Standards for call duty and student workload in the Clerkship

Dear Medical Students,

We are writing to inform you of three recent amendments to the standards for call duty and student workload in clerkship.  In brief, these amendments include:

  • A revision to the maximum number of hours per day that a student may spend in required clinical and didactic experiences to: no more than an average of 12 hours per day across the duration of a clerkship rotation, excluding days on which a student is on-call or post-call.
  • The addition of the following stipulation: For rotations that include an on-call requirement that extends into the evening but is not overnight and where students are expected back to work the following day, the on-call period must end by 11:00 pm.
  • The addition of the following stipulation: A medical student who is pregnant will not be required to participate in on-call duty after 31 weeks’ gestation unless agreed to otherwise by the medical student.

As well as informing you about these recent amendments, we are writing to ask for your help to ensure that you are not being required to exceed the limits stipulated in the amended Standards. If you are being required to exceed these limits, we are requesting that you:

  • Include an observation about this on the end-of-rotation evaluation in response to the questions about duty hours
  • Let your course representative know
  • If possible, e-mail the course director and/or the Clerkship Director

A copy of the full Standards, with the most recent amendments, is attached to this message.

The U of T Undergraduate Medical Education (MD) program underwent accreditation in 2012, and the result overall was full accreditation for eight years. Three accreditation standards were judged to be not in compliance, including standard ED-38, in particular the requirement that medical schools “must develop and implement policies regarding the amount of time medical students spend in … clinical and educational activities during clinical clerkship rotations.” We are required to submit a report to the accrediting bodies by August 2013. Our demonstrated commitment to monitoring and enforcing our Standards for call duty and student workload in the Clerkship, which have been amended to ensure you are able to have a comprehensive experience during clerkship without having an excessive workload, is an essential step in addressing the finding of non-compliance with accreditation standard ED-38.


We are sending similar messages to the residents and to the faculty, and we will be closely monitoring the situation via both continued surveys and periodic interviews with students.  We thank you in advance for your cooperation with this important issue.  If you have any questions or concerns, please do not hesitate to contact any of us.


Patricia Houston                             Stacey Bernstein                                            Martin Schreiber                           

Vice-Dean, UME                             Clerkship Director                                         Director,UMECurriculum