School of Medicine: Clinical Supervision of Medical Students Policy

Unit Policy

Title

School of Medicine Offices of Medical Student Education: Policy on Clinical Supervision of Medical Students

Introduction

Purpose

This Policy defines the University of North Carolina at Chapel Hill ("University") School of Medicine's (SOM) expectations for supervision of Medical Doctorate (MD) degree program students ("Students") in clinical settings.

Scope

This Policy applies to Students, course directors, Supervisors, Phase Leaders and Committee members, and Education Committee members for all courses and at all campuses and sites.

Policy

Policy Statement

The SOM is committed to ensuring that it adheres to expectations that protect patient and Student safety in accordance with Element 9.3 of the Liaison Committee on Medical Education (LCME) Functions and Standards. In furtherance of this commitment, the SOM has established expectations for the clinical supervision of its Students.

Supervisors and/or course directors are responsible for ensuring that this Policy is followed by all individuals within its scope.

Expectations of Supervisors/Course Directors

Supervisors and course directors are expected to do the following with regard to Student supervision in clinical settings:

  1. Define the level of patient interaction expected of Students.
    1. Foundation, Application, and Individualization Phase Committees: Review and approve the course‑specific level of expected patient interaction appropriate to Students' training level.
  2. Model professional behavior in interactions with patients, Students, staff, and all other individuals in a health care team.
  3. Provide Students with progressively autonomous opportunities for learning that are commensurate with Students' level of knowledge, technical skill, and level of training and address specific learning objectives for their courses.
  4. Ensure that Students are appropriately supervised to ensure patient and Student safety according to the policies and procedures of the SOM and of sites.
    1. Students may perform the history and physical exams under Indirect Supervision. Students may perform procedures under Direct Supervision.
  5. Ensure that all individuals who interact with Students are appropriately trained and credentialed for patient care interactions.
  6. Ensure that the allied health professionals (physician assistants, nurse practitioners, etc.) that interact with Students are appropriately credentialed or functioning under the supervision of a credentialed faculty member and are performing tasks that are within their scope of practice.
    1. Attending faculty members are responsible for the integrity of medical information and/or clinical procedures.
  7. Ensure that call schedules provide for a Supervisor to always be designated and available to provide the appropriate level of clinical supervision.
  8. Ensure Students are aware of expectations for their behavior and of the procedures or other tasks they are permitted to perform.
  9. Ensure patients are aware of the status of Students and that they accept that Students may participate in their care.
  10. Review and confirm information collected by Students through history taking, physical examination, or other activities and provide feedback that enhances the Students' learning experience.
  11. Complete Student assessments in a timely manner, with all assessments completed in time for calculation of final grades.

Expectations of Students

Students participating in clinical settings are expected to:

  1. Maintain professional behavior standards with supervising physicians, other members of medical teams, including resident physicians, other health professionals, members of medical staffs, patients, and any other individuals encountered in clinical settings.
  2. Maintain self-awareness of own competence and seek assistance/advice when clarification is needed.
  3. Inform patients and/or patients' family members of their status as a Student and the name of the Supervisor under whom they are working.
  4. Proactively inform their Supervisors or course directors regarding their concerns about levels of supervision (excessive supervision or sub-standard supervision).

Reporting and Monitoring

Student Reports

Any Student who is concerned about the level of supervision they are receiving should address their concerns (whether verbally or via email) as soon as possible with their Supervisor and/or course director. Any Student who feels that their concerns have not been adequately addressed should then communicate their concerns (whether verbally or via email) to the campus director, course director, or Curricular Affairs Leadership (Assistant Dean for Preclinical Curriculum, Assistant Dean for Clinical Curriculum, Associate Dean of Curriculum, and/or Senior Director of Curriculum). Students' reports regarding their clinical supervision will be kept confidential if possible. However, this may not be possible in situations where Student or patient safety may be compromised, illegal activities may have occurred, or other situations which require immediate contact with a reporting Student.

Students provide feedback on their satisfaction with the level of the clinical supervision they received during a course through end-of-course evaluations.

Monitoring

Course directors are notified through the SOM's evaluation system, One45, when Students report concerns about clinical supervision. During annual course reviews, course directors summarize Student feedback on supervision provided through end-of-course evaluations and report to the appropriate Phase Committee on how they are ensuring that Students receive the appropriate level of clinical supervision.

Phase Leaders present to their respective Phase Committees a summary of Student reporting on the appropriateness of clinical supervision across all courses in the phase. This phase‑level report is then brought forward to the Education Committee annually to ensure oversight and address any identified areas of concern.

The Education Committee conducts an annual review of Student supervision reports from the Foundation, Application, and Individualization Phases to identify concerns related to clinical supervision and recurring issues reported by Students. The Education Committee reviews reports from each Phase Committee describing how they ensure appropriate levels of clinical supervision. Identified concerns are addressed through established oversight and remediation processes.

Definitions

Supervisor can be:

  1. A physician with a SOM faculty appointment;
  2. A resident physician or fellow in a Graduate Medical Education program; or
  3. Other licensed health professionals acting within their scope of practice.

Levels of Supervision

  1. Direct Supervision: The Supervisor is physically or virtually present with the Student and able to provide real‑time instruction and feedback, assuming patient‑care responsibilities when necessary. Direct supervision may also be provided by a resident physician or another licensed health professional working within their scope of practice, under the indirect supervision of an attending physician.
  2. Indirect Supervision: The Supervisor is on duty, immediately available, and can be called to the location of the Student if necessary.

Phase Committee: The subcommittees of the Education Committee corresponding to the three phases of the MD degree program curriculum: Foundation Phase, Application Phase, and Individualization Phase.

Foundation Phase: The first eighteen (18) months of the medical school curriculum comprised of:

  • Nine (9) Medical Science courses (three (3) per semester)
  • Three (3) semesters of Patient Centered Care (PCC)
  • Three (3) semesters of Social and Health Systems (SHS)

Application Phase: The thirteen (13)-month phase of the medical school curriculum dedicated to core clinical experiences, beginning in March and ending in February of the following year consisting of:

  • Six (6) clinical courses:
    • Obstetrics and Gynecology
    • Internal Medicine
    • Community Based Primary Care
    • Pediatrics
    • General Surgery
    • Psychiatry
  • One (1) Conclusion of Application Phase (CAP) Course
  • One (1) longitudinal course:
    • Social and Health Systems 4

Individualization Phase: The final thirteen (13) months of the medical school curriculum dedicated to the completion of graduation requirements and electives tailored to a Student's career interest, beginning in March and ending in May of the following year consisting of:

  • Two (2) Acting Internships
  • One (1) Critical Care Selective
  • One (1) Neurology Selective
  • Three (3) Electives
  • Transition to Residency (TTR)
  • Two (2) longitudinal courses:
    • Science of Medicine
    • Social and Health Systems 5

Related Requirements

External Regulations

Contact Information

Primary Contact

Title: Senior Director for Curricular Affairs

Name: Mary Hauser

Email: mary_hauser@med.unc.edu

Publication Details

Issuing Officer: Heather Tarantino, Associate Dean for Curricular Affairs, heather_tarantino@med.unc.edu

Effective Date: March 1, 2026

Review Cycle: The Education Committee shall review this Policy within each even numbered fiscal year with input from the Application Phase Committee.

Next Review Date: February 28, 2028

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