Office of the Dean

O’Dowd Hall, Room 428
586 Pioneer Drive
Rochester, MI 48309-4482
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(248) 370-3634

Office Hours:
Monday – Friday: 8:00 a.m. – 5:00 p.m.

Student Duty Hours

Student Duty Hours

 

Authorizing Body:

Curriculum Committee

Author:

Lynda Misra DO FACP MEd

Date Issued:

October 1, 2015

Last Update:

 

Scope and Applicability:

Clinical Rotations at Beaumont Health

Standard Practice Guideline:

It is readily acknowledged that gaining experience in a wide range of clinical care situations requires a significant time commitment. At the same time, an educational experience can be maximally learned and integrated into subsequent medical care when the learner is well rested and actively engaged in the educational process. Finally, and above all, patient safety (as well as the safety of health care providers) is optimized in an atmosphere in which providers are sufficiently rested. OUWB’s Duty Hours Policy is designed to optimally balance all these considerations, in order to ensure that medical student alertness is not significantly compromised. 

  • Maximum Hours of Work per Week: 
    Duty Hours must be limited to 80 hours per week, averaged over a 4-week period, inclusive of all in-house call activities. 
    Requests for Duty Hour exceptions will not be considered.

  • Mandatory Time Free of Duty 
    Students must be scheduled for a minimum of one day free of duty every week (when averaged over 4 weeks).

  • Maximum Duty Period Length 
    Duty periods of medical students must not exceed 24 hours in duration. 

  • Minimum Time Off Between Scheduled Duty Periods 
    Medical Students should have 10 hours – and must have 8 hours – free of duty between scheduled duty periods.

  • Maximum Frequency of In-House Night Float 
    Medical Students must not be scheduled for more than 6 consecutive nights of Night Float.


Frequently Asked Questions:

  1. What is included in the definition of the term “duty hours” under the requirement “duty hours must be limited to 80 hours per week, averaged over a 4-week period”?

    Duty hours are defined as all clinical and academic activities related to the M3 and M4 required clerkships and courses, as well as the M4 electives. This includes inpatient and outpatient clinical care, in-house call, short call, night float and day float, transfer of patient care, and administrative activities related to patient care such as completing medical records, and ordering and reviewing diagnostic tests. 

    Hours spent on activities that are required by the M3 and M4 curriculum, including assembly days, block lectures, Simulation Learning Institute activities, OSCEs and SHELF exams, are all considered a part of duty hours.

    Duty hours do not include reading, studying, and academic preparation time, such as time spent away from the patient care unit preparing for presentations or journal club.

  2. If a journal club is held in the evening (outside of the hospital and outside of the regularly scheduled duty hours) and attendance is strongly encouraged but not mandatory, would those hours count toward the 80-hour weekly total?

    If attendance is “strongly encouraged,” the hours should be included because duty hours apply to all required hours in the program, and it is difficult to distinguish between “strongly encouraged” and required. 

  3. Do tasks that can be completed at home (i.e., studying ) count toward the 80-hour limit?

    Duty hours do not include reading, studying, and academic preparation time, such as time spent away from the patient care unit preparing for presentations or journal club.

  4. What if a student decides, on his/her own accord, to stay later in the hospital to study, observe an interesting surgery, or attend a specific lecture such as tumor board or mortality and morbidity conference?

    OUWB School of Medicine has implemented the Student Duty Hours Policy because of the belief that it is vital for students to get adequate rest during the clinical curriculum. It is readily acknowledged that gaining experience in a wide range of clinical care situations requires a significant time commitment. At the same time, an educational experience can be maximally learned and integrated into subsequent medical care when the learner is well rested and actively engaged in the educational process. Finally, and above all, patient safety (as well as the safety of health care providers) is optimized in an atmosphere in which providers are sufficiently rested. The OUWB Student Duty Hours Policy is designed to optimally balance all these considerations, in order to ensure that medical student alertness is not significantly compromised. 

    Furthermore, it is a matter of professionalism and a responsibility to patients for students to monitor their own hours to assure that voluntary violations of duty hours limits do NOT occur. 

    Students are expected to respect and operate according to the Student Duty Hours Policy. Working longer than 80 hours/week leads to fatigue that can both diminish learning for students and add unnecessary risk to patient safety; therefore, intentional violation of the Student Duty Hours Policy could represent a lapse in professional responsibility.

  5. How is the OUWB Student Duty Hours Policy Disseminated to Clerkship Directors, Faculty Members, and Students?

    Students are informed of the OUWB Student Duty Hours Policy during the M3 year orientation. The Student Duty Hours Policy is re-emphasized at the orientation to each individual clerkship and sub-internship throughout the clinical years. The policy is posted on the Moodle website for each clerkship and sub-internship and in the OUWB student handbook. The OUWB Office of Medical Education produces an online educational mandatory module which all members of the clinical faculty who interact with students are required to complete annually. The mandatory module includes information such as clinical objectives, duty hour restrictions for students, and evaluation and assessment tools and forms. Each faculty member will be required to certify that the mandatory was read, reviewed, and understood.

  6. How is the Implementation and Effectiveness of the Student Duty Hours Policy Monitored?

    The Student Duty Hours Policy is reviewed and adjusted annually by the Curriculum Committee to reflect compliance regulations, fairness, patient safety and best practices in assuring an effective and productive student-learning environment. Evaluation considers changes in LCME and ACGME regulations, state and federal legislation, best practices, and Beaumont Health patient safety initiatives. The evaluation also considers policy compliance within the clerkships, including the numbers and types of violations, to identify trends or repeat offenses in particular clerkships, departments, or programs. Any revision of the existing policies regarding duty hours or the level of student responsibility in a clerkship must receive the approval of the M3/M4 Curriculum Subcommittee, the Curriculum Committee, the Associate Dean for Undergraduate Clinical Education and the Associate Dean for Medical Education.

  7. What Mechanisms Exist for Reporting Violations of the Student Duty Hours Policy?

    Students may report a violation of the Student Duty Hours Policy by contacting any faculty or clinical staff member. Those faculty or staff members that hear the initial complaint are required to report the violation to either the clerkship director, the Associate Dean for Undergraduate Clinical Education or the Associate Dean for Student Affairs. The clerkship, elective or sub-internship director, the Associate Dean for Undergraduate Clinical Education and the Associate Dean for Student Affairs review any reported violations of the Student Duty Hours Policy in real time to assess compliance with the policy and take action on a case-by-case basis.

    The student-completed portion of the mid-clerkship clinical performance evaluation forms and the summative student evaluation of the clerkship also have an area for a student to identify any duty hour problems. Clerkship directors and the Associate Dean for Undergraduate Clinical Education review these forms. Nevertheless, it is preferred that any anticipated violations of the Student Duty Hours Policy are brought to the attention of faculty, staff, and/or the clerkship or sub-internship director prior to the violation occurring.

Rationale:

 

Procedures:

Definitions:

Related Policies and Forms:

 

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