Medical Trainee Intern - Clinical Practice Requirements and Safety
Richardt E. made this Official Information request to University of Auckland
Response to this request is long overdue. By law University of Auckland should have responded by now (details and exceptions). The requester can complain to the Ombudsman.
From: Richardt E.
Dear University of Auckland,
I submit to your organisation, a request for information regarding the following to analyse your compliance to student and patient welfare throughout the required work-based learning programme MBChB for medical trainee interns.
1. Clinical Placement Hours Requirements:
a) Outline the clinical placement hours required for medical students during each year of the medical programme from Year 4,Year 5, and Year 6 from the year 2022, 2023, and 2024.
b) Explain how these hours align with the pre-registration compliance requirements of governing or professional body organisations and if they are based on any specific time requirements spent learning within the clinical environment.
c) Provide the rationale for the chosen amount of hours. If specific hours were not chosen, detail the evidence and guidelines the university based its decision on, and please provide references to these below which are accessible to the public community.
2. Uniformity Across Training Levels and Cohort Sites:
a) Confirm whether the clinical placement hour requirements are the same for all medical students at the same year level of training, and specialty, across all cohort sites.
b) If there are differences, explain why these exist at each site and whether they impact the fairness or equality in student academic success, i.e. students that spend multiple years of their clinical practice time at the same facility.
3. Contracts and Agreements:
a) Indicate whether a contract exists between the Ministry of Health, Te Whatu Ora, or each health organisation outlining the clinical placement or work-based learning arrangements for medical student clinical placements.
b) If such contracts exist, provide a copy with your response. If not available for public view, explain why, and if legal implications are the reason to this, please provide links to the specific legislation outlining this.
4. Financial and Other Benefits:
a) List any financial or other benefits gained by the university or the health organisations because of these agreements.
b) Explain if these benefits affect the negotiated hours of work expected by medical students.
5. Health and Safety Considerations:
a) Describe how patient and student health and safety have been considered when determining the clinical placement hours.
6. Formal Complaints and Outcomes:
a) Provide information on any formal complaints made by students or pastoral support persons regarding long placement hour requirements or the impact they have had on student or patient health and wellbeing from each year including 2019-2024.
b) Detail the outcomes of these complaints.
7. Limits on Unpaid Working Hours:
a) State the limitations on unpaid working hours for students to ensure patient and student safety and fatigue prevention. If there are no limitations, please provide reasons as to why and whether any legislation prevents exploitation of or governs the student work-based learning pathway.
b) Include specifics on hours per day, shift start and end times, consecutive hours worked, consecutive days worked, and meal or rest breaks that students are entitled to.
8. Adherence to Workplace Health and Safety Legislation:
a) Explain how the university ensures adherence to legislation regarding workplace health and safety, specifically focusing on fatigue, safety, stress, and burnout for trainee interns in clinical practice.
b) Detail the measures in place to monitor and mitigate fatigue among medical students during clinical placements.
c) Describe the strategies implemented by the university to manage and reduce stress and burnout among medical student during their clinical training years and whether this has been deemed sufficient by students undergoing these placement requirements.
d) Provide information on the rights of students, volunteers, or others in the work-based MBChB learning programme, including any protections against overwork and unsafe working conditions that the University has used to
e) Explain how the university ensures compliance with relevant health and safety regulations and guidelines, such as those from WorkSafe New Zealand1.
f) Outline the rights of the medical students and the processes they can take when and if they are enabled the right to refuse excessive workloads or excessive clinical placement hours and whether this would implicate their ability to pass the specific run/programme and if they would be reprimanded for doing so.
g) Provide a list of the likely outcomes for the student should they undertake this process.
9. Impact on Student Well-being:
a) Discuss any initiatives or support systems in place to promote the well-being and mental health of medical students during their clinical placements.
b) Provide data or evidence on the effectiveness of these initiatives in reducing stress and burnout that the university has identified.
10. Self-Directed Learning Expectations:
a) During these clinical placements, how many hours each week per year level does the university expect a student to undertake self-directed learning to ensure they maintain an adequate passing grade?
b) In combination with clinical placement hours, is this deemed appropriate given this is a full-time unpaid clinical programme and the legal definition of a full-time working week is 40hours?
11. Compliance with Educational Standards:
a) Detail how the clinical placement hours and self-directed learning expectations comply with the educational standards set by the New Zealand Qualifications Authority (NZQA) and the Medical Council of New Zealand (MCNZ).
b) Provide any relevant guidelines or standards from these bodies that the university has used when deciding the above.
12. Feedback and Continuous Improvement:
a) Describe the process for collecting feedback from students regarding their clinical placement experiences.
b) Explain how this feedback is used to make continuous improvements to the clinical placement programme.
c) Provide examples of changes or improvements made to the work-based learning programme that has been based on student feedback.
Yours faithfully,
Richardt. E.
From: Landon Watt
University of Auckland
Dear Richard,
I refer to your email of 26 August 2024, in which you have made a very
large and wide-ranging request for information. Please advise by 26
September 2024 whether you are willing to significantly narrow your
request and, if so, how. If you are not willing to narrow your request, it
is likely that the University will refuse it on the basis that the
official information requested that is held by the University cannot be
provided without substantial collation or research.
Please also note that the OIA allows eligible persons to request an agency
to provide them with specified official information – it does not require
agencies to create justifications or explanations on a matter of interest
to the requester.
As your request is for a large quantity of official information or
necessitates a search through a large quantity of information and meeting
the original time limit would unreasonably interfere with the operations
of the University, and consultations necessary to make a decision on your
request are such that a response cannot reasonably be given within the
original time limit, the University has extended the time limit for your
request under section 15A(1)(a) and (b) of the OIA. The new maximum time
limit for the University’s response is 19 November 2024; we will respond
to your request as soon as reasonably practicable. You have the right to
make a complaint to an Ombudsman if you are dissatisfied with this
extension.
Yours sincerely,
Landon Watt
Legal Advisor
Office of the Vice-Chancellor
Waipapa Taumata Rau | University of Auckland
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Dear University of Auckland,
Please review the amended FYI ROI as per following.
I submit to your organisation, a request for information regarding the following to analyse your compliance to student and patient welfare throughout the required work-based learning programme MBChB for medical trainee interns.
1. Minimum Clinical Placement Hour Requirements
a) Outline the minimum clinical placement hours required during each year of the medical programme to pass Year 4, Year 5, and Year 6 in 2023 and 2024.
b) Explain how these hours align with the pre-registration compliance requirements of governing or professional body organisations MCNZ.
c) Explain how this minimum requirement was chosen: Provide links to the governing requirements/research that the university has used to define the minimum clinical placement time.
2. Uniformity Across Training Levels and Cohort Sites:
a) Confirm whether the clinical placement hour requirements are the same for year 4, year 5, and year 6 medical students at the same level of training, and specialty, across the Auckland and Waikato district cohort sites.
b) If there are differences, explain why these exist at each site and state (YES or NO) as to whether they impact the fairness or equality in student academic success, i.e. students that spend multiple years of their clinical practice time at the same facility.
3. Contracts and Agreements:
a) Indicate (YES or NO) whether contractual agreements exist with Te Whatu Ora, or each health organisation (Te Whatu Ora, Auckland, North Shore, Counties Manukau and Waikato regions) outlining the clinical placement or work-based learning arrangements for medical student clinical placements.
4. Financial and Other Benefits:
a) List any financial or other benefits gained by the university or the health organisations because of these agreements.
b) Explain if these benefits affect the negotiated hours of work expected of medical students and how they were influenced.
5. Health and Safety Considerations:
a) Describe how patient and student health and safety have been considered when determining the clinical placement hours. i.e. Limits on working hours per day, week, or consecutive days worked.
6. Formal Complaints and Outcomes:
a) Provide a number for how many formal complaints have been made by medical students or pastoral support persons regarding long clinical placement hour requirements expected of students from 2020-2024.
b) State whether actionable change has been made to the placement time requirements because of these complaints.
7. Limits on Unpaid Working Hours:
a) State the limitations in place for clinical students on the number of clinical hours they are required to work to ensure patient and student safety and fatigue prevention. If there are no limitations, please provide reasons as to why.
b) provide specifics on hours per day, shift start and end times, consecutive hours worked, consecutive days worked, and meal or rest breaks that students are entitled to.
8. Adherence to Workplace Health and Safety Legislation:
a) Explain how the university ensures adherence to legislation regarding workplace health and safety, specifically focusing on fatigue, safety, stress, and burnout for trainee interns in clinical practice.
b) Detail the measures in place to monitor and mitigate fatigue among medical students during clinical placements.
c) Describe the strategies implemented by the university to manage and reduce stress and burnout among medical student during their clinical training years and whether this has been deemed sufficient by students undergoing these placement requirements.
d) Outline the steps that medical students can take when and if they are enabled the right to refuse excessive workloads or excessive clinical placement hours and whether this would implicate their ability to pass the specific run/programme and if they would be reprimanded for doing so.
e) Provide a list of the likely outcomes for the student should they undertake this process.
9. Impact on Student Well-being:
a) Provide data or evidence on the effectiveness of these initiatives in reducing stress and burnout that the university has identified.
10. Self-Directed Learning Expectations:
a) During these clinical placements, how many hours each week per year level does the university expect a student to undertake self-directed learning to ensure they maintain an adequate passing grade?
b) In combination with clinical placement hours, is this deemed appropriate given this is a full-time unpaid clinical programme and the legal definition of a full-time working week is 40hours?
Yours faithfully,
Richardt. E.
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