Policy Number: CU.08.01.170808
Applies to: All medical students assigned to participate in clinical and educational sessions
Date: 8/6/2024
1.0 Policy Statement
Washington State University’s Elson S. Floyd College of Medicine seeks to maintain an appropriate balance among clinical activities, educational sessions and unscheduled time for all medical students that optimizes patient safety, student education, and student wellbeing. As such, the College of Medicine establishes as policy that:
- 1.1 In concordance with the Accreditation Council for Graduate Medical Education’s work hours policy standard, clinical and educational work hours must be limited to no more than 80 hours per week, averaged over a four-week period, inclusive of all in-house clinical and educational sessions and clinical work done from home.
- 1.2 Students may voluntarily remain longer than 80 hours in unusual circumstances where, in the student’s judgment, the extra time benefits patient care or the student’s education. Such additional hours must be accounted for in the allocated 80 hours when averaged over four weeks.
- 1.3 At minimum, an 8-hour rest is required between work periods.
- 1.4 Clinical work periods must not exceed 24 hours of continuously scheduled clinical work, except in rare circumstances as outlined below.
- 1.5 In rare circumstances, after handing off all other responsibilities, a student, on their own initiative, may elect to remain at the clinical site for up to four hours in the following circumstances: (1) to continue to provide care to a single severely ill or unstable patient; (2) to provide humanistic attention to the needs of a patient or family; or (3) to attend unique educational events. These additional hours of care or education will be counted toward the 80-hour weekly limit when averaged over four weeks.
- 1.6 Students may be on overnight call or 24 hours of continuously scheduled clinical work no more than every 3rd night (when averaged over a 4-week period).
- 1.7 After 24 hours of in-house call, students should have at least 14 hours free of clinical activities or related educational sessions.
- 1.8 Students must be provided with one day in seven free of all educational and clinical responsibilities, averaged over a four-week period, inclusive of call.
- 1.9 The College of Medicine is responsible for educating students, faculty, and staff about fatigue and fatigue mitigation strategies.
- 1.10 Students will track and report their duty hours in a timely fashion.
- 1.11 The College of Medicine is responsible for overseeing student duty hours and managing any violations of student duty hours.
2.0 Definitions
Clinical Activities
Curricular, time-limited instructional events that are based on or substantially related to the clinical care of patients. Such activities may include, but are not limited to, direct patient care, patient rounds, patient documentation, case conferences and clinical lectures in healthcare delivery that take place as part of clinical training.
Duty Hours
Hours that students spend on their scheduled clinical curriculum activities and/or related educational sessions.
Educational Sessions
Curricular, time-limited instructional events delivered to students to impart knowledge that may, but need not be, substantially clinical.
Clinical Work Done From Home
Tasks done from home that are substantially related to the clinical care of patients, including using an electronic health record to complete clinical activities at home and taking phone calls from home. Reading done in preparation for the following day’s cases, studying, and research done from home are not included in this definition. If the student goes into the clinical environment, this would count towards their clinical duty hours.
3.0 Responsibilities
Office of Educational Affairs
4.0 Procedures
(subject to change – see the Office of Curriculum for updated procedures)
Reporting, Managing and Elimination of Duty Hour Violations
Students will be required to document duty hours in the learning management system. Students should report duty hour violations to the clerkship director with an explanation of the circumstances.
Managing Duty Hour Violations
Violations will be brought to the attention of the Vice Chair of the respective specialty and reported to the relevant Associate Dean of Clinical Education. The LIC and Year 4 co-directors are responsible for oversight of student duty hours and any violations and for reporting to the Clinical Experience Subcommittee of the Curriculum Committee if a pattern of violations exists. The Associate Deans of Clinical Experiences are responsible for resolving violations in duty hours.
5.0 Related Policies
N/A
6.0 Key Search Words
Duty hour restrictions, reporting violations.
7.0 Revision History
Original Approval: 4/13/2016
Policy Number: CU.08.01.161216, CU.08.01.170808
Review/Revision: 8/8/2017, 12/13/2019, 8/6/2024