Clerkship Roles and Responsibilities

CLERKSHIP ROLES AND RESPONSIBILITIES 

Professionalsim

• Professionalsim is a key component of this clerkship and students are expected to be professional

• Professionalsim breaches will be flagged on the final clerkship form

• Examples of unprofessional behaviour include, but are not limited to:

  • Breaching patient confidentiality

  • Neglecting patient responsibilities such as not completng charting or following up on tasks

  • Not notifying preceptor of absence

  • Not submitting absence requests through Cally

  • Failing to attend AHD without an authorized absence such as an authorized flex day or postcall day

  • Signing into AHD and then not staying for the session

Pages

• Answer pages promptly

• Clearly identify yourself as a medical student when answering pages or when contacting other HCWs.  There have been some instances when ward staff have mistaken medical students for residents.

Daily Patient Reviews:

• Students will be assigned up to 6 patients each

• Students are expected to assess their assigned patients daily.  This includes reviewing their charts, reviewing investigations, reviewing any changes since last review, reviewing patient orders, obtaining history from patient and doing targeted physical exam.  

• Part of assessing patients is the generation of a problem list and management plan.

• Students are expected to present their patients to their preceptor each day.

• Daily progress notes are required

When to Contact Resident/Attending:

• If a patient is unwell, contact the covering resident/preceptor immediately.  Examples of unwell patients include, but are not limited to, new high fever, increasing O2 requirements, new atrial fibrillation, new sustained tachycardia, chest pain, hypotension, seizures and altered mental status.

• If you have any other concerns about a patient, please contact the covering resident/preceptor immediately

• The covering resident should be your first point of contact.  If there are any difficulties/delays in reaching the resident or if there is no resident on the service, please contact the preceptor.

• If a patient has died, please notify the resident/attending physician

• If you notify a resident/preceptor about a patient who has a notable change in status or if you discuss a patient with a resident/preceptor, please document who you notified and the outcome of any discussion if a discussion was had.

Documentation:

• Ensure that you document a daily progress note each day for each of the patients assigned to you

• If a patient becomes unwell, please ensure this is documented in their chart once patient has been stabilized (note resident/attending should be contacted immediately if patient is unwell)

• Students are expected to create dicharge summaries for pateints they are following.  These will then be reviewed by staff before the staff sign them.

Orders:

• • Students are NOT permitted to issue verbal orders (e.g. for labs, medications) to ward staff.  

  • Students are encouraged to pend orders on Connect Care.  If you do pend an order, please notify a resident or attending to inform them of the pending order.  If the resident and attending physician are not notified, the orders are left unsigned and nursing staff are unable to act on them.

Expected Patient Deaths:

• • It is NOT within the scope of practice of a medical student to declare a patient deceased.  If a patient dies, please contact the covering resident/preceptor immediately so that death can be formally declared.

Students Providing care to other learners/faculty:

• Learners Caring for Learners Policy

• Medical students should NOT be directly or indirectly involved in the care of other medical students, residents, or staff physicians.  Indirect care duties include but are not limited to charting responsibilities (e.g. Discharge summaries), contacting family members or other medical providers, participating in multidisciplinary meetings, or any other form of access to medical information and records. 

Dress Code:

• The MD Program Dress Code was updated and simplified last year to better address the needs of the learners in the context of their work environments. Students now in clerkship will agree that there are unique norms of dress and conduct in different settings. For MD students as with others on the health care teams, professional attire communicates our role and values to our patients and colleagues.  Sensible guidelines also help to minimize health and safety risks. Please take a moment to familiarize yourself with the dress code.  Regarding scrubs, we ask students to adjust to the norms and site expectations in their working environments.  Students should wear their hospital ID.  When not in scrubs, students should always wear business casual attire in clinical settings. 

• Please ensure that nails are short.  Examining patients with long nails can cause pain/discomfort to patients.