Policy on Supervision of Medical Students


This policy is intended to guide the activities of medical students and their supervising physicians (faculty, residents, or fellows) to ensure that medical students are appropriately supervised in patient care activities during inpatient and outpatient training for the safety of both patients and students. To ensure oversight of medical student supervision and graded authority and responsibility, the program utilizes two classes of supervision: Direct Supervision and Indirect Supervision.

When Direct Supervision is required, the supervising physician is physically present with the student and patient. Supervision begins with the student’s initial contact with the patient and continues through all contact with the patient. When performing a clinical activity posing any risk to patient safety, students must be directly supervised.

When Indirect Supervision is required, the supervising physician is physically within the hospital or other patient care site, and is immediately available to provide direct observation. When Indirect Supervision is required, Direct Supervision is immediately available.

Students must be supervised in such a way that the student assumes progressively increasing responsibility only according to the ability and experience of the individual student. The level of
responsibility accorded to each student must be determined by the supervising physician according to the clerkship or course-specific criteria.

Students may not independently prescribe medications or authorize orders. The proximity and timing of supervision as well as the specific tasks that a student may perform with supervision depend on a number of factors including:

  1. the level of training (i.e. year in medical school)
  2. the skill and experience of the student with the particular care situation
  3. the familiarity of the supervising physician with the student’s abilities, and
  4. the acuity of the situation and the degree of risk to the patient.

Inpatient Care

  • The supervising physician shall evaluate the patient in person and be in a position to confirm the findings of the student and discuss the care plan. At least on a daily basis (more often as the needs of the individual patient may dictate), the student and the supervising physician will review progress of the patient, make the necessary modifications in the care plan, and agree on the type and scope of documentation for the medical record.
  • The faculty member must ensure the completeness of the medical record, including the provision of additional comments in the progress notes.

Outpatient/Ambulatory Care

  • An appropriately credentialed and privileged faculty member will be available for supervision during clinic hours. Faculty members are responsible for ensuring the coordination of care that is
    provided to patients.
  • All patients should be seen by the faculty member at each visit.
  • The faculty member must ensure the completeness of the medical record, including the provision of additional comments in the progress notes.

Supervision of Students Performing Procedures

  • A student will be considered qualified to assist in performing a procedure if, in the judgment of the supervising physician, the student has had previous training in the procedure and has the skill and knowledge appropriate to the procedure. The student should not perform the procedure without Direct Supervision. All procedures will have the faculty member documented in the procedure note, and that faculty member will be ultimately responsible for the procedure.