While this sounds draconian, have one of the med students photocopy their lecture schedule and hang it in the call room/locker rooms. They did this on our ob/gyn rotation, and it helped both the students and the residents - the residents would be aware of when we had class, so they didn't hold us in the OR when they knew we needed to go, and the residents also knew that we wouldn't lie to them about having class or meetings.
The thing is an enterprising medical student who wants to cut outta work will always find a way, NO MATTER THE COST. So unless they wanna learn, I don't see any poking or prodding is going to help.
When I was younger in the program as an R3 and R4 I did a lot of policing of medical students. Found out where they were, what they were up to, and generally keeping tabs on them at all hours. The end result was just an escalation in the elaborateness of the lies they told. "Risky" doesn't begin to describe some of the things these kids did.
One student who grew up in the Bronx, went to college in Upper Manhattan (non-gentrified Harlem), and at the time attended medical school in the roughest-ass part of Brooklyn. He never had an ounce of trouble in all those environments. Comes to rotate at my institution which arguably is the safest area of New York City, within two weeks of slacking at the rotation, one day DISAPPEARS from the hospital in the middle of the morning. Around 10AM. "Where they heck did the med student go?" "I dunno. I haven't seen him around since the morning."
This was the week leading up to the shelf exam.
He comes back at the end of the week. Just pops up on rounds one day in the morning around 6:30AM (we start at 6AM).
"Where the hell have you been?"
"Oh, Dr. Viejo, you wouldn't believe it. The other day after M&M I went outside to get something at my car. I parked it on that street," which is a big, broad avenue with constant traffic in front of the hospital, oh and by the way, we have a parking lot for all the staff including medical students, "and when I went to my car I got jumped by these two guys. They beat me up, broke my nose and everything. Afterwards I just wigged out and went home and I've been just stunned and shell shocked the whole week."
Please. Great story. Stuff of legends. But I don't believe a single friggin' word.
So when I hit this year and my responsibilities and paperwork all of a sudden started piling up, I decided I couldn't police everyone. Not even interns all the time. So I rely on the R4s and R3s to do that. Obviously it hasn't gone exactly to plan.
Some of these medical students are second-career people, in their mid 30s (older than me generally) who WANTED to switch careers and go into medicine, and this is how they're going to behave on rotation? Yeah right. Why are they worth my time if they don't care enough about themselves and THEIR education and training?
Last night the R3 and I took someone to the OR for dead gut. During the case I talked the R3 through it but also involved the medical student. It was sometime around midnight this case went. The medical student had NO interest whatsoever. Kept yawning. Kept talking to the tech. Kept talking to the Anesthesia resident (who was kinda hot, but still...). I mean, c'mon! As a medical student I would've loved it if a resident talked to me about every little thing that happened during the case. I even got on the R3s ass a bit about how he tied... All to make it a little more fun (mainly for me) for everyone who wanted to sleep (mostly me). I even let the med student fire the GIA and stitch something. I think that's kinda neat.
But he kept talking and talking. So I asked him to leave the case if he wasn't interested and go back up to the floors. He scrubbed out without a word. The intern said the med student never went to the floors. My guess is that he went to the callroom to sleep. Big surprise.