The undersigned licensed physician (“Physician”) agrees to provide, and Washington State University Elson S. Floyd College of Medicine (“WSU”) undergraduate medical education student (“Student”) agrees to participate in, a shadowing experience as stated in this Physician and Medical Student Shadowing Agreement (“Agreement”). Physician and Student will individually be referred to as a Party, and collectively as the Parties. The Parties acknowledge and agree WSU is not a party to this Agreement, and this shadowing experience is not part of a WSU curricular or practicum experience. The Parties acknowledge WSU has no direct or indirect oversight of this activity, and the Parties are voluntarily and freely entering into this Agreement on their own and assuming all risks and liabilities therein.
Definitions
For purposes of this Agreement, shadow or shadowing means an “observational experience which includes a student observing a licensed healthcare provider caring for patients.”1 There is no physical or hands on patient contact when observing the physician performing clinical services or professional tasks.
Purpose
As medical students matriculate in their program, they typically do not get clinical experiences in certain medical practice areas or specialties or get long enough experiences that can help them make informed decisions about medical residency programs or a desired specialty.2 Shadowing a physician is an informative way for a medical student to experience clinical practice of medicine including specialty practice. The purpose of this Agreement is to afford Student a high-quality shadowing experience and Physician assurances that the Student will behave in a safe, compliant and ethical manner.
Student Responsibilities
- Student will not engage in any physical contact with a patient or engage in clinical activities or professional tasks
- Student will identify themselves as a medical student and respect patient autonomy including allowing the patient to decide whether they want a medical student present
- Student represents they have previously received patient privacy (e.g., HIPAA) education and will respect patient confidentiality and comply with all privacy laws
- Student represents they have received WSU required immunizations and health screenings and will provide this information to Physician or the clinical site upon request
- Student represents they received a background check in accordance with WSU requirements, they have no disqualifying crimes or charges, and agree to provide this information to Physician or the clinical site upon request
- Student will follow clinical site policies, and dress code requirements
- Student will act in professional and ethical manner consistent with WSU medical student standards and expectations
Physician Responsibilities
- Physician will provide a positive and professional shadowing experience for Student within the scope of their medical license, practice and specialty
- Physician will not discriminate based on any protected classification (e.g., race, color, ethnicity, sex, sexual orientation, disability etc.)
- Physician will not offer or allow Student to have any physical contact or hands on experiences with a patient while shadowing
- Physician will provide all clinical services and professional tasks and be responsible for all patient care
- Physician will share information about their medical practice or specialty with Student
- Physician will carry malpractice insurance for all clinical services and tasks performed
- Physician will comply with all federal, state and local laws and regulations, and professional standards
Each Party acknowledges that a shadowing experience in an institutional setting may have additional requirements including forms, education, screening, and malpractice coverage. Both Parties agree to be responsible for complying with any additional requirements or expectations where a shadowing experience occurs in an institutional setting (e.g., hospital, IRF, SNF, LTCH, hospice, etc.).
Each Party acknowledges they have read, understand and agree to all the terms and conditions in this Agreement. This Agreement shall become effective and binding upon the last signature of a Party.