Monday, May 4, 2020

Medical student perspectives on COVID-19

- Enkhee Tuvshintogs, MD, AFP Resident Representative

For this post, I interviewed medical students in their second, third, and fourth years to share some of the ways that COVID-19 has impacted their education, training, and understanding of medicine going forward.

“When [we] hear ‘we need more doctors and providers!’ we want to [help] but we can’t right now. It is a weird thing,” says second-year student Alicia Hobbs (AH).

Medical students usually follow a strict timeline of classes, rotations, and examinations. Going through medical school is like “drinking from a fire hose.” It requires a constant balance of time, energy, learning, and growth. This path was altered by COVID-19.

AH had only been two weeks into her dedicated study time for the United States Medical Licensing Examination (USMLE) Step 1. Amidst her studying, she followed the news about the pandemic and grew more concerned as the situation evolved. Eventually the test that was scheduled for April got moved back to May. She is still not sure if it will happen. Her “clinical rotations have changed as well. [They] were supposed to start third year in the first week of May; that has been pushed back to mid-July now.”

Michelle Do (MD) explains that she had her fellow third year medical students are “kind of in between. We know some clinical duties; [each person’s] skill varies based on the rotations they did. ... Most medical students want to help - they care about the community.” Many are volunteering at drive-through screening sites, picking up groceries for people who can’t get them, providing child care, participating in “phone-a-senior” groups, and staying involved as much as they can. Still, the impact of COVID-19 is apparent. Their fourth year schedules - carefully planned with specialty-specific away rotations or sub-internships in other locations - are now up in the air. Their USMLE Step 2 examinations have been postponed, too.

Perhaps the most bittersweet changes have affected fourth year medical students. When most “stay-at-home” orders started, students all over the U.S. were waiting for the much anticipated Match letters that announced where they would be going for their residency. Not only was Match Day changed into a virtual experience, graduation ceremonies will be different as well. Many students like Libby Wetterer now have the interesting task of planning to move to another city or state from a distance. She has “begun to do purely virtual apartment searching” and has been also having “Zoom calls and group chats with her soon to be co-residents.”

MD, like many students, feels “conflicted - [she] wants a good educational experience, but [she] is also worried about being an asymptomatic carrier.” AH is thinking about the implications for COVID testing “knowing who’s immune and who’s not. [We are thinking about] how to look at a systems-approach for when something like this happens again. How to have better screening, stockpiles, PPE, etc.” The situation may put a different perspective on what scope of care they may select in the future. Students have begun to talk about the breadth of specialties - whether a particular specialty is so narrow that they can no longer do intubations, or if they would even want to do intubations in hazardous situations like this in the future.

Restrictions on participating in direct patient care recommended by the American Association of Medical Colleges were intended to safeguard their health, but medical students have been left feeling torn. They see their calling, but they also recognize the barriers. Rather than be disheartened, they are instead instinctively finding creative ways to support practicing health professionals and their communities.