XII.      Policy on Resident Supervision and Teaching of Medical Students

Medical school graduates are accepted into MSU/CHM residencies recognizing the need for additional training under supervision prior to accepting the responsibilities of an independent medical practice.  Based on this premise, the following policies apply:

A.                 Residents are not eligible for Medical Staff privileges at the Participating Institutions.

B.                 Residents are only to assume responsibilities for patient care as delegated by an attending physician of the Medical Staff at the Participating Institutions (or other designated training site, i.e. outpatient clinic).

C.                Residents are to be supervised in providing medical care by an attending physician of the Medical Staff of each Participating Institution. 

1.                  Each resident will take action as necessary to remain knowledgeable of the clinical status of all patients assigned to him/her, and discuss any significant changes in clinical status with the attending as soon as possible.

2.                  In life-threatening emergencies (e.g., code situations), residents may initiate or modify major diagnostic and therapeutic actions consistent with their level of ability and training.  

3.                  In case of an emergency, the resident may ask another health care provider to immediately contact the attending physician while the resident initiates emergency interventions but must inform the attending as soon as possible and receive additional instruction as indicated.

4.                  Prior to performing an invasive procedure on a patient, residents must have approval of the attending physician, and follow the attending physician’s directions regarding supervision, consistent with residency policy.

D.                Attending Physicians are responsible for:

1.                  Supervising the patient care activities of residents, or arranging supervision by a qualified physician, and communicating the supervision requirements and arrangements to the resident.  Supervision policies for each sponsored program will be determined by the Program.

2.                  Delegating responsibilities to residents consistent with their level of ability and training.

3.                  Responding promptly to resident questions or requests.

4.                  Teaching residents the necessary medical knowledge, skills, attitudes, and decision-making abilities relevant to patient care.

5.                  Documenting resident supervision. 

6.                  Supervision of Residents

E.                 The program director must ensure, direct, and document adequate supervision of residents at all times. Residents must be provided with rapid, reliable systems for communicating with supervising faculty.

1.                  Faculty schedules must be structured to provide residents with continuous supervision and consultation.

2.                  Faculty and residents must be educated to recognize the signs of fatigue and adopt and apply policies to prevent and counteract the potential negative effects.

E.                 Monitoring

Any alleged infractions of the supervision policy should be reported to the resident’s Program Director or his/her designee.  The Residency Program Director or his/her designee should resolve the issue.  If not resolved, the problem should be brought to the attention of each program’s Training and Evaluation Committee (TEC).

F.                 Teaching of Medical Students

1.         Resident Responsibilities in Medical Student Instruction

a.                  All residents in MSU/CHM Sponsored Residency Programs are expected to provide guidance, instruction and evaluation for medical students and any other medical personnel or its students who may be in training on the service.

b.                  Residents may be delegated responsibility for medical student supervision by an attending physician.

c.                  Resident may be delegated the responsibility by an attending to review, correct and countersign the medical records presented to them by medical students. 

2.                  Faculty Responsibilities in Medical Student Instruction

a.         The College of Human Medicine, through its faculty governance process, will outline responsibilities for teaching and supervision of medical students. 

b.         The attending physician is ultimately responsible for the supervision of a medical student, however, a resident may be delegated such responsibility by a faculty member. 

c.         Attending physicians should endeavor to remain aware of the activities and performance of any medical student(s) assigned to them for supervision.

3.                  Medical student responsibilities

a.         To participate in clinical learning experiences, medical students from the College of Human Medicine must be enrolled in the specific course related to the clinical activity.

b.         Medical students are expected to be appropriately dressed, and have an appropriate name identification card.

c.         Medical students are expected to properly identify themselves to the patients, by name and level of training. 

d.         Medical students must communicate with the attending physician, or supervising resident, prior to initiating any procedure or implementing any changes in the treatment plans.

e.         Medical students may enter information into the medical record, i.e., history and physical, discharge summary, and progress notes. However, any such entries must be countersigned by a physician.  Each hospital sets its own policies about what a student may enter into the medical record.