In This Section

Academic Policies and Procedures

Evaluation of Courses, Clerkships and Faculty/Residents

At the end of each course (including clerkships), students are expected to complete an evaluation of the course as a whole, and of individual faculty or residents who taught or supervised them. These evaluations are reviewed by the respective course or clerkship directors. The evaluations are essential in the annual review of the curriculum, and in evaluation of faculty/resident performance in the education mission of the school. Any recommended modifications to the curriculum are taken to the Curriculum Committee. Faculty and resident evaluations are discussed by the course or clerkship director with the individual's Department Chair or Section Chief.   

Pre-clerkship Contact Hour Policy

All required pre-clerkship blocks and Doctoring must adhere to the following policy regarding classroom contact hours:

In the pre-clerkship years, students’ weekly schedule will, on average, be comprised of no more than 24 direct contact hours for the blocks and Doctoring per week. In most weeks, this will include Monday-Friday from 8am-noon, Monday from 1-3pm, and an additional 2-hr period for Doctoring or other small group activities, Monday-Thursday, based on the student’s Doctoring College. Unscheduled time may be used for study, preparation for interactive conferences, or student activities of their choice.

Clinical Clerkship Duty Hour and Supervision Policies

Clerkship directors are responsible for ensuring that all students on clinical rotations have comparable clinical experiences, and the opportunities to meet the educational goals of the rotation. In order to make sure the learning environment is optimal, clerkship directors must ensure that their students follow the duty hour policy and are appropriately supervised. These policies were developed by the clerkship directors and reviewed with faculty and site directors. The policies were then approved by the Curriculum Committee and the Dean and are reviewed annually. All required clinical clerkships, selective and elective rotations must adhere to these policies. 


Duty Hour Policy


  1. Students are permitted no more than 80 hours of assigned clinical contact responsibilities per week, including on-call responsibilities, averaged over a four-week period within a given clerkship.
  2. Students must not have more than 28 hours of continuous assigned clinical contact responsibilities. For non-overnight call rotations, there must be a duty-free period of at least 10 hours before the resumption of assigned clinical contact. 
  3. Students must be provided with one day (24 hours) free from assigned clinical contact responsibilities every 7 days, averaged over any two-week period, within a given clerkship.

Assigned clinical contact responsibilities include activities where students are involved in patient care experiences (including overnight call when you are sleeping in the hospital) or scheduled didactic sessions. It does not include time spent commuting, studying or preparing for patient care or time in the hospital not related to clerkship requirements. 

The clerkship directors, or designated faculty, are responsible for monitoring student work hours. Clerkship directors must ensure that everyone involved in teaching the students is aware of the policy. The student end-of-clerkship evaluation form asks about work hours, and is reviewed by the clerkship directors and the Dean’s Office. Students are advised to report all instances of work hour violations to the clerkship director or the Office of Medical Education or Student Affairs.

Reports of noncompliance or violation of the policy will be investigated and discussed with the respective clerkship and/or site director. Any retaliatory action against a student who reports infractions is prohibited. Any persons found to be responsible for retaliation will be subject to disciplinary action through the Office of Faculty Affairs (for faculty) and/or the Office of Graduate Medical Education (for residents).


Clinical Supervision Policy


Students on clinical rotations are expected to participate in patient care under the supervision of their attending physicians. At times, students will be working with residents and fellows, and may be directly supervised by them, however the ultimate responsibility for supervision is the attending physician. A student’s involvement in patient care should include taking a patient history, completing a physical examination, documenting findings in the medical record, communicating patient information to, and working with, other healthcare members, communicating with and counseling patients and their families, and performing procedures. 

All students entering the third year (phase 2) curriculum are expected to be able to take a patient history and complete a physical examination without direct supervision. They have developed these skills during the first two years of the medical school curriculum through successful completion of the first and second year Doctoring course. Chart documentation must be reviewed and corrected by the supervising attending or resident/fellow, and co-signed according to the hospital policy. All students entering the fourth year curriculum are expected to take on increased responsibility in patient care, while remaining under supervision of their attending physicians and residents/fellows.

It is the attending physician’s responsibility to determine when a student is able to participate in specific aspects of a patient’s care, in particular discussion of sensitive issues, counseling/education, and procedures. For procedures, students must always be under the direct supervision of their attending or a resident/fellow who is proficient in the specific procedure, until the student has proven proficiency. Students are not permitted to perform high risk procedures without direct supervision of an attending physician.

The clerkship director or site director for each rotation is responsible for ensuring the supervising attendings and residents/fellows are aware of their role in student supervision and the appropriate responsibility of the students in patient care. The Clinical Supervision Policy is reviewed annually and is aligned with all hospital policies. On the end of clerkship evaluation form, students are queried regarding appropriate supervision.  Responses are reviewed by the clerkship directors and the Dean’s Office.  The students are advised to inform the clerkship director or the Office of Medical Education or the Office of Student Affairs if they believe they are not being appropriately supervised. 

No faculty member or resident/fellow who has provided care for a student may participate in the student’s direct supervision or evaluation. It is the responsibility of both the faculty/resident/fellow and the student to request a change of assignment as soon as such a situation arises by contacting the clerkship director or the Associate Dean for Clinical Education. This may not be waived even if both parties agree. 


Process for Assignment of Clinical Schedules


Policy for Change in Clinical/Regional Campus Assignments

All students are assigned to a specific campus at the time of admission, based on the student’s preference as stated on their application. Every effort is made to accommodate a student’s preference, based on site availability at the time of his/her admission.

Following matriculation, a student may request a change in campus assignment only for significant extenuating circumstances, in writing, to the Office of Medical Education.  The request will only be considered if space and resources are available and another student is willing to switch in the opposite direction.  The Senior Associate Dean for Education will track requests, including the dates of requests and reasons for the requests. In June (at the end of the first curricular year), the Senior Associate Dean will convene a committee, including the deans for education, student affairs and the affiliates, to review all requests, check availability, and notify the students of their decision. This process is repeated in November of the second year to review new and unfulfilled requests.

Selection of YEAR 3 Clerkships

Students choose their MS3 schedule through a lottery process towards the end of their second year. They choose a template schedule for each half of the year (one half of 6 week rotations, one half of 4 and 8 week rotations), their family medicine site and their elective block. Students are randomly given alternating lottery numbers for each round of the lottery. Students choose their schedule based on their lottery number, and availability of clerkship and site at the time of their selection.    

In a situation where a student must have a particular schedule and location, his or her assignment will be scheduled prior to the lottery. A student may request a particular schedule for extraordinary, extenuating circumstances such as when (s)he is the primary care taker for a family member or when (s)he has a personal issue requiring the student to remain in a specific geographic area. Requests for a particular schedule must be made to the Office of Student Affairs or Education by January 15th of the second year. The Student Affairs or Education Deans must approve all requests.

If a student wishes to change his/her schedule once the assignments have been made, (s)he must request the change through the senior coordinator in the Clerkship Office. Requests for schedule changes must be made at least four weeks prior to the start of the block/rotation. No schedule changes may be made within four weeks of the start of the rotation without approval of the Student Affairs or Education Deans. If the requested rotation/site is unavailable, students will be put on a waitlist.

Selection of YEAR 4 Clerkships

Students will choose their required and elective rotations through an online lottery process. 

If a student wishes to change his/her schedule once assignments have been made, (s)he must request the change through the senior coordinator in the Clerkship Office. Requests for schedule changes must be made at least four weeks prior to the start of the block/rotation. No schedule changes may be made within four weeks of the start of the rotation without approval of the Student Affairs or Education Deans. If the requested clerkship is unavailable, students will be put on a waitlist. 

Fourth Year Scheduling Policy

The fourth year consists of twelve 4-week blocks and a 2-week capstone course. Students are required to complete a total of 10 blocks (or 40 weeks) plus the capstone course.


  • Sub-Internship (Medicine, Surgery or Pediatrics), Emergency Medicine, Critical Care, Radiology, Capstone Course and six elective blocks
  • Students may complete up to two visiting student (away) rotations. Students may complete a third visiting student rotation only with approval from the Associate Dean for Clinical Education or Senior Associate Dean for Education.  
  • Students may not complete more than four rotations total in a given specialty.
  • Students may complete one international rotation, which will not reduce the number of visiting student rotations.
  • Students may complete up to two non-clinical rotations (academic medicine, research, etc.)
  • Students may complete and receive block credit for a year-long scholarly project (which will fulfill one of the electives in Block 7, 8 or 9).

Visiting Student (Away) Rotations

We recognize the value of experiencing a variety of clinical settings during the fourth year, for education as well as the opportunity to make personal connections at potential residency sites. Therefore, fourth year LKSOM students may take two clinical rotations at sites other than LKSOM or its academic affiliates to satisfy clerkship elective requirements. Students are not permitted visiting student rotations in their third year. 

It is important that students wanting to complete visiting student rotations follow standard procedures to ensure that they receive credit for the experience:

  • The student applies for the visiting student rotation through the VSAS system.
  • If the school is not part of the VSAS system, the student must get approval from the Associate Dean for Clinical Education or Senior Associate Dean for Education prior to applying. All clinical schedules are reviewed by the Dean’s office.
  • The student works with LKSOM staff in the Offices of Medical Education, Student Records, and Student Health to ensure all required documentation is provided via VSAS or directly to the school.
  • Upon receipt of an offer from the host school:
    • The student provides a copy of the offer letter to the clerkship scheduler, Gina Ralph, via email ( or in person in MERB 229;
      • If there is no academic affiliation agreement in place between LKSOM and the host school, and it is determined one is needed, the clerkship scheduler will confer with the Associate Dean for Clinical Education to have the site approved and work with the Office of Academic Affiliations to have the affiliation agreement process started.
  • The student must relay to clerkship staff ( the name of his/her preceptor at the host institution to ensure a completed evaluation is received.
  • The student provides feedback on the rotation via One45.

Return to the Medical Education page of the MD Student and Faculty Handbook