Duty Hour Policy for Medical Students

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* This policy applies to fourth-year students as well.

Clerkship directors and directors of other clinical rotations are responsible for monitoring and ensuring that duty hours are adjusted as necessary. Duty hours are defined as all clinical and academic activities related to medical student education including patient care (both inpatient and outpatient), administrative duties (completion of paperwork, dictation of charts, etc.), the provision for transfer of patient care (check-in, check-out, etc.), time spent in-house while on call, and scheduled academic activities (i.e., required academic conferences). Time spent reading, doing write ups, etc, after leaving the hospital (or after having been told you can leave) does not count toward duty hours. Student duty hours are set taking into account the effects of fatigue and sleep deprivation on learning and patient care.

  • Students must not be scheduled for more than 80 clinical duty hours during a seven-day week, averaged over a four-week period.
  • Students must have a minimum average of four 24-hour periods off over four weeks. Note: official school breaks and holidays should not be counted towards this minimum time off requirement.
  • Students must not be on overnight call more frequently than every third night.
  • Students cannot be on call for more than 24 successive hours, with an added period of up to 4 hours for continuity, educational debriefing, and didactic activities. No new patients should be assigned to students after the 24-hour call limit.
  • All WUSM third- and fourth-year students will have all official Washington University holidays off, regardless of whether the students’ team is on-call or post-call the day of the holiday. On the work day directly preceding the holiday, students will be dismissed by 5 p.m., and will not be assigned call duties, or regular clinical duties, until the day following the holiday at the time set forth by the clerkship director, chief resident, or fourth-year elective course master.
  • Students are strongly encouraged to discuss issues pertaining to days off with the resident at the beginning of the clerkship, or fourth-year elective, and to contact the respective clerkship director, elective course master, or resident, in writing (by letter or email) to obtain permission for any planned absences well in advance of the planned absence.
  • Individual clerkship directors and directors of clinical rotations may choose to implement duty hour guidelines that are more restrictive than the above. However, duty hours may not exceed the above regulations.
  • If you encounter a duty hour violation, please discuss first with the clerkship director or elective coursemaster. If the issue is not resolved to satisfaction, you may approach Deans Michael Awad, Lisa Moscoso, or Alison Whelan.