Principle

Overview 

The Committee on Accreditation of Canadian Medical Schools (CACMS) Element 8.8 states the following: 

The curriculum committee and the program's administration and leadership implement 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 required clinical learning experiences.

Purpose

To define the amount of time Learners can spend in clinical and educational activities during Required Learning Experiences, establishing the concept of Protected Time within the undergraduate medical education (UGME) curriculum. This policy will also serve as a guide to curricular planners to ensure sufficient time in the UGME curriculum is available for active and self-directed learning.

Scope

Doctor of Medicine (M.D.) program at Memorial University (Memorial).

Definitions

Break — A day or days during which no required learning experiences are scheduled in the curriculum.

Clinical Learning Experience — A period of clinical training in a health care setting which is part of the Doctor of Medicine (M.D.) program. For the purpose of this policy, a clinical learning experience includes required and elective experiences.

Duty Hours — Time in Phase 4 during which Learner is scheduled to participate in patient care or clinical educational activities. Study time is not included in Duty Hours.

Holiday — Holidays as listed in the Key Dates and Holidays section of the Student Handbook.

Learner (as defined in Protected Time and Duty Hours Policy) — An individual registered in the M.D. program at Memorial University (Memorial).

Phase — A unit of the curriculum with an integrated theme composed of  a number of courses after which a Learner’s academic and professional performance is reviewed by the Student Promotions Committee for promotion or graduation.

Protected Time — Time during which Learners are not required to participate in clinical or educational activities.

Required Learning Experience — An educational unit (e.g., course, clinical learning experience or  longitudinal integrated clerkship) that is required of a Learner in order to complete the medical education program. These educational units are usually associated with a university course code and appear on the Learner’s transcript.

Session — A component of course delivery which includes, but is not limited to, a lecture, lab, or tutorial. All sessions including assessment and/or skills development are mandatory for Learners to complete.

Vacation — Normally measured in week long blocks, a period of time in Phase 4 during which Learners are exempted from all clinical and educational activities related to the M.D. program, providing the opportunity for leisure activities.

Policy

1.0 Phases 1-3 

1.1. Learner attendance is expected at all Required Learning Experiences, but is mandatory when a Session includes assessment (e.g. quiz, examination, lab report,) or skill development (e.g. labs or clinical skills sessions).

1.2. The scheduling of Sessions and the establishment of Protected Time will be guided by the following provisions:

1.2.1. Sessions may be scheduled from 0900h until 1600h Monday, Wednesday, Thursday and Friday, and from 0900h – 1200h on Tuesday. 

1.2.2. A one (1) hour break must be given between 1200h and 1400h on Monday, Wednesday, Thursday, and Friday. 

1.2.3. A four (4) hour break must be given from 1200h to 1600h on Tuesday for Learners to attend to professional and personal business. 

1.2.4. Exceptions may be made at the discretion of the Undergraduate Medical Studies (UGMS) committee. Exceptions may also be made by the Associate Dean, UGME, in consultation with the Assistant Dean, Student Affairs, in emergency situations. Exceptions made by the Associate Dean, UGME, will be brought to the UGMS committee for information purposes. Exceptions may be appropriate in the following circumstances:  

1.2.4.1. sessions are cancelled due to storms or other emergency closures; or, 

1.2.4.2. with respect to Clinical Skills teaching, Learners are notified in advance and an equivalent or greater amount of protected time is provided elsewhere in their schedule. 

1.2.5. Holidays, as outlined in the Key Dates and Holidays section of the Student Handbook, are free of any required learning experiences. 

1.2.6. At least twenty-four (24) hours must elapse between the end of a session where new content is taught and the exam assessing this content. 

1.2.7. Weekends are free of any required learning experiences except that they may be used for special examinations (e.g., OSCEs) or in the event that scheduled exam time was lost due to a storm or an emergency closure. 

1.3. Absences  

1.3.1. Learners should make every effort to schedule appointments to access health services or attend to personal/professional business during the breaks provided in the schedule to avoid missing required learning experiences.

1.3.2. It is recognized that there may be circumstances where absences from required learning experiences cannot be avoided. Learners who must attend appointments to access health services during non-mandatory sessions may do so without requesting leave. Learners who must attend appointments to access health services during mandatory sessions may request leave as outlined in the Leave Request section of the Student Handbook. 

2.0 Phase 4 

2.1. Duty Hours

2.1.1. Attendance is mandatory during all scheduled duty hours. 

2.1.2 A clinical block normally starts on a Monday and ends, at the latest, by 1700h on the last Friday of the clinical block.

2.1.3 Duty hours shall not exceed ten (10) hours per day, five (5) days per week, when averaged over the entire clinical block (excluding call days), unless warranted by urgent or emergency circumstances. 

2.1.4 Regular duty hours (excluding call or shift work) are generally scheduled within the hours of 0645 – 1800, Monday through Friday. Duty hours may vary due to circumstances and conditions inherent to specific clinical environments. Learners will have duty hours on weekends when scheduled for call or a designated shift. 

2.1.5 Learners must be dismissed from duties by 1700h on the day preceding an examination. Learners writing the final summative comprehensive clinical science exam will have the day off prior to the examination starting at 0800h. 

2.1.6 Pregnant Learners will be excused from in-hospital duty including shift work or any scheduled time on call, after 1700h Monday to Friday, or at any time during the period of 0800h Saturday to 0800h Monday, subsequent to their twenty-eighth (28th) week of pregnancy. 

2.1.6.1 Deviations may not be allowed by the clinical service. 

2.1.6.2 Learners requiring additional accommodation should seek the support of the Blundon Centre through self-referral or via the Office of Learner Well-being and Success. 

2.1.7 Learners must be excused from clinical duties to attend educational activities that are part of the M.D. program such seminars, lectures, and academic rounds. 

2.1.8 A Learner may request two (2) hours off service each week to attend to personal business. 

2.1.8.1 The request must be approved by the preceptor/Clerkship Discipline Coordinator prior to the Learner taking the time off service. 

2.1.9 All deviations must be approved by the Phase Lead. 

2.2. On-call Duty Hours and Designated Shift Work 

2.2.1. Normally, on-call responsibilities will not exceed seven (7) days in a twenty-eight (28) day period (i.e., normally one (1) in four (4) call).

2.2.2. Learners who are on-call after midnight normally are not expected to work past mid-day the following day. 

2.2.3. After twenty-four (24) consecutive hours of service, Learners must be excused from new consults and clinic duties.

2.2.3.1. After twenty-four (24) hours of consecutive service and before noon of that day, duties should be limited to rounds, follow-up care of patients/transfer of patient care, or academic sessions. 

2.2.4. On-call duties and designated shift work end at midnight on the eve of an official break (e.g., call ends at 2359h on the 17th of the month, when the break period commences on the 18th of the month). 

2.2.5. Academic Half-Days post call or following overnight designated shift work are mandatory. 

2.2.5.1. Learners are expected to attend sessions that are scheduled in the morning or, with the permission of the Clerkship Discipline Coordinator, be required to complete the session asynchronously by reviewing a pre-recorded version of the session. 

2.3. Holidays 

2.3.1. Unless on call, Learners are entitled to the Holidays as outlined in the Key Dates and Holidays section of the Student Handbook. 

2.3.2. Regardless of the Holiday, call duty and designated shift work must be fulfilled. 

2.3.3. On-call duties or shift work cannot start on a Holiday, but the end of on-call duties or shift work can extend until 12 noon on a Holiday. 

2.4. Vacation 

2.4.1. For specific information regarding Learner vacation, please see the Breaks and Vacation section of the Student Handbook.

3.0 Any protected time and/or duty hour violations should be reported to the appropriate Phase Lead.

Related Documents

CACMS 

Procedures:

There are no procedures associated with this policy.