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Advanced Clinical (MS4 Electives)
Duty Hours Violation Reporting Form
Please use this form to report a violation of the Medical Student Duty Hours Policy (see below). The information you enter will be reviewed and acted upon by the Dean's Office
.
DGSOM DUTY HOUR POLICY:
Maximum Hours of Work per Week
Duty hours must be limited to
80 hours per week, averaged over the course of the rotation
, inclusive of all in-house call, clinical and educational activities.
Maximum Duty Period Length
Duty periods for students must not exceed
28 hours of continuous scheduled duty
.
Minimum Time Off between Scheduled Duty
Students must have at least 8 hours free of clinical work and required education between clinical shifts and/or required educational sessions. After 24 hours of continuous call, students must have at least 14 hours free of clinical work and/or required education.
Maximum In-House On-Call Frequency
Students must be scheduled for in-house call no more frequently than every third night when averaged over the course of the rotation.
Mandatory Time Free of Duty
Students must be scheduled for a minimum of one day free of duty per week when averaged over the course of the elective.
What is the course number? (example: ME452.01)
Date:
Previous Month (March 2025)
April 2025
Next Month (May 2025)
Su
Mo
Tu
We
Th
Fr
Sa
30
31
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30
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Describe the circumstances and cause of the duty hour violation
What could be changed to avoid similar problems on this elective for students in the future?
Student Name
Student Mednet Email Address
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