VCOM College Catalog and Student Handbook

• Indirect supervision with immediate availability: The supervising faculty physician is not physically present with the student in the performance of clinical care but is physically located in the facility where clinical care is performed and is available immediately if needed. The determination of the appropriate level of supervision of the medical student is the responsibility of the supervising faculty physician, and should be based on multiple factors, including but not limited to:

• The level of training of the student. • The clinical abilities of the student. • The acuity of the patient and the level of risk to the patient. • The complexity of the clinical case/procedure.

• Students must always have direct supervision by a licensed healthcare provider who is qualified to independently perform the given procedure when performing any invasive procedures or sensitive examinations, including breast, pelvic, rectal, and genitourinary exams. 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

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