EA-3202 Student Work Hours During Clerkships and Clinical Rotations Phase 2 and 3 of VTCSOM Curriculum

1.0      Purpose

The Phase 2 medical curriculum at VTCSOM integrates four educational value domains into all clinical clerkships and electives. Education primarily occurs across Carilion Clinic clinical locations and affiliated sites under the direction of the clerkship directors, the Directors of Phase 2 and Phase 3, the Office of Educational Affairs, the Phase 2–3 Integration Committee (PIC 2-3), and the Medical Curriculum Committee. Each clerkship director designs the overall schedule for their respective clerkship or rotation in accordance with established guidelines, ensuring alignment with curricular goals and inclusion of free time to support student well-being. In accordance with Standard 8.8 of the Liaison Committee on Medical Education (LCME), the clinical course directors, directors of clinical electives, and the Office of Educational Affairs collaboratively monitor and adjust duty hours as needed to maintain compliance and promote balance in students’ educational and clinical experiences.

2.0      Guideline

• Clinical and educational work hours are limited to no more than 80 hours per week, including all in-house and at-home clinical and educational activities.
• Students must have at least one full day (24 consecutive hours) free of clinical work and required education every seven days, averaged over four weeks. At-home call cannot be assigned on these free days.
• Students should have a minimum of eight hours off between scheduled clinical work and educational periods.
• Continuous clinical and educational work periods must not exceed 24 hours.
• In-house call may be scheduled no more frequently than every third night.
• Students must have at least 14 hours off following any 24-hour in-house call period.
• Students will have at least 10 hours off between all scheduled work periods.
• Clerkship and elective directors may establish more restrictive duty hour limits but not exceed these maximums.
• Students should refer to the attendance policy for details regarding excused absences from clinical duties.
• Students with concerns about duty hour violations should first contact the clerkship director or Phase 2 Director. If unresolved, they may escalate concerns to the Associate Dean for Educational Affairs, the Associate Dean for Student Affairs, or the Senior Associate Dean for Medical Education.

3.0      Procedures

Clerkship directors and faculty are responsible for monitoring and ensuring that students remain within established duty hour limits. Any violations or concerns should be reported to the appropriate clerkship director, who will determine whether the violation was initiated by the student or occurred under the direction of an attending or resident. Confirmed violations will be addressed by the Clerkship Director, the Director of Phase 2 and/or Phase 3, or the Associate Dean for Educational Affairs, and communicated with the Phase 2–3 Integration Committee (PIC 2-3) for ongoing monitoring of repeat occurrences. Anonymous reports submitted through end-of-clerkship evaluations will be reviewed by the Learning Environment Advocacy Committee (LEAC), and will be addressed directly by the Clerkship Director, Phase Director, or Office of Educational Affairs.

Repeated violations by a student will be addressed by the Associate Dean for Student Affairs and the Associate Dean for Educational Affairs in collaboration for further investigation and action, which may include referral to the Medical Student Performance and Promotion Committee (MSPPC). Patterns of faculty or departmental behavior that encourage or require duty hour violations will be referred to the Senior Associate Dean for Medical Education (in collaboration with the Clerkship Director and Chair of the Clinical Department) for investigation and corrective action. If residents are responsible for such violations, the appropriate Program Director and Designated Institutional Officer (DIO) will be notified for review and intervention.

Students participating in research may adjust their free-time schedules to accommodate research activities, provided the total work hours remain within the established guidelines. Research mentors may not require additional time outside of the student’s scheduled research period, and any adjustments must be at the student’s discretion without coercion.

Duty hour compliance is assessed through standard clerkship evaluations. Patterns of repeated violations may indicate curricular or structural concerns, which the PIC 2-3 will refer to the Medical Curriculum Committee (MCC) for review and appropriate action.

4.0      References

• Office of Educational Affairs
• Director of Clinical Clerkships (Phase 2)
• Director of UME-GME Transition and Electives Curriculum (Phase 3)
• Associate Dean for Educational Affairs
• Senior Associate Dean for Medical Education
• Associate Dean for Student Affairs

5.0      Approvals and Revisions

Approved by the Medical Curriculum Committee on November 20, 2025