VCOM Faculty Handbook

Medical students are vital members of the healthcare team but are NOT licensed healthcare providers until they have graduated, completed residency, and are licensed and therefore, they cannot engage in the unsupervised practice of medicine. It is a violation of state law and a violation of VCOM policy for any unlicensed person to engage in or attempt to engage in the unlicensed practice of medicine. The regulated practice of medicine includes such unsupervised activities as independently making and providing a diagnosis to a patient, the rendering of medical care or advice, prescribing medications, performing procedures, and all other activities normally performed by physicians or other licensed professionals. Students on clinical clerkships or participating in patient care related activities may engage in patient care but must recognize that as students, their scope of training is limited. They are permitted to perform clinical care only in supervised settings and under the 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

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