VCOM College Catalog and Student Handbook

supervision of the faculty physician. At no time should a student assume independent responsibility for the care of any patient, provide a diagnosis to a patient, prescribe medication, order tests, or render care without supervision and authorization of the faculty physician. Further, no student is authorized to receive or to collect for himself/herself or for any other person, any fee or gratuity for professional service they provide during the course of their medical education training. Any student delivering unsupervised medical care is engaging in the unlicensed practice of medicine, which violates state law and VCOM policy. Medical students who engage in such activities may lose protection under VCOM’s professional liability insurance and may face disciplinary action including dismissal. Engaging in the unlicensed practice of medicine can also result in civil and/or criminal actions being filed against the student. While some medical students may be fully licensed in other health care disciplines/professions (e.g., Physical Therapists, RN’s, PA’s, Chiropractors, Podiatrists, Dentists, etc.), they may NOT exercise the rights and responsibilities of their license while simultaneously performing their duties and responsibilities as a medical student on clinical rotations or during other VCOM-sponsored experiences. While working or volunteering in the healthcare field under a certification earned outside of VCOM, the individual will not be covered by any of VCOM’s insurance policy including any medical malpractice or professional liability coverage. Furthermore, the paid or voluntary work will not be overseen, considered for academic credit, or regulated by VCOM. If students have a doctorate in any field, they cannot use this title while in any clinical settings related to their education whether in a student environment or not. Expectations for Student Performance in Patient Care VCOM has adopted the RIME framework (Pangaro, 1999) to describe the expectations of medical students in the context of their level of training in patient care activities. Students can use it to monitor their own progress and faculty can use it to monitor student progress and to provide appropriate feedback. The RIME framework is based on the understanding that students’ progress through a sequence of developmental stages: Reporter > Interpreter > Manager > Educator R : Reporter • Focus at this stage: Reporters can accurately and reliably gather clinical information on each of their patients. Reporters can communicate clearly (both verbally and in writing) the clinical information they have obtained. Reporters are able to distinguish important information from unimportant information and are able to focus data collection and presentation on central issues. • Emphasis: The S/O (Subjective/Objective) part of SOAP. • Learner: Pre-clinical learners – It is expected that all students will function as master Reporters and be transiting into beginning Interpreters by the end of the OMS 2 year. Students are expected to move through the Reporter stage during pre-clinical training. • Level of Supervision: Direct Supervision I : Interpreter • Focus at this state: Interpreters are capable of identifying problems independently and prioritizing them, including addressing new problems, as they arise. Interpreters are able to develop a differential diagnosis independently and to make a case for and against each of the important diagnoses under consideration for a patient’s central problem(s). Helping students make the transition from Reporter to Interpreter is one of the focal efforts of the clerkship. • Emphasis: The A (Assessment) part of SOAP. • Learner: Predominantly expected to be third year medical students. All students are expected to begin their OMS 3 year primarily at this stage, and to demonstrate significant progress to a Manager towards the end of the OMS 3 year.

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