COM – Curriculum Contact Hours

Policy Number: 3349-AC-409
Effective Date: 07/01/2018
Updated: 09/17/2021
Reviewed: —
Approval Authority: Senior Associate Dean for Academic Affairs
Responsible Department: College of Medicine, Office of the Dean and Medical Education
Responsible Office: Office of the Dean and Medical Education

A. Purpose

The purpose of this Policy is to specify the amount of time medical students may spend in scheduled curricular activities in accordance with the Liaison Committee on Medical Education (LCME). LCME requires that “the medical school faculty committee responsible for the medical curriculum and the program’s administration and leadership ensure the development and implementation of effective policies and procedures regarding the amount of time medical students spend in required activities, including the total number of hours medical students are required to spend in clinical and educational activities during clerkships” (LCME Functions and Structure of a Medical School, effective July 1, 2019).  The relevant LCME element is as follows:

• Element 8.8 Monitoring Student Time

B. Scope

This Policy applies to all credit-bearing courses that are contained in the College of Medicine Curriculum, M1 though M4 years. It does not apply to any pre-matriculation courses or offerings, or any co-curricular activities at any level.

C. Definitions

1. Contact Hour: A contact hour is considered to be fifty (50) minutes, which is typically the amount of time in a 60-minute period used for instructional purposes.
2. Credit-bearing Course: A course offered by the College of Medicine in which a student is enrolled, the course appears on the student’s official transcript with either contact hours or credit-bearing acknowledgment, and a grade is assigned.
3. Structured Teaching: For the purposes of this Policy, structured teaching (an instructor-intensive activity) includes, but is not limited to instructional activities such as lectures, grand rounds, and whole class sessions/lectures that contain peer instruction and/or small group interaction.
4. Unstructured Teaching: For the purposes of this Policy, unstructured teaching (a student-intensive activity) includes, but is not limited to, instructional activities such as small group discussions, laboratory sessions and team-based learning.

D. Policy and Procedure

1. Monitoring adherence to the Policy for all academic years is the responsibility of the Curriculum Committee, with support from the Curriculum Subcommittees.
2. Students shall be informed of the curriculum contact hours via individual course syllabi schedule, and this policy as provided on the NEOMED Office of the General Counsel Policy Portal.
3. Faculty shall be informed of the curriculum contact hours via the Course Director Handbook and the Site Director Handbooks for clerkships as well as the NEOMED Office of the General Counsel Policy Portal.
4. M1 and M2 Years
   1. Curriculum hours in the M1 and M2 years are calculated in terms of contact hours of scheduled activities each week.
   2. Scheduled contact hours per week should be twenty-three (23) or fewer every week. (This applies to M1 year only for AY 20-21 and to both M1 and M2 years in AY 21-22 and moving forward.)
   3. Contact hours may exceed twenty-three (23) hours only if granted an exception by the Curriculum Committee.
   4. Estimated out-of-class time for preparation should be equal to in-class time and is assumed in the credit calculations as part of preparation time per the Semester Credit Definition Policy.
5. M3 and M4 Years
   1. Contact hours in the M3 and M4 years shall include both clinical experience and educational activities related to all courses, clinical courses as well as non-clinical courses that may be offered concurrently or independently (considering acceptable limits of comparability across clinical teaching sites).
   2. Clinical and educational work hours will adhere to the guidelines provided by the Accreditation Council for Graduate Medical Education, Common Program Requirements.
      1. Clinical and educational work hours must be limited to no more than eighty (80) hours each week, averaged over a four (4)-week period, inclusive of all in-house clinical and educational activities (e.g., lectures, simulation labs, clinical skills assessments, examinations, specified independent learning activities) and clinical work done from home, such as home call.
         1. While the requirement is written with the intent of allowing students to remain beyond their scheduled work periods to care for a patient or participate in an educational activity, these additional hours must be accounted for in the allocated eighty (80) hours averaged over four weeks.
      2. Students should have eight (8) hours off between scheduled clinical work and education periods.
      3. Students must have at least fourteen (14) hours free of required clinical work and education after twenty-four (24) hours of in-house call.
      4. Students must be scheduled for a minimum of one (1) day in seven (7) free of clinical work and required education, when averaged over four (4) weeks.
      5. Clinical and educational work periods for students must not exceed twenty-four (24) hours of continuous scheduled clinical assignments. Students who have completed a twenty-four (24)-hour clinical and educational work period may spend up to an additional four (4) hours at a clinical site for transitions of care including rounds, and in educational activities; this additional time must not be used for care of new patients.
      6. In rare circumstances, after handing off other responsibilities, a student, on his/her own initiative, may elect to remain or return to the clinical site in the following circumstances:
         1. to continue to provide care to a single severely ill or unstable patient;
         2. to continue to provide care to a single severely ill or unstable patient;
         3. to attend unique educational events.
      7. These additional hours of care or education should be counted toward the eighty (80)-hour weekly limit.
   3. To better ensure comparability of study time for the NBME shelf examination across sites, students should have time set aside the final week of the clerkship for independent review. This time is outside of their curriculum contact hours and should not count as an absence. Students in Family Medicine, Pediatrics, Psychiatry and Obstetrics-Gynecology clerkships should have a ½ day for preparation /independent learning time during the final week and students in Internal Medicine and Surgery should have two ½ days or 1 full day set aside during their final 1-2 weeks.
   4. It is the responsibility of the clinical education/course directors in the M3 and M4 years to develop and seek curriculum committee approval of mechanisms for collecting information about and monitoring clinical experience and education hours.
   5. Each clinical teaching site is provided with flexibility of determining students’ on-call requirements in compliance with this Policy and with approval of the course director within specified limits of comparability.
6. Students may report violations of contact hours (M1 and M2) and clinical experience and education hours (M3 and M4) without fear of retaliation. Students may submit violation reports or any incidents of retaliation to the course director, the clinical experiential director, the clinical site director, or an associate dean for medical education.

Download the Policy*