Who looks this happy in a face mask? Me…you’ll find out why in a minute.
So, in the last 2 weeks things have escalated quite a bit. We now have a Pandemic on our hands with the Coronavirus which is also known as “Da Rona” or “Rona” for short.
I can hear Cardi B’s voice in my head even with this meme! LMAO! Ok back to the issue at hand….
International travel has been restricted to known countries associated with the virus along with the UK, Ireland, several establishments have shut down, restaurants have closed or restricted customers to To-Go meals only and school districts have closed down schools for about 2 weeks. On the university level, schools are closed for in-house lectures until the end of the semester and forcing students out of dorms. This is crazy. For medical schools, MD1 and MD2 students have been allowed to stay home and attend virtual lectures. For the students with discipline this might be great….just wake up and watch lecture with a bowl of cereal and pajamas but for others it might be more difficult since there is no obligation to wake up and go to class every morning. Some people need more structure….so I hope this semester people can buckle down and maintain their grades.
Now as for us MD3/MD4 students on clinical rotations…we remained in out clinical rotations until today. You have some people with the whole: “You signed up for this argument and you’re needed on the front lines!” Then you have the other argument…since we’re still in training, if we aren’t contributing anything significant to the team or in the most critical stages of our training then why increase student exposure?
It has been interesting to see how the different facilities enacted protocols to decrease “exposure”. At my clinical site, they reduced the amount of entrances to 3. You were questioned about recent travel and each symptom associated with da Rona and given a label to wear on your chest to confirm you were questioned. People were covered from head to toe wearing, scrubs closed toed shoes, masks and masks. It really did look like something out of a movie. Clinical sites were removing students from clinical experiences left and right to decrease their possible exposure and ours. Anyone that coughs or sneezes is a suspect. 👀 My allergies were acting up yesterday morning and one of my attendings started questioning about when it started…in the middle of questioning me she got up and sanitized her hands glaring at me. LOL! Ma’am, if I got it, we all got it by now. We have been working together in this small resident room for 5 weeks. With the asymptomatic phase you just don’t know. One of my patients decided to fly into Atlanta from Colorado 2 weeks ago on a red eye, she could of brought it onto the unit too….you just never know. Anyways….I ate some chili, hit 2 pumps of my Flonase and it cleared my sinuses right up. 😊
So, with Rona causing all of these changes, as it should, why keep students on clinical rotations? We are restricted from coming in contact with any patient under investigation (PUI) and some specialties restricted students from going down to the ER or entering the OR at all.
We aren’t actively on the “frontlines” as some would say:
We are not gathering lower respiratory specimen’s by collecting sputum, bronchoalveolar lavage or tracheal aspirate.
We are not gathering upper respiratory specimens by collecting both nasopharyngeal AND oropharygeal swabs or nasopharyngeal wash/aspirate.
We are not running PCR testing to test for COVID-19.
It’s just me here in Atlanta so if I contracted the virus I’d probably be quarantined and recover on my own. But what about the medical students that are parents. Increased exposure increases the possibilities of them going home to their child/children and possibly transmitting it to them. Or what about those that care for older parents and grandparents, they would be putting them at risk too. Students have their own comorbidities too, making them more susceptible to infection and a prolonged recovery. Many clinical sites have decreased supplies…you would have to go through several persons or multiple departments just to get the N95 mask we’ve been trained to use. If everyone is not adequately protected, especially in a hospital, you can spread the virus even more.
So, why increase the risk of exposure to students in clinical years but decrease clinical exposure of students in pre-clinical years? 🤔A document was circulating listing the status of lectures, clinical rotations, match day, graduations and away rotations. Check it out below:
Most schools have cancelled match day or modified the event by hosting multiple students in smaller rooms. Students receive an email saying that they have “Matched” meaning they have matched into a residency of their choice. Medical students in their 4th year rank their top residency, those top schools rank them and the system matches up students based on some algorithm. You might get your top choice if they make you their top choice. On Match Day, each student opens an envelope which has the residency program where they will complete the final years of their medical training. It’s a time to celebrate with family, friends and classmates. Now, students can choose to open their envelopes with fellow classmates at their institution in a small gathering or with family and just wait for the official email at 1:00 pm this Friday. Even graduation ceremonies are in limbo. I’m sure students will make the best of the circumstances but I could not imagine ending my medical school career with every major event being cancelled.
More than 50% of medical schools pulled students from rotations prior today. I would assume the other medical schools that continued “business as usual” did so to continue meeting the standards of the the Liaison Committee on Medical Education (LCME) which is an accrediting body for educational programs at schools of medicine in the United States and Canada. The LCME states medical students must complete a certain amount of clinical hours to graduate, likewise these clinical hours contribute to the accreditation of the medical school. So, I do understand the need to continue clinical rotations to ensure accreditation and to make sure I’m still on tract for graduation. However, I’m sure there are ample materials we can use to supplement our clinical experiences like Aquifer which offers advance clinical learning through innovative teaching and learning tools online and other online platforms for learning offered through the designated specialties clinical education organizations. I’m not saying this should supplement an entire rotation but it would due for a 2-week hiatus.
The Association of American Medical Colleges (AAMC) released a statement earlier last week advising medical schools to temporarily remove students from clinical rotations or to contact the LCME Secretariat for advising. Thankfully, today the LCME stopped clinical rotations effective immediately.
The COVID-19 pandemic is rapidly affecting all aspects of life. As our medical schools and teaching hospitals work to address the steadily mounting challenges, including balancing the demands of clinical care with those of education, collaboration across all institutions is essential. Recognizing these extraordinary circumstances, starting immediately, the AAMC strongly supports our member medical schools in placing, at minimum, a two-week suspension on their medical students’ participation in any activities that involve patient contact.
The rationale for and goals of this temporary suspension are summarized below:
1. First and foremost, this temporary suspension will allow medical schools a window of
opportunity to develop and implement appropriate programs to fully educate all their
students for their return to clinical rotations with (a) up-to-date information on COVID19; and (b) appropriate steps in place to ensure their own and their patients’ safety.
2. Second, this temporary suspension will contribute to the conservation of personal
protective equipment (PPE) across our institutions. The full extent and likely trajectory
of COVID-19 will become better understood as more widespread testing is
implemented. Some localities remain relatively unaffected; however, there are currently
shortages of PPE in some localities that may become acute, necessitating such resources
to be pooled across institutions.
Although clinical experiences have been temporarily suspended, testing (NBME exams) has not so I’ll be putting in some work on UWorld questions and working on ADMSEP modules to supplement my clinical experiences. Now what type of wine should I drink to get started….
-I’m out, Future Dr. Jones ❤
Pretty Nerdy Doc 