Medical Student Duty Hours
The recent implementation of the ACGME guidelines for work hours has led
to a corresponding evaluation of the work hours of medical students. Primarily
resident work hour restrictions were implemented to enhance patient safety
under the theory that fatigued residents were hazardous in their patient care
responsibilities. However, medical student fatigue does not have the same
consequences as resident physician fatigue because medical students have
different responsibilities and should never be making clinical decisions in a
completely unsupervised capacity. Issues of work hours and fatigue are relevant
to medical student education and responsibilities though, for differing reasons.
Medical student learning during the 3rd year comes from many sources,
which include, but are not limited to, clinical interactions with patients and the
health care team, didactic sessions from lecturers and preceptors, and
individual reading. Moreover, in addition to clinical activities and duties that
medical students may perform, students also have the responsibility of taking
exams, making presentations, and are constantly being evaluated. Because it is
generally accepted that such learning and the performance of students other
responsibilities are most effective when students are not sleep deprived, the
Curriculum Review Committee (CRC) Working Group on Student Duty Hours
recommends the following:
- During call days, do not to give the students patients after 8:00 PM and get them out by 10:00 PM to have enough time before they have to return in the morning.
- During non-call days, the student is expected to leave in the afternoon once work for their patients is done (typically between 2-5pm). It is important to be mindful of students’ time and prioritize their education. Do not have them stay late unnecessarily every day (i.e: after 4 pm), because they need time for studying as well as other activities.