Student (Learner) Work Hour Restrictions

Rationale

In an effort to support learner success and wellness, the Brody School of Medicine (BSOM) implements work hour restrictions for learners. The policy on learner work hour restrictions is based on 2017 guidelines developed by the Accreditation Council for Graduate Medical Education. ACGME – Common Program Requirements. Learners, residents, and faculty are expected to comply with the work hour restrictions for PGY1s and beyond as outlined.

Scope

All required clinical and educational hours related to a rotation in the clinical years (M3 and M4) are considered work hours. Reading, studying, and academic preparation time are not considered in the determination of clinical work hours. This policy regulates hours per week, duty periods, and periods during which learners should be free of duties.

Definitions

Work Hours: All required clinical and educational activities related to a rotation.

Responsibilities

Medical students (learners)

Learners are expected to comply with the guidelines listed below under the procedures for implementation for work hour restrictions. If, upon advance review of a clerkship schedule or at any other point, a learner notes a work hour violation, the leaner is responsible for first addressing the issue with the Clerkship Director and Coordinator as soon as possible. If the discrepancy cannot be resolved with this conversation, the learner should bring the concern to the Associate Dean for Student Affairs, Clinical Sciences. Learners are expected to accurately and timely complete their Clerkship evaluation and AAMC Graduation Questionnaire (GQ).

Work Hour Restrictions

• Learners shall not work more than eighty (80) hours per week, averaged over a four (4) week period. This includes all required clinical and educational activities.
• Duty periods must be limited to a maximum of twenty-four (24) consecutive hours.
• Leaners may be asked to remain on site for patient care transitions or educational activities after a twenty-four (24) hour shift. This period of time following the twenty-four (24) shift must not exceed four (4) hours.
• Learners shall not be assigned additional clinical responsibilities, such as seeing a new patient, after twenty-four (24) hours of consecutive duty.
• Following twenty-four (24) hours of in-house call, learners must have at least fourteen (14) hours free of required clinical clerkship activities and educational sessions.
• Learners must have a minimum of one (1) day in seven (7) free of clinical work and required educational sessions, when averaged over a 4 week period.

Clerkship Directors and Coordinators

Clerkship Directors and Coordinators will work with learners to address work hour violations and discrepancies and will review data on work hours by Clerkship annually at the Clerkship Directors’ Retreat.

Associate Dean for Student Affairs

The Associate Dean for Student Affairs, Clinical Sciences will address concerns that cannot be resolved with a conversation between the learner and the Clerkship Director and Coordinator. They are responsible for bringing all work hour violation concerns, both resolved and unresolved, to the Clinical Curriculum Committee for review. They will also be responsible for distributing the policy at M3 and M4 Orientation each academic year.

Clinical Curriculum Committee

This Committee will discuss any issues that cannot be resolved with the Associate Dean for Student Affairs, Clinical Sciences and make final decisions on those issues. This Committee will also review work hours data from clerkship evaluations and the GQ yearly at the Clerkship Directors’ retreat.

Office of Medical Education

This office will collect and collate data from the GQ and clerkship evaluations to be reviewed yearly at the Clerkship Directors’ Retreat.

Procedures for Implementation and Review

This procedure is to be reviewed by the M1-M4 Curriculum Committees before approval by the Executive Curriculum Committee every three years.

This procedure will be disseminated by the Office of Student Affairs to students and teaching faculty/administration as part of a ‘student handbook’ during orientation each year.

The Office of Medical Education will distribute this policy yearly with the Institutional Learning Objectives. This office will also coordinate the review of the Graduation Questionnaire and clerkship evaluations yearly at the Clerkship Directors’ Retreat.

Applicable Laws, Regulations & Standards

LCME Standard 8, Element 8