DRAFT Student Fatigue Mitigation Policy, 2020-2021 Academic Year

Appendix #16

The University of California, Riverside School of Medicine is committed to maintaining training environment that foster wellness.  This document summarizes the fatigue mitigation policy that forms an important component of a wellness-focused learning environment.  

Medical education can lead to situations in which a trainee’s alertness can drop bellows levels required for safe patient care.  While the medical education literature has traditionally paid more attention to fatigue among resident physicians, published studies also document the risks of excessive fatigue among medical students.   It is therefore imperative that all faculty members, resident physicians, staff and medical students recognize when a student’s level of alertness is inadequate for patient safety or for the student’s own well-being.  The UCR School of Medicine developed the following policy in accordance with LCME requirements to provide guidance when such a situation develops:

• The safety of patients and trainees should be paramount and supersedes concerns about productivity or other short-term training requirements.
• Any faculty member, resident physician, staff member or medical student can initiate a fatigue mitigation process by raising the concern.
• Medical students on clinical rotations must notify a supervisor if they believe they are in a state of suboptimal alertness or fatigue.
• Supervisors who have concerns that a medical student may be fatigued must discuss these concerns with the student and choose the best option(s) to mitigate the risks of fatigue:
• Medical students may end their clinical duties for the day and, if safe to do so, return home to rest.
• Medical students may retire to a call room for a strategic nap, then afterward reassess their ability to safely care for patients or to travel home.
• Faculty members, resident physicians and staff members may release a medical student from clinical duties if they believe the student is too fatigued.
• In the event that a medical student must terminate clinical duties due to fatigue, the event must be reported to the UCR School of Medicine Office of Student Affairs.  A cumulative record of any such events will be presented at meetings of the Medical Education Executive Committee.
• Medical students are expected to use professional judgment to ensure adequate rest prior to clinical duties.  Reports of excessive fatigue related to extracurricular activities should be reviewed with the student and a plan to reduce fatigue during clinical duty hours instituted.

Medical students who are concerned that they may be too tired to travel home safely have the following options:

• They may obtain access to a call room and nap prior to traveling home.
• They may use a taxi or shared ride service to return home within a 30-mile radius of the work site, the cost of which will be reimbursed by the UCR School of Medicine.