Student Work Duty Hours

Students are not allowed to write orders without explicit approval and oversight by a licensed physician, are not responsible for patient care activities, and do not perform procedures on patients without direct, on site, close supervision by a licensed health care provider.  As a result, student fatigue will not lead to patient care errors or misjudgments.  While students must learn that high quality patient care requires personal sacrifice including, at times, loss of regular sleep patterns, erratic meal times, and absence from customary social events and personal recreation, they must strive to discover compensatory strategies to maintain physical and mental health, as well as appropriate social and personal relationships.  Therefore, the following standards must be followed by students, faculty, and staff:

  1. Students will not be asked or encouraged to provide professional services without appropriate supervision.
  2. Students must be instructed on the signs and consequences of sleep impairment and emotional fatigue.
  3. Students must be provided resources to address the causes and correction of sleep deprivation and/or emotional fatigue.
  4. Students must not spend more than 80 hours a week, averaged over a four week period, in the School of Medicine patient care related environments, classroom activities, or other structured educational programs.  This does not include time that students may elect to study outside the formal, structured, scheduled learning environment.  Students may elect to volunteer time at other health care facilities that are not part of their assigned clerkship experience but must monitor the affect of such activities on their mental alertness.
  5. Student assignment for 24-hour "call" experiences should be scheduled based on student learning requirements and not on any service needs of the institution.  Certain types of learning opportunities arise more frequently in the overnight hours and resource availability is often modified during late night and morning times.  The student will learn about the unique aspect of health care that occurs at that time of the 24-hour day/night cycle.  It is advisable that the supervising faculty/residents provide the student with 4-5 hours of continuous sleeping time if the educational opportunities are not critical to the student's learning.  If extremely valuable learning opportunities override the opportunity for student rest and/or sleep during the 24-hour call time block, the faculty/residents should monitor the student's alertness and ability to participate in the learning program.  If the student's learning is compromised because of fatigue or sleep derivation, they should be allowed to rest.
  6. Students must have adequate, private 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.
  7. If a student feels that s/he 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.  The faculty must encourage the student to avoid driving if they feel the student is impaired because of fatigue or sleep deprivation.
  8. Students must have, at least, one weekend (from 5 p.m. Friday evening until 7 a.m. Monday morning) free of all formal activities associated with a clerkship every 4 weeks.
  9. Faculty (and residents) must 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.
  10. Faculty must notify the Associate Dean of Student Affairs of any student who suffers continued, persistent signs of sleep deprivation or emotional fatigue.
  11. Students should notify the Associate Dean of Student Affairs if they feel their learning is impaired due to sleep deprivation or emotional fatigue.

Last modified: Jan 30, 2013
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