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  • United States Codes, 5 USC Sec 3111, Acceptance of Volunteer Service.
  • Public Law 104-91, Health Insurance Portability and Accountability Act, 21 Aug 2006.
  • OTSG/DASG-PSZ-MG Memo, Standards for Student Shadow Experiences at Army MTFs, 17 July 2013.
  • MEDCOM Memo, Student Visitor and the Health Insurance Portability and Accountability Act, 22 Aug 2006.
  • TAMC Regulation 40-27, Pre-Placement Medical Immunizations Requirements for Military and Civilian Students/Trainees, 25 February 2019


  • Shadowing is a time-honored recruitment tool, not only for medical professions, but for the Army in general. With the impressive resources we have here the opportunities for recruitment of future physicians, health care providers and non-allied health individuals who wish to participate.
  • This policy does not apply to active duty military or DoD (Department of Defense) civilians wanting to shadow here at Tripler Army Medical Center (TAMC). Individuals wanting to shadow must contact the Red Cross.
  • The purpose of this policy is to address the privacy and security requirements for observing, and to enable Tripler Army Medical Center to ensure patient confidentiality rights are respected, patient safety is optimized, and Tripler Army Medical Center policies and procedures are followed.
  • It is part of the mission of Tripler Army Medical Center to provide educational opportunities to the community and to members of the health care profession.
  • Observation/Shadowing allows students to follow and observe a hospital staff member as they carry out their job responsibilities.
    • Students must be at least 16 years of age, and enrolled in high school or college.
    • Eligible "student" (all observers must be in an actual "student" status at a school or institution).
    • Does not include students participating in a contracted program of study with Tripler.
    • Student must be a U.S. citizen.
    • Short-term observation/shadowing opportunities are intended to give the student an inside look at careers at TAMC, both in clinical and non-clinical areas, in order to aid in career decisions.
    • Tripler Army Medical Center does not offer long-term shadowing.
    • Any student seeking educational credit will be excluded and redirected to the Red Cross.
    • Observation/Shadowing shall be prohibited in Behavioral Health. Exceptions may be made in Behavioral Health with written administrator approval, signed consents from patients or patients' authorized decision makers, and written explanation on the Observation Shadowing Agreement at
  • Observation/Shadowing at Tripler Army Medical Center is limited to 40 hours and between the hours of 0800 to 1600 (8 A.M. to 4 P.M.), Monday through Friday. No observation/shadowing during the evening, weekends or holidays.
  • We strongly recommend that students observe/shadow only after exploring health care careers via other avenues and after narrowing interest to a particular career or area.


  • The scope of this policy applies to individuals who meet the above description of an observer/shadow.
  • This policy does not apply to patients, family members or friends visiting or accompanying patients, or to medical staff residency rotations.
  • The Graduate Medical Education (GME) Office is the proponent of observer/shadow program at Tripler Army Medical Center per U. S. Army Medical Command (MEDCOM); any exception to this policy must be coordinated with the GME Office.
  • MEDCOM student visitor policy implies that we should only be hosting students who have a potential interest in the military Health Professions Scholarship Program.
  • The GME Office is not responsible for obtaining a sponsoring department/service or an escort for observer/shadow participants.

Observer/Shadower Responsibilities

  • To get a sponsor.
  • Must complete the Observation Shadowing Agreement at
  • No-later-than fifty (50) days out from start of observation/shadowing, provide sponsor TAMC Form 944, Immunization Requirement at with all required documentation.
    • Observer is responsible for obtaining vaccines at their own cost.
    • Observer will not be able to begin the observation/shadowing experience without providing proof of the required immunizations.
    • No immunization exemptions of any type is allowed.
  • Since immunization records are Protected Health Information (PHI), under the Health Insurance Portability and Accountability Act (HIPAA) the transmission of such will be via a secured website such as DoD SAFE (Department of Defense Safe Access File Exchange) and follow the instructions on the website for submission at
  • Contact sponsor for official address to send immunization form.
  • You will not contact the Occupational Health Services for any reason. If you have any questions concerning immunizations, please address your concerns with your sponsor.

Sponsor Responsibilities

  • Will provide immunization form to Occupational Health Services for review per instructions contained in Tripler Army Medical Center Regulation 40-27.
  • If any discrepancies in Occupational Health Services review, sponsor will notify observer to provide necessary documentation to correct such and resubmit for review and approval of pre-clearance requirements.
  • Sponsor shall agree to minimize the amount of PHI to which the observer is exposed. Under no condition is the observer to be provided with copies of any PHI or materials containing PHI.
  • Ensure that observer will not partake in any direct clinical care.
    • Will request permission in advance from each patient, or the patient's legal representative, an opportunity to agree or object to the presence of the student.
    • Consent is sought without the observer present so that patient or the patient's legal representative is given every opportunity to refuse.
    • If patient or legal representative refuses the observer to be present the sponsor will need to place observer with another staff member or in an area conductive for the observer to wait until the sponsor can continue the experience.
  • Agreement must be documented in the patient's medical record.
    • For example, the patient' agreement to the observer presence could be documented as "Consent obtained to have observer participant present."
    • In situations where the patient may be unable to provide consent, observation will not occur (i.e., where the patient is unconscious, etc.)
  • Provide an environment of learning.
  • Assure observer is in compliance with observer responsibilities.
    • If not, request the termination of the observation/shadowing experience.
    • Reason for termination should be in writing to the observer.

Department Responsibilities

  • Chiefs of department will review all requests and will have final approval for all observation/shadowing before allowing observer to shadow, based on the department's ability to accommodate the request. Request can be denied.
  • Each department should establish procedures regarding oversight, sponsorship, availability and the means by which observer is scheduled and coordinate his/her experience.
  • Be responsible for the in- and out-processing of observer.
  • Maintain a record of observer who have participated in the observer/shadowing experience.
  • Ensure that all observers sign-in and –out with the GME Office.
  • Ensure that each observer obtain and wear a badge identifying him/her as a shadow/observer.
  • Inform the GME Office 24-hours in advance of observer arrival for observation/shadowing experience.

Graduate Medical Education Office Responsibilities

  • Verify observer by two forms of picture ID.
  • Verify that observer has proof of medical insurance coverage.
  • Verify that observer has been precleared by Occupational Health Services.
  • Have observer sign Visitor (Shadow/Observation) Badge Sign-in/Sign-out Sheet.
  • Issue observer Shadow/Observe badge.
  • Inform observer that while shadowing that he/she must sign-in/-out every day with GME.
Don't forget to keep your family's information up-to-date in DEERS.