Clerkship Work Hours and Call

The purpose of the Clerkship Work Hours Policy is to establish standards regarding the number of hours’ medical students participate in clerkship rotations; as well as to specify call and post-call requirements.

This policy ensures that the Undergraduate Medical Education program meets or exceeds the following Committee on Accreditation of Canadian Medical Schools (CACMS) and Liaison Committee on Medical Education (LCME) accreditation standards:

8.8 Monitoring Time Spent in Educational and Clinical Activities: The curriculum committee and the program’s administration and leadership implement 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 required clinical learning experiences.

Transparency: The College of Medicine is committed to ensuring a transparent approach to the number of hours per week during clerkship as well as call and post-call requirements.

Clerkship: The third, fourth, and fifth years of the University of Saskatchewan Undergraduate Medical Education Program (UGME) are termed “clerkship”. During this program phase, medical students participate in clinical learning activities known as rotations, which occur on the College of Medicine campuses in Regina, and Saskatoon, and distributed sites in Prince Albert and various Saskatchewan Integrated Longitudinal Clerkship locations.

This policy applies to all undergraduate students registered in the Doctor of Medicine (MD) program at the University of Saskatchewan irrespective of the geographically distributed site to which they are currently assigned.

1.0 Clerkship Duty Hours

Hours of daytime work on weekdays will vary by rotation. Clerks should not be expected to work more than 11 hours per day on a regular basis, though this may occur on occasion. The weekly maximum (not including evening, night or weekend call) is 55 hours per week. Calculations include clinical work and scheduled educational sessions.

2.0 Clerkship Call

As part of clerkship, all Clerks are required to take call on some rotations. On-call experience is considered an essential part of clinical education during clerkship. Please note that the call schedules and hours may differ between sites. The following criteria applies to all rotations:

• Weekend call is defined as between Friday at 1700h to Monday at 0800h, including statutory holidays.
• Clerks should not be on call 3 weekends in a row.
• The call schedule for Clerks should not exceed 1-in-4 days (or 1-in-3 days if home call) averaged over the entire rotation.
• On occasion, in some rotations, the call schedule may be more than 1-in-4 but must not exceed this standard on average during the whole rotation. Where 1-in-4 is modified, the departmental Rotation coordinator should consult with the student(s) involved.
• Home Call is defined as either not being in hospital for call, or with call finishing at 2300h. If a student who is on Home Call has to come into the hospital, or work in the hospital, after 2300h for clinical duties, the post-call policy will be followed (i.e. they can be off call after 1200h and have a post-call day.)
• Please note: if a student is on “home call” less than or equal to 2300h, they are expected to attend regular duties the next day.
• No clerk should be on call after 1700h on the last day of the rotation.
• No clerk should be on call after 1700h the night before an oral or written exam.
• No clerk should be on call later than 2300h, on Monday night and should be finished their clinical duties at this time to allow Clerks adequate rest in preparation for the mandatory Selected Topics in Medicine sessions scheduled every Tuesday from 0800h to 1100h.

• If a student is travelling to a Rural Rotation or Elective in the next block, they will not be on call at least 36 hours before the start of that rotation (I.e. not past 2300h on Saturday). The onus is on the student to inform the admin of this prior to the release of the final call schedule for that rotation.
• Students who take vacation are not required to take extra call.
• Switchboard must be notified if a switch is made in the call schedule where applicable.
• Clerks may request up to 2 days off-call per 6-week rotation, with a maximum of 1 weekend considered. Off-call is not allowed on 2 and 4 week rotations. Please note that these are only requests and may not be granted nor should these requests create undue hardship for other learners on the rotation nor the rotation itself
• “Off call” days do not count as vacation days and are subject to approval by the department. A minimum of 6 weeks notice is required.

Clerks who are on duty on a statutory holiday for 8 hours between 0800h and 2300h are eligible for time off in lieu of that day. Time off in lieu must be requested through  SharePoint and must be taken on the rotation in which the time was earned. If the stat falls at the end of a rotation, the day in lieu may be requested on a day prior to the stat in that same rotation, with the understanding that if the clerk is absent on the stat day for any reason they will be required to make up the time on that rotation.  If a clerk requests to work on a stat holiday, they will not be eligible for a day off in lieu.

Students may be required to do call on Electives. Not all rotations will have required call. If the clerk is wanting more call opportunities, they must speak with their rotation director. The call work hour policy must be followed. Extra call is dependent on capacity. Timely notification of call schedules is an essential part of ensuring optimal student education during clerkship. The provision of the call schedule on a timely basis is the professional responsibility of the departmental rotation coordinator or departmental administrator of the rotation. Final call schedules must be provided to the students at a minimum of two-weeks prior to the start of the rotation.

For clerks that are pregnant, call shifts will cease at 28 weeks of gestation.

3.0 Clerkship Post-Call

Attendance at clinical duties and teaching activities during clerkship is part of the core professional and academic responsibilities of medical students; this includes those activities scheduled post-call. The following is the policy for Clerks post-call:

• 1200h, noon, is the latest a student can ever be expected to participate in clinical care/educational sessions and may go home.
• Clerks are not excused from clinical duties following Selected Topics in Medicine Half Day, even if on-call until 2300h the previous night.

The post call procedure in the Resident Doctors of Saskatchewan (RDOS) agreement is not applicable to the clerk call schedule.

The Associate Dean, Undergraduate Medical Education, is responsible for providing oversight to the overall administration of the Clerkship Work Hours Policy in the College of Medicine.

The Manager, Undergraduate Medical Education, with the assistance of the Undergraduate Medical Education Office and Office of Admissions, is responsible for the implementation, monitoring, maintenance, and evaluation of the Clerkship Work Hours Policy at the College of Medicine campus in Saskatoon, Saskatchewan.

Instances or concerns of non-compliance with the Clerkship Work Hours and Call Policy should be brought to the attention of the Year Chair, Undergraduate Medical Education, within the College of Medicine.

The Manager, Undergraduate Medical Education, provides overall stewardship to the standard operating procedures associated with the Clerkship Work Hours Policy.

Manager, Undergraduate Medical Education
Phone: 306-966-6104
Email: ugme.policies@usask.ca