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Clerkship Division of Responsibilities 

Student and Preceptor Responsibilities

The CUNY School of Medicine PA Program is committed to the development of knowledge and ethics that are consistent with responsible professional and social behavior. During orientation to the program, each student received a copy of the Physician Assistant Program Academic Handbook and prior to the start of the clinical clerkships, each student receives a copy of the Policies and Requirements for Students in the Clinical Year.  These documents govern student activity while enrolled in the CUNY School of Medicine PA Program. Students are expected to meet academic requirements and demonstrate a sense of responsibility with an understanding of and respect for the rights of others. The atmosphere of the University reflects these goals; and, in turn, each student must be aware of his/her individual responsibility to act accordingly. By enrolling as a student at the CUNY School of Medicine PA Program, a student agrees to abide by the rules and regulations of CCNY. The rules concerning student behavior are outlined in the Community Standards section of the Division of Student affairs in the CCNY website. Specific conduct expectations of the CUNY School of Medicine Physician Assistant student can be found in the “Standards of Conduct” section of this handbook. Alleged violations of the program’s Standards of Professional Behavior will be referred to the Course and Standing Committee. 

The student is responsible for:

  • To maintain professional behavior towards patients, their families, preceptors, staff, and their colleagues.

  • To report to the preceptor on the first day of the rotation;

  • To review rotation learning objectives;

  • To communicate with preceptors any information regarding the care, evaluation, management or documentation of all patients;

  • To understand the rules and regulations of the clinical site;

  • To meet the learning objectives as directed by preceptors and Program faculty. The preceptor and supervising clinicians will retain full responsibility for the care of patients and will maintain administrative and professional supervision of the student;

  • To ensure all orders, documentation and notes are countersigned by the preceptor prior to being carried out or accepted by the institutional staff.  Some clinical sites will prohibit a student from performing certain procedures, or from making entries in the patient record. It is the duty of the student to respect the parameters of their role in each clinical site. 

The student, under the supervision of a licensed physician or PA preceptor, will be expected to:

  • Collect and record a complete database (detailed histories, and complete physical examination) on all patients, both inpatient and outpatient;

  • Write appropriate orders for diagnostic tests and studies;

  • Perform routine procedures (i.e., draw venous and arterial blood samples, begin intravenous therapy, perform lumbar punctures, insert and remove CVP catheters, nasogastric tubes and urinary catheters);

  • Assist the clinician in the performance of operative procedures (i.e., venous cut-downs, joint aspiration or injections, bone marrow aspiration or biopsy, and endotracheal intubation);

  • Observe and assist in surgery and deliveries;

  • Suture non-complicated lacerations;

  • Obtain informed consent;

  • Write orders of medications and indicated treatment modalities, as directed by the clinician and hospital protocol;

  • Make daily rounds to observe and document patient progress;

  • Participate in on-call activities and responsibilities;

  • Initiate appropriate resuscitative therapy for the patient in a life-threatening condition until the arrival of the clinician and other assistance;

  • Maintain appropriate BLS/ACLS certification for each rotation. Uncertified students will not be allowed onto a rotation site;

  • Participate in ALL Call Back Day activities. 

Students WILL NOT be permitted to:

  • Initiate patient care that has not been outlined and supervised by the clinician;

  • See, treat, or dismiss a patient without review and discussion of the patient’s problem with the clinician;

  • Dispense or write prescriptions for any medications without approval of the clinician, and his/her signature as co-signer;

  • Initiate disclosure of, or draw conclusions from, findings or treatment plans with the patient without prior discussion with the clinician;

  • Change standing orders without consultation and approval of the supervising clinician;

  • Initiate treatment for a patient that has not been seen or examined;

  • Participate in a treatment modality, diagnostic procedure, or other activity that is beyond their level of training or level of competence;

  • Discuss findings with a patient prior to conferring with the preceptor;

  • Discuss a patient by name with anyone except other members of the health care team, without the patient’ consent;

  • Discuss a patient’s condition with family members without the patient’s consent;

  • Discuss a patient in a public place such as in the elevator or hallway;

  • Take pictures of a patient;

  • Check the Electronic Medical Record of any patient that is NOT part of their service;

  • Perform duties that do not achieve the purpose, goals, and objectives of the rotation, including personal requests from either patients or preceptors (should such requests be made, one of the Clinical Coordinators should be notified).

 The Preceptor is responsible for:

  •  Evaluating each student in the following areas: academic knowledge, content of documentation, professionalism, team work, communication skills, patient management skills, and clinical decision-making skills;

  • Orienting students at the onset of the rotation to the practice/site policies and procedures and review the expectations and objectives for the rotation;

  • Providing ongoing and timely feedback regarding clinical performance, knowledge base, and critical thinking skills. This can be done with the student informally each week or at a designated time and can be formally reported to the Clinical Coordinator by submitting mid-rotation and end-of-rotation evaluations;

  • Increasing levels of responsibility for clinical assessment and management as appropriate to the student’s experience and expertise;

  • Observing and evaluating oral and written presentations;

  • Assigning and discussing readings concerning best practice;

  • Meeting with PA faculty during site visits to evaluate student progress;

  • Auditing and co-signing charts in order to evaluate the student’s ability to write appropriate and complete progress notes, histories, physical examinations, assessments, and treatment plans;

  • Submitting student mid-rotation and final evaluations via the Typhon logging system;

  • Tracking student attendance and performance;

  • Promptly notifying the PA Program of any circumstance that interferes with meeting the published objectives or diminish the overall training experience;

  • Modeling best practice and ethical, professional behavior;

  • Demonstrating cultural competency through interactions with patients and students;

  • Meeting with students on a regular basis and discussing progress and deficiencies;

  • Maintaining physical presence on-site for the length of clerkship;

  • Assuring a safe learning environment;

  • Assuming strict professional boundaries and not compromising the student by asking for non-clinical tasks;

  • Providing the student with opportunities to meet the objectives. At a minimum, preceptors should provide opportunities for interviewing and physical examinations, formulating primary and differential diagnosis, determining treatment and management plans, presenting patient cases, and performing or assisting in diagnostic and therapeutic procedures. 

Preceptor Review and Countersignature

All patients evaluated by a PA student must be then examined by the supervising preceptor. The supervising preceptor must review and countersign all notes submitted by the student. The student must sign each note with their name and title (PA-student) and not the abbreviation “PA- S” to prevent confusion.  The supervising preceptor must countersign the note immediately.

The student is not authorized to initiate any orders for a patient without the consultation and the signature of the supervising preceptor.  Students are not permitted to sign any prescriptions.

Failure to adhere to these policies will result in a disciplinary hearing before the Committee on Course and Standing. 

Patient’s Bill of Rights

Patients in a hospital in New York State have the right, consistent with law, to:

  • Understand and use these rights. If for any reason, you do not understand or you need help, the hospital MUST provide some assistance, including an interpreter.

  • Receive treatment without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation, source of payment, or age.

  • Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.

  • Receive emergency care if you need it.

  • Be informed of the name and position of the doctor/provider who will be in charge of your care in the hospital.

  • Know the names, positions and functions of any hospital staff involved in your care and refuse their treatment, examination or observation.

  • A no smoking room.

  • Receive complete information about your diagnosis, treatment and prognosis.

  • Receive all the information that you need to give informed consent for any proposed procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment.

  • Receive all the information you need to give informed consent for an order not to resuscitate. You also have the right to designate an individual to give this consent for you if you are too ill to do so. If you would like additional information, please ask for a copy of the pamphlet “Deciding About Health Care — A Guide for Patients and Families.”

  • Refuse treatment and be told what effect this may have on your health.

  • Refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.

  • Privacy while in the hospital and confidentiality of all information and records regarding your care.

  • Participate in all decisions about your treatment and discharge from the hospital. The hospital must provide you with a written discharge plan and written description of how you can appeal your discharge.

  • Review your medical record without charge. Obtain a copy of your medical record for which the hospital can charge a reasonable fee. You cannot be denied a copy solely because you cannot afford to pay.

  • Receive an itemized bill and explanation of all charges.

  • Complain without fear of reprisals about the care and services you are receiving and to have the hospital respond to you and if you request it, a written response. If you are not satisfied with the hospital’s response, you can complain to the New York State Health Department. The hospital must provide you with the State Health Department telephone number.

  • Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors.

  • Make known your wishes in regard to anatomical gifts. You may document your wishes in your health care proxy or on a donor card, available from the hospital.

    Public Health Law (PHL) 2803 (1) (g) Patient’s Rights, 10NYCRR, 405.7, 405.7(a) (1), 405.7(c)

Patient Rights and Confidentiality

All information regarding a patient’s health is privileged information. All students must strictly adhere to each institution’s policy governing patient rights and confidentiality and to all federal, state and local regulations. Students must not discuss any information regarding a patient in a manner or location that might

reveal the identification of the patient to individuals not directly involved in that patient’s care. Patients’ chart, inclusive of progress notes or lab reports, must not be removed from the clinical site. If photocopies of a patient’s record are needed for a site evaluation, all identifying information must be removed to protect patient confidentiality.

For more information, please see: http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/