The global coronavirus outbreak will continue to change our lives in ways we can’t yet anticipate. But one of the more relevant questions about this upheaval, given fears that covid-19 will overwhelm our hospitals and doctors, is how medical schools plan to respond to the pandemic and whether medical students will play a part in that response.
While medical students do spend most of their first two years in the classroom, they usually transition into clinical rotations during their third and fourth year of school. During these rotations, students shadow residents and physicians on a shift and occasionally interact with patients directly.
But the covid-19 outbreak has complicated this learning process, according to Suzanne Allen, vice dean for Academic, Rural and Regional Affairs for the University of Washington’s School of Medicine.
Not only is there the danger of unnecessarily exposing students to covid-19, there’s also the risk of using up precious resources like personal protective equipment (PPE), including masks. Hospitals across the country face shortages of PPE as the outbreak grows; any mask that has to go to a medical student shadowing a doctor treating a suspected case of covid-19 is one fewer available to someone else.
“We really want to try to protect the amount of PPE we have left,” Allen told Gizmodo.
In lieu of these challenges, University of Washington and many of the medical schools Gizmodo contacted have implemented temporary suspensions of their clinical rotations. The University of Pennsylvania’s Perelman School of Medicine, for instance, has suspended rotations for at least two weeks, while Harvard Medical School told its students over the weekend that rotations would be suspended until March 22. Medical schools at the University of Virginia and Yale University have not put in place suspensions of their clinical rotations, their respective spokespeople told Gizmodo, but these rotations won’t involve covid-19 patients.
The Association of American Medical Colleges released a memo this week advising all of its members to suspend any activities that involved patient contact for at least two weeks, citing the need to preserve PPE and to first better educate students about covid-19 for both their own and patients’ safety.
Colleges and universities across the U.S. are steadily cancelling their in-person classes and switching to courses online. But there’s still the conundrum of what exactly to do with all these medical students who need clinical training, especially those set to enter their next phase of training as medical residents.
“We want to make sure students are getting the education they need, and that our students graduate on time,” Allen said. “Their residency education starts the beginning of July, and if we aren’t graduating medical students on time, then we will have a workforce issue come this summer.”
While its students are taking virtual classes until March 22, Harvard Medical School plans to give faculty and hospitals a week’s time to decide where students should be deployed once they return to the clinic, a spokeswoman told Gizmodo. These students won’t be deployed to help care for any covid-19 patients and will work with other populations instead.
Of course, any workload that can be lightened by medical students is useful, as new cases of covid-19 are expected to heavily tax some hospitals and doctors to the breaking point. Some students will be able to help out more directly with covid-19.
The University of Washington, UPenn’s Perelman, and other medical schools are considering or will implement plans to have students practice telemedicine, such as answering the phones to screen people worried they could have covid-19. Other students may help with triage, helping decide which patients are most in need of urgent care.
“We expect that students who wish to help specifically in the war on COVID-19 will have the opportunity to volunteer in support of efforts such as telephone screening or follow-up,” a Yale University representative told Gizmodo.
“Volunteer” is the key word there. According to Allen, many medical students are conflicted about what they will do once covid-19 is in full force in the U.S. Any plans to enlist medical students to help with the covid-19 response should take those feelings into consideration.
“Some students say, ‘Hey, you know, I went into medicine to help people. And given all the information we have so far, I’m unlikely to get very sick from this, so I want to be out there doing what I can do to help.’ And other students have said, ‘Hey, I’m a student, I’m trying to get a learning experience, I don’t want to pay money to actually go get sick,’” Allen said. “So there are different kinds of students out there, and they’re different from a resident or fellow in their capacity to help.”