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Supervision of Medical Students Policy

The University of Maryland School of Medicine (UMSOM) shall ensure appropriate levels of student supervision during the entirety of their undergraduate medical education training. The UMSOM will work with all student teaching sites to ensure that medical student education is of the highest quality and occurs in a safe environment for students, staff and patients. The UMSOM shall provide all medical students an education that is progressive in autonomy, as much as an educational experience can allow in a safe and effective manner, as it applies clinically and academically according to requirements of the Liaison Committee for Medical Education (LCME).

The amount of supervision required for each student will vary according to the clinical nature of each patient and experience and shall be commensurate with the level of training, education, and experience of the student involved with a patient’s care. While engaged in clinical rotations or clinical activities, medical students shall be incorporated into the medical team as integral team members, permitted to participate in team care of the patient, and expected to demonstrate individual ownership of patient care responsibilities as permitted based on the student’s level of training, expertise and experience.

Individual courses/clerkship directors will provide specific guidance to students to explain the student’s level of responsibility and the scope of approved activities and procedures expected or permitted on any given rotation. This information will be shared with all teaching faculty, residents and staff at a minimum annually.

  1. Supervision of all students must be provided by qualified faculty and/or resident physicians at all times that a student is on an educational or clinical rotation.
  2. Students will be provided with easily accessible, reliable, and effective systems for communication with faculty and resident physicians.
  3. Supervision is designed to foster progressive responsibility and autonomy, as appropriate, throughout medical school education.
  4. Levels of progressive responsibility and supervision are based upon a student’s level of training, demonstrated clinical acumen and ability, and competence in the various LCME domains, as well as the specific objectives for each rotation.
  5. Supervision is designed to provide formative constructive feedback to students in an ongoing manner and summative feedback at the end of rotation assignments.

Expectations of Faculty and Resident Physicians for Supervision of Medical Students:

  1. Provide opportunities for students to demonstrate responsibility and ownership for patient care responsibilities:
    • Take patient histories and perform complete and/or focused physical examinations. If the opportunity affords, any entries in the medical record of a patient will be for educational and student evaluation purposes only and cannot be used in lieu of any required medical staff and/or house staff documentation. Students must clearly sign all entries in the medical record, along with the designation that they are medical students. Supervising attending physicians or graduate medical trainees are to review student all notes and provide feedback to the student.
    • Provide patient care services under the direct supervision of the attending physician or designated house staff. In all patient care contacts the patient shall be made aware that the individual providing the care and/or performing the procedure is a student.
    • Review focused topics related to patients on the service and report information back to the team to demonstrate self-directed, clinical learning and application of knowledge to the care of patients.
  2. Provide students with regular feedback.
    • Medical students should receive formative feedback by at least the mid-point of courses and clerkships of four weeks (or longer) duration. Such formal formative feedback early enough during each required course or clerkship is to allow sufficient time for remediation. A course or clerkship less than four weeks in length should provide alternate means by which a medical student can measure his or her progress in learning. Final evaluations should be completed at the end of each rotation.
    • The clerkship or course director should be notified immediately if serious academic or professional gaps in student performance exist. Students should also perform self-assessment and report to the attending physician and resident identified areas for improvement along with a plan for improvement. Students should be encouraged to contact the attending and/or the clerkship or course director with problems or concerns in clinical, administrative, professional or educational matters.
  3. Set a model example of professionalism, collegiality and interprofessional collaboration.