All students are expected to deal with patients, colleagues, residents, faculty, nurses, etc. in a professional manner adhering to the ethical standards of the practice of medicine. Evaluation of each student's performance will include aspects of professionalism.
Attire & Appearance
All students are expected to wear attire appropriate to each clinical venue. Appropriate attire in non-surgical settings includes ties for men, skirts, or slacks for women. Blue jeans or shorts are not acceptable at any time. Cleanliness is a must. Facial hair must be neatly trimmed. A white laboratory jacket should be worn at all times. A name tag should be worn at ALL times, either affixed to the laboratory jacket or onto the scrub suit.
Scrub suits should be worn only in surgical areas. If you must leave a surgical area, while still wearing scrubs, a white coat or gown should be worn over the scrub suit. During surgery, hair must be covered by a scrub cap and mask. Shoe covers, caps, and masks are never to be worn outside of surgical or delivery room areas.
Attendance / Duty Hour Polices
Student attendance at all scheduled patient care and structured didactic learning sessions is required. In the event of a personal/family emergency or extremely important event (marriage of sibling, etc.), the student should contact the clerkship director, the clerkship coordinator, and the chief resident of the team to which he/she is assigned.
Duty hours are defined as all clinical and academic activities related to the education of the medical student; i.e., patient evaluation, time spent in-house during call activities, and scheduled activities such as conferences. Duty hours do not include reading time spent away from the clerkship or elective site.
Per USC school policy, duty hours must be limited to 80 hours per week, inclusive of all in-house call activities. Medical students must be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over the clerkship, inclusive of call. One day is defined as 1 continuous 24-hour period free from all clinical and educational duties. Adequate time for rest and personal activities must be provided.
The assigned weekly duty hours for each course range from 50 to 70 hours. Only students participating in Acting Internships will be assigned on-call responsibilities. However, all students may have required clinical duties on the weekends.
The purpose of third and fourth year medical student notes is educational in nature, allowing the student to gain experience in documenting patient care in a written form that provides a mechanism for feedback and constructive criticism from the attending physician and/or resident. CMS guidelines state that the only portions of a medical student note that may be referred to by attending physicians for billing purposes are the review of systems and family/social history. All other portions of the history and physical exam must be re-performed and re-documented in order for the attending to bill for his/her services.
The following guidelines apply to all medical student entries into the medical record:
Inpatient History & Physical Exams:
- 4th year students must complete a Histories and Physicals on all assigned patients as per the direction of the supervising residents and faculty.
- These must be reviewed by an attending and/or resident with detailed feedback provided for educational purposes.
- The 4th year medical student History and Physical will become part of the medical record but may not replace a resident or attending physician history and physical.
Inpatient Progress Notes:
- Students are expected to write daily progress notes on their patients.
- The notes must be countersigned by the attending physician and/or resident.
- The medical student note cannot replace a resident note.
- Daily medical student notes will become part of the medical record.
- Charting by medical students should be congruent with the charting process utilized in the particular setting.
- A note may be entered into the medical record by the medical student if and when his/her findings on history and physical exam have been reviewed and confirmed by the attending physician and/or resident.
- The attending physician and/or resident must personally see all outpatients evaluated by a medical student.
The attending physician and/or resident must also countersign the chart confirming his/her agreement with the findings and treatment plan.