CODE OF VIRGINIA

INTERNS AND RESIDENTS IN HOSPITALS (§ 54.1-2961)

A. Interns and residents holding temporary licenses may be employed in a legally
established and licensed hospital, medical school or other organization
operating an approved graduate medical education program when their practice is
confined to persons who are bona fide patients within the hospital or other
organization or who receive treatment and advice in an outpatient department of
the hospital or an institution affiliated with the graduate medical education
program.

B. Such intern or resident shall be responsible and accountable at all times to
a licensed member of the staff. The training of interns and residents shall be
consistent with the requirements of the agencies cited in subsection D and the
policies and procedures of the hospital, medical school or other organization
operating a graduate medical education program. No intern or resident holding a
temporary license may be employed by any hospital or other organization
operating an approved graduate medical education program unless he has completed
successfully the preliminary academic education required for admission to
examinations given by the Board in his particular field of practice.

C. No intern or resident holding a temporary license shall serve in any hospital
or other organization operating an approved graduate medical education program
in this Commonwealth for longer than the time prescribed by the graduate medical
education program. The Board may prescribe regulations not in conflict with
existing law and require such reports from hospitals or other organizations in
the Commonwealth as may be necessary to carry out the provisions of this
section.

D. Such employment shall be a part of an internship or residency training
program approved by the Accreditation Council for Graduate Medical Education or
American Osteopathic Association or American Podiatric Medical Association or
Council on Chiropractic Education. No unlicensed intern or resident may be
employed as an intern or resident by any hospital or other organization
operating an approved graduate medical education program. The Board may
determine the extent and scope of the duties and professional services which may
be rendered by interns and residents.

E. The Board of Medicine shall adopt guidelines concerning the ethical practice
of physicians practicing in emergency rooms, surgeons, and interns and residents
practicing in hospitals, particularly hospital emergency rooms, or other
organizations operating graduate medical education programs. These guidelines
shall not be construed to be or to establish standards of care or to be
regulations and shall be exempt from the requirements of the Administrative
Process Act (§ 2.2-4000 et seq.). The Medical College of Virginia of Virginia
Commonwealth University, the University of Virginia School of Medicine, the
Eastern Virginia Medical School, the Medical Society of Virginia, and the
Virginia Hospital and Health Care Association shall cooperate with the Board in
the development of these guidelines.The guidelines shall include, but need not
be limited to (i) the obtaining of informed consent from all patients or from
the next of kin or legally authorized representative, to the extent practical
under the circumstances in which medical care is being rendered, when the
patient is incapable of making an informed decision, after such patients or
other persons have been informed as to which physicians, residents, or interns
will perform the surgery or other invasive procedure; (ii) except in emergencies
and other unavoidable situations, the need, consistent with the informed
consent, for an attending physician to be present during the surgery or other
invasive procedure; (iii) policies to avoid situations, unless the circumstances
fall within an exception in the Board’s guidelines or the policies of the
relevant hospital, medical school or other organization operating the graduate
medical education program, in which a surgeon, intern or resident represents
that he will perform a surgery or other invasive procedure that he then fails to
perform; and (iv) policies addressing informed consent and the ethics of
appropriate care of patients in emergency rooms. Such policies shall take into
consideration the nonbinding ban developed by the American Medical Association
in 2000 on using newly dead patients as training subjects without the consent of
the next of kin or other legal representative to extent practical under the
circumstances in which medical care is being rendered.

F. The Board shall publish and distribute the guidelines required by subsection
E to its licensees.

HISTORY: Code 1950, § 54-276.7; 1952, c. 690; 1958, c. 294; 1964, c. 284; 1975,
c. 508; 1978, c. 408; 1986, c. 307; 1987, c. 44; 1988, c. 765; 1998, c. 614;
2002, cc. 87, 478; 2003, c. 482.