Student (Learner) Work Hour Restrictions

SOP #:
8.8.1
Version #:
4
Implementation Date:
January 17, 2018
Last Reviewed/Update Date
February 11, 2026
Approval by EAC
March 26, 2026
Expiration Date
March 26, 2029

Rationale

In an effort to support learner success and wellness, the Brody School of Medicine (BSOM) implements a comprehensive policy for monitoring educational workload and duty hours across all four years of the medical curriculum. This policy is designed to ensure that students have adequate time for learning, self-directed study, and personal well-being, in compliance with the standards set by the Liaison Committee on Medical Education (LCME), particularly Element 8.8. The policy is based on the Accreditation Council for Graduate Medical Education (ACGME) guidelines and best practices in medical education.

Scope

This policy applies to all medical students enrolled at the Brody School of Medicine and encompasses all required educational and clinical activities in both the foundational (pre-clinical, M1-M2) and clinical (M3-M4) phases of the curriculum. This includes all scheduled classes, labs, clinical rotations, and any other mandatory activities. Time spent on academic preparation, reading, and studying is also monitored to ensure a manageable overall workload.

Definitions

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

Scheduled Activities:  All required class sessions, lectures, labs, small group sessions, and other mandatory scheduled events.

Required Out-of-Class Activities:  Mandatory pre-work, assigned readings, online modules, and any other required activities that are not part of the scheduled curriculum.

Responsibilities

Medical students (learners)

Students are expected to comply with this policy and accurately and timely complete all required workload and duty hour monitoring forms. If a student anticipates or experiences a work hour violation, they should first address the issue with the Course or Clerkship Director. If unresolved, the concern should be escalated to the Office of Student Affairs.

Office of Student Affairs

This office is responsible for the central collection and review of all student workload and duty hour data from the LMS. The Office of Student Affairs will investigate all reported violations and work with course/clerkship directors to resolve them. They will also prepare summary reports for the Executive Curriculum Committee.

Executive Curriculum Committee

This committee will review summary reports of student workload and duty hours to ensure compliance with this policy and to identify any trends or systemic issues that may need to be addressed.

Policy Statements

Foundational Curriculum (M1-M2)

  • Scheduled Activity Limits: The total number of required scheduled activities (e.g., lectures, labs, small group sessions) for students in the foundational curriculum should not exceed 25 hours per week, when averaged over a block or term. This aligns with standards from a majority of accredited U.S. medical schools.
  • Total Workload Limit: The total educational workload, which includes all scheduled activities, required out-of-class work, and estimated independent study time, should not exceed 60 hours per week on average. This comprehensive limit is a widely adopted best practice to ensure adequate time for self-directed learning and personal well-being.

Clinical Curriculum (M3-M4)

  • 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: Duty periods must be limited to a maximum of twenty-four (24) consecutive hours. Learners may be asked to remain on site for up to four (4) additional hours for patient care transitions or educational activities.
  • Rest Periods: Following twenty-four (24) hours of in-house call, learners must have at least fourteen (14) hours free from required clinical clerkship activities. Students must also have a minimum of one (1) day in seven (7) free from clinical work, averaged over a four-week period.

Monitoring Procedures

Foundational Curriculum (M1-M2)

  • System: Student workload will be monitored using an assessment form through REDCap.
  • Frequency: The assessment will be delivered twice a year, at the end of the fall and spring terms.
  • Survey Content:  Assessment questions will ask students (or learners) to estimate their weekly time spent in scheduled academic activities (i.e., classes, labs, and required sessions), mandatory out‑of‑class work, and other school-related activities (i.e., independent study, review, and exam preparation)
  • Failure to Complete: If a medical student fails to complete this assessment by the prescribed completion date, they will receive In Progress (IP) grades for their coursework for that term. This IP designation will only be removed once this assessment is completed.  Failure to complete this assessment may lead to referral to the Professionalism and Community Standards Committee.

Clinical Curriculum (M3-M4)

  • System: A REDCap assessment form will be used to monitor clinical duty hours for all required courses and clerkships.
  • Frequency: Students are required to complete and sign off on their work hours forms on a biweekly basis.
  • Failure to Complete: If a medical student fails to log their clinical duty hours by the time their grade is ready for submission by course leadership, they will receive an In Progress (IP) grade. This IP designation will only be removed once work duty hours are completed. Failure to complete clinical duty logs may also lead to referral to the Professionalism and Community Standards Committee.

Procedures for Implementation and Review

This policy will be reviewed every three years by the curriculum subcommittees and approved by the Executive Curriculum Committee. It will be disseminated to all students, faculty, and staff at the beginning of each academic year.

Applicable Laws, Regulations & Standards

  • LCME Standard 8, Element 8.8
  • Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements

References

[1] Liaison Committee on Medical Education. (2023). Functions and Structure of a Medical School: Standards for Accreditation of Medical Education Programs Leading to the MD Degree. https://lcme.org/publications/

[2] Institute of Medicine (US) Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve Patient Safety. (2009). Resident Duty Hours: Enhancing Sleep, Supervision, and Safety. National Academies Press (US).

[3] Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Academic Medicine, 81(4), 354-373.

[4] Young, J. Q., Van Merrienboer, J., Durning, S., & Ten Cate, O. (2014). Cognitive Load Theory: implications for medical education: AMEE Guide No. 86. Medical Teacher, 36(5), 371-384.

[5] Harvey, C. J., Leedham-Green, K. E., Koppel, C., Maini, A., Smith, S. F., Morrell, M. J., & Emerson, M. (2025). Improving medical students’ learning strategies, management of workload and wellbeing: a mixed methods case study in undergraduate medical education. BMC Medical Education, 25(1), 606.

[6] Fletcher, K. E., Reed, D. A., & Arora, V. M. (2011). Patient safety, resident education and resident well-being following implementation of the 2003 ACGME duty hour rules. Journal of General Internal Medicine, 26(8), 907-919.