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Expectations | Overview


Administrative process – “signing up for a rotation”

A. Harvard Medical School (HMS) students

  •  Any HMS student who rotates through the Department of Otolaryngology must arrange their rotation through the Registrar’s Office at Harvard Medical School. The HMS Registrar’s Office will provide guidance with regard to registration, assignment and credit for the rotation.

B. Non-HMS students

  • It is strongly encouraged that any non-HMS medical student who rotates through the Department of Otolaryngology arranges their rotation through the Registrar’s Office at Harvard Medical School for the same reasons as above. However, a medical student may participate under “observer status.” A student under “observer status” may not engage in any patient care. Please refer to definitions and further detail below.


  • “Medical student” is a student rotating on an accredited HMS rotation.
  • “Observer status” applies to students (or others) who are observing on the service but not in an accredited HMS rotation.
  • “Supervising physician” means the attending physician, fellow or resident on service who is responsible for the patient(s) that a medical student is helping to care for.


Students and others on “observer status” may not engage in any patient care, with or without supervision, and may not document in the medical record. Students on “Observer status” may meet and talk with families (with their permission) but this informal interaction cannot substitute for obtaining the medical history, which must be done by a physician on service.


  1. With the exception of obtaining a history and performing a physical examination, all care delivered by medical students must be directly supervised by a physician. “Directly supervised” means the supervising physician must be physically present at all times.
  2. Children with Otolaryngology issues can sometimes present with serious or live-threatening problems that are not immediately apparent. Therefore, it is the responsibility of the supervising physician, not the medical student, to determine whether a patient can be safely interviewed and examined by a medical student. Medical students may obtain a history, and perform an examination, without direct supervision only if directed to do so by the supervising physician. The supervising physician must ensure that the patient does not have a condition that requires urgent management. The student must identify himself/herself to the family and patient, and obtain explicit permission to see and examine the child.
  3. Inpatients who have an acute change in status, or suffer any untoward event, should be seen promptly by a physician on service, not by a medical student.
  4. Students may perform non-invasive and minor procedures with the continuous physical presence of a supervising physician, who is responsible for ensuring that the student is capable of performing the procedure safely. 
  5. Students may scrub and assist in surgery with the continuous physical presence of a supervising physician.
  6. “Phone medicine” is common in Otolaryngology. Since the patient is not seen, it requires a higher level of judgment and experience. Therefore, while students may answer pages and relay messages for physicians, they may not give medical advice to patients by phone.
  7. If the supervising physician is temporarily unavailable for any reason, a student in need of supervision should promptly attempt to contact any other physician in the department (resident, fellow or attending), either by pager or by calling their home or cell phone.
  8. No guidelines can anticipate every situation. These guidelines are not intended to prevent physicians from using their best judgment to respond to unusual or emergency situations. In extraordinary situations, actions that are appropriate and in the patient’s best interest may differ from these guidelines.

Please review the hospital’s Code of Conduct policy here.