Policy Abstract

The University of Alabama at Birmingham Marnix E. Heersink School of Medicine recognizes that education is the primary goal of medical students. This policy outlines the limitations on work hours to allow students to maximize the educational benefit and limit fatigue which may impair the student's ability to learn. The policy includes oversight of all aspects of the educational experience of a medical student.

Reason for Policy

This policy ensures faculty oversight of the amount of time medical students spend in required activities and that the medical school meets the requirements set forth by the Liaison Committee for Medical Education (LCME) accreditation requirements as follows:

Element 8.8: Monitoring Student Time
“The medical school faculty committee responsible for the medical curriculum and the program’s administration and leadership ensure the development and implementation of effective policies and procedures regarding the amount of time medical students spend in required activities, including the total number of hours medical students are required to spend in clinical and educational activities during clerkships.”

Scope

This policy applies to all UAB Heersink School of Medicine students and visiting students participating in medical school coursework.

Policy

Students will be provided a sound educational experience that is carefully planned and balanced with concerns for patient safety and student well-being. The learning objectives of each educational experience cannot be compromised by excessively scheduled contact hours in the preclinical educational experience or clinical assignments in the clinical educational experience. The oversight of this policy will be the responsibility of the Associate Dean for Undergraduate Medical Education and the Medical Education Committee.

Procedure

Preclinical Education

1. The general structure of each preclinical module is defined by the module directors in collaboration with the Office of Undergraduate Medical Education. Educational content may be delivered to students in two broad categories: face-to-face learning and asynchronous learning. The contact hour equivalent of each learning activity within a preclinical module, face-to-face and asynchronous, will be calculated and totaled each week. A contact hour is typically defined as 50 minutes of instruction. Weekly contact hours should not exceed 20 per week for face-to-face learning and 10 per week for asynchronous learning when averaged over the length of the module.

1. Face-to-face learning activities include lectures, laboratories, case-based learning, team-based learning, questions @UAB, learning communities, simulations, assessments, clinical skills, and other active learning sessions. In general, attendance at all active learning sessions and assessments will be required while lecture attendance is optional.
2. Asynchronous learning refers to assigned learning activities that students complete outside of regularly scheduled class time. Asynchronous activities may include readings, viewing videos, working problems, answering questions, or self-directed learning.

In addition to structured content delivery, students are expected to engage in independent study of module content, which will not be calculated or factored into weekly contact hours.

2. The Medical Education Committee will formally assess student contact hours in the preclinical curriculum as a component of the formal module evaluation process. Student contact hours are also monitored by the Office of Undergraduate Medical Education and reviewed with module directors at least 90 days prior to beginning of each module.

 Clinical Education

1. Clinical work hours are defined as all clinical and academic activities related to the educational experience, i.e., patient care (both inpatient and outpatient), administrative duties relative to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled activities such as conferences. Clinical work hours do not include reading and preparation time spent away from the duty site.
2. In the clinical curriculum, student clinical work hours are assigned in accordance with the ACGME regulations for first-year residents. Specifically, students:
   
   1. Must have at least 14 hours free of clinical work and education after 24 hours of in-house call.
   2. Must average 1 day off per week when averaged over the length of the clinical course or clerkship.
   3. Cannot be on duty over 80 hours per week when averaged over one month.
   4. Should have eight hours off between scheduled clinical work and education periods. There may be circumstances when a student chooses to stay to care for their patients or return to the hospital with fewer than eight hours free of clinical experience and education, this must occur within the context of other work hour requirements and one-day-off-in-seven requirements.
3. Clerkships students can report clinical work hour violations on the clerkship evaluation form. Violations can be reported directly to the clerkship director, the Associate Dean for Undergraduate Medical Education, the Associate Dean for Students, the Assistant Dean for Clinical Education, or the Senior Associate Dean for Medical Education. In addition, students can use the SOM ReportIt System or the UAB Hotline to report violations. Retaliation against any individual who reports violations in good faith or who participates in the investigation of a report of workhour violations is prohibited and will not be tolerated.
4. The Medical Education Committee will formally assess student clinical work hours in the clinical curriculum as a component of the formal clerkship evaluation process. In addition, reports of clinical work hour violations are reviewed in Clerkship Directors Committee meetings on a regular basis.
5. The Associate Dean for Undergraduate Medical Education and Assistant Dean for Clinical Education will work with clerkship directors to resolve issues relative to reported or identified duty hour violations.

History

Created: 2014
Approved: January 1, 2024 by UA Systems Office
Revised: December 15, 2023

University of Alabama at Birmingham Marnix E. Heersink School of Medicine policies shall be reviewed periodically to determine whether revisions are appropriate to address the needs of the medical school community.