期望|概述
Expectations
Administrative process – “signing up for a rotation”
A.哈佛医学院（HMS）学生
- 任何旋转耳鼻喉科系的HMS学生mustarrange 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强烈鼓励由于与上述相同的原因，任何旋转耳鼻喉科部门的非HMS医学生都会在哈佛医学院的注册官办公室安排旋转。但是，医学生可以在“观察者身份”下参加。“观察者身份”下的学生可能不会从事任何患者护理。请参阅下面的定义和更多详细信息。
DEFINITIONS
- “医学生”是一名学生，在经过认可的HMS轮换上旋转。
- “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.
DELINIATION OF PRIVILEGES: OBSERVER STATUS
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.
特权划分：HMS轮换的学生
- 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.
- 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.
- 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.
- 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.
- Students may scrub and assist in surgery with the continuous physical presence of a supervising physician.
- “电话医学”在耳鼻喉科中很常见。由于没有看到患者，因此需要更高的判断力和经验。因此，尽管学生可以回答医生的页面和中继消息，但他们可能不会通过电话向患者提供医疗建议。
- 如果由于任何原因而暂时无法获得监督医师，则需要监督的学生应迅速尝试通过Pager或致电他们的家庭或手机与该部门的任何其他医生（居民，居民或参加者）联系。
- 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.