ENCL. (2) TO COMDTINST 6400.1A
STUDENT EXTERN PROGRAM (SEP) ORIENTATION
PURPOSE. Provide an orientation guide for student externs within Coast Guard clinics
including supervisory controls, duties, and limitations.
DISCUSSION. The material contained herein shall be the general operating guidelines for the
Welcome Aboard. The Coast Guard will strive to ensure that extern experiences will be
informative, educational, and enjoyable. To attain the maximum benefit from this
program, externs shall read these instructions carefully and comply with them at all times.
Status. Student externs have no legal status (i.e., authority to practice a profession) within
the military establishment. An officer shall be responsible to the commanding officer and
the patient for the extern's actions. As students, externs are subject to all applicable
Federal and local laws in the same manner as military members functioning in Coast
Authority. Externs are directly responsible to their preceptors for all clinical and
administrative matters. Although externs possess a higher level of training than Health
Services Technicians (HSs), they, as civilians, are outside of the clinic's authority.
Therefore, in the absence of a commissioned officer, HS personnel are in charge of the
clinic or specific areas within it.
Clinical Supervision. Every extern must work under the direct or immediate supervision
of a commissioned officer or civilian equivalent who is qualified and licensed to provide
the service rendered by the extern. Externs must use judgement to know when to call their
preceptor for consultation. In all cases, no treatment should be initiated or performed
without the consent of the preceptor. Treatment plans must be approved, and appropriate
points of evaluation specified, prior to initiation of treatment.
Support Staff. Externs will be working with HSs who have training, experience, and a
certain degree of latitude in patient treatment not extended to students. HS's duties
include clinical and administrative assistance to externs.
Health Record Entries. The military health record is a legal document which is the
property of the U.S. Government. It may be consulted or subpoenaed at any time for legal
determination of disability entitlements, for court proceedings, or to establish line'of