Medical Student Supervision Policy

Purpose

LCME Element 9.3: A medical school ensures that medical students in clinical learning situations involving patient care are appropriately supervised at all times in order to ensure patient and student safety, that the level of responsibility delegated to the student is appropriate to the student’s level of training, and that the activities supervised are within the scope of practice of the supervising health professional.

Scope

This policy applies to clerkship and clinical course directors; clerkship and clinical faculty, residents, and fellows; and other health care providers who supervise medical students in all curricular components. Medical students must be aware of PSOM’s expectations for their supervision.

Policy

The University of Pennsylvania (Penn) Perelman School of Medicine (PSOM) recognizes that active involvement in clinical learning situations is essential for medical student learning and growth. The Academic Programs Office expects each department to be responsible for ensuring student and patient safety in the required clinical experiences of their clerkship and post-clerkship years. PSOM will provide supervision of medical students in all clinical areas to ensure quality education as well as patient and student safety. Students engaged in volunteer opportunities with Penn Medicine affiliates will be directly supervised by physicians at each site.

At each clinical course and clerkship orientation, students must be informed of the expectations for their participation and supervision in patient care. Clinical course and clerkship directors are responsible for informing teaching faculty, residents, and house staff of these same expectations. Students participating in clinical activities in the Department of Obstetrics and Gynecology must adhere to the Pelvic Exams Under Anesthesia by Medical Students Policy.

Clinical course and clerkship directors are responsible for assigning students to designated faculty and resident supervisors for all clinical experiences and for ensuring that faculty, residents, fellows, and students are made aware of these assignments.

The level of responsibility delegated to a medical student must be appropriate to the student’s level of training, experience, and competence. The amount of direct and/or indirect supervision required for each student will vary according to the clinical nature of each patient, and be commensurate with the level of training, education, and experience of the student that is involved with the patient’s care. Supervision is intended to foster progressive responsibility. While engaged in clinical rotations or clinical activities associated with prescribed course work, medical students should be incorporated into and accepted as an integral part of the team, permitted to participate in team care of the patient, and expected to demonstrate individual ownership of patient care responsibilities.

Clinical faculty must supervise medical students appropriately at all times. Clinical privileges must be assigned in a fashion that is compliant with the guidance provided by Penn Medicine. Students must be provided with rapid, reliable systems for communicating with supervising faculty and resident physicians.

Where clinically and educationally appropriate, physicians who are supervising medical students may delegate responsibility for some elements of teaching and supervision to residents, fellows, or other health care providers (e.g., physician assistants, nurse practitioners, certified registered nurse anesthetists, nurses) within the institution as outlined in the Graduate Medical Education Policy II-M: Roles and Responsibilities of House Staff. It will be the responsibility of each supervising physician to determine which learning experiences are appropriately delegated, and to ensure the individuals providing such supervision are working within their scope of practice.

If students have any concerns about the adequacy and availability of supervision in the clinical environment, they should direct their concerns to the course directors, and if further issues persist, contact the Associate Dean for Clinical and Health Systems Sciences Curriculum or the Associate Dean for Student Affairs and Wellness. If confirmed that students do not have adequate or available supervision on their clinical rotations, the Deans will meet with the course director to ensure compliance with the policy, with ongoing close monitoring. Students may also report any concerns anonymously if they prefer via one of several mechanisms, including Safety Net, an ombudsperson, the clinical course reps, or trusted faculty member.

Revised October 17, 2023