How Much Should Medical Students Present on Rounds?

I would say this fully depends on the medical students and how busy my team is at the time.

If things are chilling, then I rarely interrupt. I let them talk talk talk and give feedback +/- some teaching at the end.

On the other hand, if my team is busy, then I give them fair warning to focus on the pertinent and to summarize plans for problems with well established plans not requiring adjustments (chronic medical problems).

I typically scale their workloads and involvement to their efficiency, medical knowledge, and ability to do presentations concisely.

If their presentations are taking a long time (uninterrupted), then there is no way I can afford the time for them to carry 4-5 patients; nor do I think that is a good educational experience for them.

When I'm working in the ED, they can see as many patients as they want, but I typically encourage them to tap out to participate in procedures and resuscitations - even if it's not on my team.

It can be a little frustrating at times when they present a patient, and then I get a TOTALLY different impression on my assessment; but that's certainly a good opportunity for teaching and feedback.

For example, an excellent med student and I recently saw an 8 y/o kiddo in the peds ED with influenza. They saw the patient and presented to me. It sounded run of the mill URI/flu like symptoms, but when I saw the patient they were very lethargic and barely waking up. This caught me off guard, because I would have expected that to be part of the presentation. I used the opportunity to provide feedback to the student in a NONJUDGEMENTAL + SAFE way. Furthermore, situations like this rarely affect my evaluation or assessment of the student; as I mentioned, this is the perfect opportunity for feedback and learning.

The only things I expect from my students is to be engaged, participate, and do their best. Once they do that, then it's on me to titrate their workload and involvement to their efficiency level integrated with my teams level of chaos.