Attendance and Absences
Students are expected to attend all the clinical events that are scheduled for them. Although this is the "end of medical school", we still expect students to maintain their professional obligations, as they will have to do for the rest of their career. A full discussion of the Faculty's policies for student attendance in UME can be found here.
It is possible that students may have to miss an event that they were supposed to have attended in your Selective. There may be planned absences, such as for a religious observance, and unplanned absences, such as for illness or a family emergency. The policies linked above give a comprehensive overview of these types of situations.
Please document ALL student absences, no matter the reason. Students who miss more than 3 full days of work, may have to make it up. We will be asking for your report of student absences at the time of your evaluation of the student.
The experiences in your Selective would be described under the attendance policies as "Mandatory Non-assessment Activities". For such activities, permission for planned absences must be sought in advance. Students who miss a clinical activity for a planned absence, without prior notification, may have committed a Minor Lapse in professionalism. If students consult you about a planned absence, the general rule is that if the absence is unavoidable and important, then we usually grant it. Discretionary absences (eg. scheduling a personal appointment during the work day) are not usually granted.
- TIP: Check with your student early about whether there are any days where they might be absent. Document those days and reasons. If there are any questions about whether to grant an absence for the reason stated, please consult us right away.
Unplanned absences for reasons beyond the student's control, such as a family issue or a personal illness, still require notification of the clinical supervisor. Students should notify you as soon as they know they will be away. Students do not have to give you documentation of the illness or other reason for absence; however, if you have concerns, you should contact us, and we will handle the documentation requirements, if any.
Overlap of Roles: Educational and Professional Care to Students
Your responsibility to the student as an educator cannot overlap with your responsibility to them as a caregiver. Simply put, if you have a relationship with the student as their doctor, you cannot supervise them in the Selective. If you know that you are in this position already, please notify us right away. While you are supervising the student, you should not enter into a care relationship with them. You should not provide medical care to the student except under urgent or emergency circumstances. Further information can be found at the UME website by following this link.
Call Duties while on Selectives
Because of the great variety of practice settings of Selectives, we do not enforce a standard Call policy.
However, general principles of appropriate practices for students on call still apply. These principles can be found at this link.
Here is the advice we gave students about Call Duties on Selectives:
- Talk about it early. Clarifying assumptions and expectations will pay off quickly. Is there an expectation that you will work overnight, either in hospital or outside? If so, how often, and for what period of time?
- What type of work is expected when on call? Keep in mind that this course is a new entity and your supervisor may be unsure of what you are capable of doing. Begin gradually, to allow your supervisor to get a sense of your level of ability. While we expect that you will be able to work independently, you should not be working entirely without supervision. As you are not yet licensed, all your orders and major decisions should be reviewed with your supervisor very close to the time they are made.
- In general, you should not be responsible for making patient care decisions on your own in situations with higher patient risk, such as when patients are managed via telemedicine, are discharged from an emergency department, or are medically vulnerable. Contextual factors are important modifiers, but in general, the overriding principle is to check your decisions with a supervisor before anything gets beyond a point of "no return".
- "When in doubt, check it out." "The only stupid question is the one you didn't ask." These sayings highlight the importance of verifying your observations, impressions, plans, and concerns with a more experienced physician. The often stated concern that asking questions will lead to the perception that you are not confident or capable is dangerous. Put your patients first and ask.
- Sleep deprivation leads to poorer patient care and increased tendency to error. It also puts you at risk for accidents or injuries on your way home. You should not continue clinical duties past 24 hours of continuous service in hospital. Outpatient duties require more judgement. In either situation, inform your supervisor if you believe you are too sleep deprived to carry out patient care safely.
- Other aspects of duty/workload should also be discussed, such as weekend work expectations. In some settings, this should be considered more like regular work than "extra" or on-call. However, the weekly totals set out in the standards linked above should still apply
If you have any questions about the above, please contact us as soon as possible.
For a full review of other UME policies pertaining to teachers, please go here.