My Clinical Education Experience During The COVID-19 Pandemic
MD Candidate, Class of 2021
Loyola University Chicago Stritch School of Medicine
The first time I heard of COVID-19 was back in early February. On my inpatient Internal Medicine rotation we admitted a patient with respiratory distress. On rounds the following morning, we informed him that he had tested positive for coronavirus. “But not that coronavirus, unless you forgot to tell us you have been to China recently.” Ha-ha, we all laughed. At that time, we had no idea of the worldwide impact COVID-19 would have or the amount of stress and uncertainty it would inject into our lives. As a third year medical student, I was not exempt from the change that has touched all parts of our lives during the pandemic.
In early March, I began to hear rumors that students in other schools were being sent home from clinical duties. As more schools began to follow suit, I nervously checked my email every hour. Surely it would only be a matter of time before we were sent home too. It was argued that students should not be part of the workforce because we would be taking on unnecessary risk. Understandably, there was a need to limit the number of people exposed to the virus and conserve PPE. With closures of outpatient offices and cancellations of elective surgeries, we wouldn’t be able to meet all educational objectives as usual, and there would not be enough staff or time to supervise us appropriately. On the other hand, I felt a sense of loss. The COVID-19 pandemic represents a valuable learning opportunity for those of us who will make up the healthcare workforce in the future, and my primary duty as a student is to learn.
In mid-March, I started completing didactic studies from home. We continued with our scheduled lectures in an online format, had virtual OSCEs, and took shelf exams from home while being proctored via Zoom. The first two weeks were pretty nice; I didn’t miss waking up at 4am for surgery pre-rounds and appreciated having more time to study. But I soon began to feel disengaged, tuning in for a few hours of lecture then moving out of school mode for the rest of the day. I often struggled between using the extra time to be productive for school versus reading books and baking recipes I normally don’t have time for. I barely saw any of my classmates for months and missed the practical teaching moments we get when working with residents and other students in the clinical setting. There is no replacement for learning from real patients.
When we were told we would be home through the end of April, I was disappointed but not surprised. A lot of uncertainty still existed about how hard COVID-19 would hit here in Chicago. When we were told we wouldn’t be coming back for the rest of the school year I was shocked. Completing nearly half of a year of medical school from home is unprecedented and seems incompatible with getting a clinical education. While listening to an online neurology lecture, I was reminded of what a resident had taught me about differentiating vertigo, dizziness, and syncope before I evaluated a patient in the ED last year. I would not have remembered this nearly as well if I had only heard it via a Zoom lecture. Our clinical years are critical for learning and applying concepts to patient care. During this unprecedented time, medical institutions need to find ways to get students the experience they need to prepare for residency.
On July 6th, I will finally be back on a rotation in the MICU, but “the new normal” will be immensely different. I will be screened for symptoms and fever as I enter the hospital each day, and if I get sick, I will have to quarantine and get tested. Many of the teaching sites are still restricting student access outside of our own hospital system. Our 8-week core rotations have been cut down to 4 weeks, to allow for scheduling along with our existing 4th year requirements. As my peers and I prepare for the Match, it seems daunting. With away rotations on pause, how will programs get to know us? Will virtual interviews really be able to replicate the experience of visiting a potential destination program? How will the cancelation of Step 2 CS testing affect my future licensing? In the midst of uncertainty, pulling us out of the clinical setting earlier this year was likely the right way to initially balance our educational needs with the risks of working during a blooming pandemic. Though I know things will look different as we move forward, I am cautiously optimistic about the future and ready to get back in the hospital, joining my colleagues with a renewed sense of purpose.