template that will be used for the clerkships. This template will help identify faculty who are teaching medical students on the clerkships and will more closely align remuneration to activity. There was considerable discussion about how this will be implemented, how faculty teaching activity will be tracked, and how this might affect the budgeting processes within individual departments. The current plan will utilize the OASIS scheduling system as a means of tracking assigned teaching activities. One concern that was expressed was how this might affect “non-scheduled” ad hoc teaching, student advising and mentoring by individual faculty members, etc. It was thought that unscheduled small group teaching could be entered into OASIS retrospectively so that those types of activities could be captured.
The LCME “residents as teachers” standard was also discussed. There are existing programs and web-based curricula available, and these will be identified for the upcoming resident orientation. All clerkships should distribute a “paper copy” of that clerkships goals and objectives to the faculty and residents who will be involved in teaching and evaluating students.
The meeting was adjourned at 6:04 PM.
William G. Wilson, MD
Chair, Clinical Medicine Committee