Public Health Law Map - Beta 5 - Medical and Public Health Law Site

Medical students are often enthusiastic about new clinical opportunities, and it is
tempting to let them try their hand at patient care, particularly if the problem seems
simple. This situation can jeopardize a student’s future. A medical student who is
accused of practicing medicine without a license, even if it is at the instigation of a
supervising physician, may not be allowed to complete his or her degree. Even if
the school awards the student a degree, it may be difficult or impossible for the
student to get a license, residency training, or malpractice insurance. Supervising
physicians must protect themselves and their students from the temptation to
delegate too much authority.
The practice of introducing a medical student to patients as “doctor,” “young
doctor,” or a “student doctor” is fraud. A reasonable person introduced to a doctor
in a medical setting assumes that this term denotes a licensed physician with a
doctoral degree in medicine. Even holders of other doctoral degrees should not be
introduced to patients as a doctor. A medical student who has a Ph.D. should not
use the title in a medical setting in situations when it can lead to confusion. If a
person with a Ph.D. is working in a medical setting, the difference should be
explained to every patient. An example of a proper introduction might be
introducing a clinical pharmacologist to a patient by saying the following: “This is
Doctor Jones. Dr. Jones is a doctor of pharmacology who is trying to help us work
out the problem with your medications.” This tells the patient that Doctor Jones is
not a medical doctor and why a pharmacologist is involved in the patient’s care.
No matter how capable the student or how close to finishing training, medical
students do not have the legal authority to practice medicine. Everything that a
student does must be reviewed and checked by a licensed physician. The student
should not be allowed even as much independence as a nurse or a paraprofessional.
It may be permissible for a physician to delegate certain tasks to a nurse under
protocol that should not be delegated to a medical student. The legal assumption is
that the student is there to be taught. If the student knew the tasks well enough to
be allowed to do them unsupervised, then he or she would not need to be doing
them.
Under no circumstances should the student be used as a substitute for the physician
in completing routine physician tasks. It is tempting to use medical students to do
admission histories and physicals or to evaluate a patient without supervision, but it
is very dangerous legally. If anything untoward happens to the patient, the
physician will be responsible and will be in the position of having injured a patient
by not fulfilling his or her medical duties. The attending physician must personally
do the history and physical, not just cosign the work of a nonphysician.
The writing of orders and prescriptions is limited to physicians and other health
care professionals who are properly licensed in the state. This may never be done
by a medical student. A student may act as a transcriber of orders if it is the
licensed physician who signs or approves them. Hospital and office staff should
never act on an order from a medical student until it has been cosigned or
otherwise endorsed by the attending physician. Even in an emergency, a nurse
should follow established protocols and the orders of an appropriate physician,
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