Medical Student Supervision Policy

Policy Statement:

Keck School of Medicine departments and central medical school administration ensure that medical students in clinical learning settings involving patient care are appropriately supervised and that the learning environment is safe for both students and patients.

Definitions:

Direct Supervision: The supervising physician is physically present with the student and patient.
Indirect Supervision with Direct Supervision Immediately Available: The supervising physician is physically within the hospital or other site of patient care and is immediately available to provide direct supervision.
Indirect Supervision with Direct Supervision Available: The supervising physician is not physically present within the hospital or other site of patient care but is immediately available by means of telephonic and/or electronic modalities and is available to provide direct supervision.

Policy Requirement:

Students must have an identified faculty supervisor at all times. Students must be directly or indirectly supervised by faculty physicians working within the scope of their practice at all times. Resident physicians may supervise students directly or indirectly when under the indirect supervision of a faculty physician. When students are being indirectly supervised, direct supervision must be immediately available at all times by a faculty member or resident. The level of responsibility of a medical student during a required clinical experience is expected to be appropriate to the student’s level of training and experience.

Process:

Clerkship directors and Medical Student Educators (MSEs) determine and communicate the faculty and resident supervisory assignments on each required clerkship activity and clinical elective course directors provide each medical student with the contact information of their supervisor(s).
Directors for the Introduction to Clinical Medicine course and Primary Care Track Program determine and communicate the faculty supervisory assignments for each clinical learning assignment and provide each medical student with the contact information of their supervisor(s).
Faculty or resident supervisors must be immediately available to medical students in person or by cell phone or pager at all times.
Clerkship directors and MSEs ensure all resident and faculty supervisors receive the supervision policy and are informed of the expectations of supervision at the start of each clerkship rotation.
Directors for the Introduction to Clinical Medicine course and Primary Care Track Program ensure all faculty supervisors receive the supervision policy and are informed of the expectations of supervision at the start of each academic year.
The Department of Medical Education ensures all clinical elective course directors receive the supervision policy and are informed of the expectations of supervision at the start of each academic year and that they must distribute the supervision policy to all relevant resident and faculty supervisors.
Clerkship, course, and elective directors inform students of the expectations of faculty and resident supervisors and how and when to contact supervisors.
Appropriate supervision is monitored by the Medical Education Curriculum Committee through course evaluations and annual course and clerkship reviews.

Clinical and Procedure Supervision:

Medical students may gather patient histories and conduct physical exams as determined by their supervising faculty member or resident.
Medical students may record notes and enter data in the patient’s medical record as determined by the supervising faculty member or resident and by an affiliated institution’s policies.
All medical orders entered by medical students must be approved by a supervising faculty member or resident prior to implementation.
Medical students must have direct supervision (separate from appropriate chaperones) when conducting particularly sensitive elements of the physical exam, e.g., the breast, pelvic, rectal, and genital exams.
Medical students must have direct supervision when completing any procedure on a patient with the potential exception that indirect supervision with direct supervision immediately available may be determined to be appropriate by the supervising resident and/or attending when the student is performing a minor procedure, e.g., venipuncture or IV placement.
Medical students are to introduce themselves as medical students in the clinical setting and may only perform patient care activities or procedures after appropriate instruction.
Students may decline to participate in a patient care event if they do not feel that they are appropriately supervised.
Medical student supervision must conform to affiliate site policies and procedures.

Reviewed and Approved: March 19, 2025

Medical Education Curriculum Committee (MECC)