COVID-19 makes medical students feel like they are falling behind

COVID-19 disrupts almost every student’s education, but those in medical school have it particularly hard.

“It’s a nightmare scenario for the 2021 class,” said Jake Berg, a fourth-year student at Kentucky College of Osteopathic Medicine.

In March, students at the Pikeville, Ky., School were abruptly removed from hospitals and medical offices where they normally learn how to treat patients. Over the space of less than two weeks, Berg said, medical students in “pretty much the entire country” are transitioning from seeing patients in person to online learning.

“Everyone goes along with the idea that we’re all in the same boat together,” he said. “But, really, it’s like we’re all on the Titanic and he’s sinking.”

Megan Messenger, in her fourth year at the Western University of Health Sciences in Pomona, figures she has lost about 400 hours of patient time as a result of the pandemic. “I feel very backward,” said Messenger, who hopes to do a combined residency in pediatrics and psychiatry.

She said she was concerned that “the 2021 class will become the dumb class of interns.”

The third and fourth years of medical school are when most students do their core clinical training in areas such as internal medicine, pediatrics, surgery and obstetrics-gynecology. Each rotation involves a stint of one or two months in a hospital or clinic.

Fourth-year students tend to spend time in more specialized fields, often traveling to gain experience not available through their own medical schools and to conduct informal “auditions” at places where they reside. would like to do. However, due to the pandemic, these “rotations” were suspended.

Schools and hospitals are trying to recover their core training, but in many areas this is still a work in progress. The uncertainty contributes to the stress level of students.

“I have no idea how I’ll learn about the culture of the hospitals I apply to,” said Garrett Johnson, a fourth-year student at Harvard Medical School. “You can not meet any of the people or get a feel for the place.”

Karissa LeClair, a fourth-year student at Dartmouth College’s Hostage School of Medicine in Hanover, NH, shared Johnson’s concerns. “I was looking forward to knowing places I had not been to before,” she said.

LeClair, who wants to become an ear, nose and throat specialist, said the training opportunities she applied for in New York City, Boston, and Ann Arbor, Mich., Were all canceled.

Because she did not intend to be in New Hampshire for most of this year, LeClair now has no place to live at Dartmouth. “I support sublets together and stay with friends,” she said.

Messenger is dealing with similar issues in Southern California.

“I’m at Cedars now, and I love it,” she said, referring to Cedars-Sinai Medical Center in Los Angeles. “But you can only do one rotation there. I have nothing planned after this. My only audition rotation, at Tulane, was canceled. ”

Managers are sympathetic.

“They’ve had major disruptions,” Drs. Alison Whelan, Chief Medical Officer for the Assn. of American Medical Colleges. “Medical school is stressful, and with COVID it’s even more stressful.”

To become well-rounded physicians, students need to see a broad mix of patients with a diverse group of medical problems. But even at hospitals and clinics that have re-established general care, patients with ailments other than those associated with COVID-19 do not appear because they are afraid of catching the coronavirus. Elsewhere, electrical procedures have been canceled or delayed.

“That has become a challenge,” Whelan said.

In areas with high COVID-19 rates, shortages of personal protective equipment have kept students out of hospitals and other medical facilities.

The Assn. of American Medical Colleges in August updated its guidance on student participation in clinical rotations. It continued to make decisions about admitting students in areas for patient care to individual hospitals and medical schools. But it also noted that while students are not technically essential in day-to-day care activities, “medical students are the essential, emerging staff of physicians” whose learning is necessary to prevent future medical shortages.

“The progress of students over time for relatively on-time graduation is essential,” Whelan said. Enabling students to complete their education during the COVID-19 era “is an ongoing, complex, puzzle.”

Third-year students can still complete most of their required rotations, though perhaps not in the usual order. Schools have tried to fill the gaps by dramatically increasing their use of online learning of diagnostics and care.

“A fair amount of what students do is observation,” she said. “So schools have made step-by-step videos.”

Some educators are sure that students will catch up – eventually.

“Most of the learning goes on during your stay,” said Drs. Art Papier, who teaches dermatology at the University of Rochester School of Medicine in Rochester, NY. “I think it can all be made.”

In addition to the lack of educational opportunities, medical students face obstacles in conducting their national administrative research. There are several types, and they are not always easily offered near their schools.

After one required short-term test was canceled, Berg, the student in Kentucky, had to reschedule. The first open seat was three hours away and a few weeks later. Then his canceled test was reset.

While the trip may be a burden, the exams are necessary “to protect the public” from doctors who have not shown authority to care for patients, Drs. Robert Cain, director of the American Assn. or Colleges of Osteopathic Medicine, which oversees osteopathy programs such as those in Kentucky.

In the end, Cain said, this growth of students could emerge from the pandemic as better doctors than those who do not face such challenges.

“Hopefully we look back and see them as the class of firepower,” he said. “That they could work for a couple of half hours.”

Julie Rovner writes for Kaiser Health News, a non-profit news service on health issues. It is an editorial-independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.