It is safe to say this year has not gone as planned.
The COVID-19 pandemic has resulted in a nearly complete overhaul of methods of teaching and engaging students. In the past several months, medical schools have had to balance the unmatched benefit of hands-on experience with the risks involved in sending medical students into hospitals and clinics, increasing exposure to SARS-CoV-2. For those in the first or second year of their medical education, the changes have not been drastic. Instead of dressing in business casual clothing and frantically taking notes in a lecture hall, many students have transitioned to rolling out of bed and staying in their pajamas to watch online lectures. This alteration to what is an already stressful didactic phase of medical education may result in a feeling of isolation due to the lack of camaraderie and peer support. In the long run, this may have a notable impact on students’ mental health, especially when considering the already frightening rates of depression among medical students.
For those of us who are out on clinical rotations, the difference has been stark. Starting in late March 2020, medical schools across the country pulled their students from in-person rotations due to both the shortage of PPE as well as the unknown risk posed by the novel coronavirus. For those who graduated this past Spring, their last few months was completely hands-off. This left them perhaps a bit rusty in their clinical skills just before entering their intern year of residency. For students just entering their third or fourth years, the return to clinical rotations has been rocky. Rotations scheduled months in advance had been canceled by facilities just weeks before they were meant to begin. Many hospital systems and clinics still refuse to take on students, and while their caution is understandable it is quite difficult to find the hands-on opportunities we so need at this critical point in our education. Students are eager to be in the clinics and hospitals helping where possible and using this as a valuable learning experience.
The pandemic has also impacted board examinations. Starting in late spring, board exams were cancelled due to testing facilities’ uncertainty in their ability to provide a safe environment. Once scheduling became available again, there was a scramble across the country to snatch up testing dates. This disorganization left many students with exams scheduled for months later than originally planned, forcing them to make changes to their carefully planned out schedules which had been tailored months in advance for residency applications. Add to the confusion the cancellation of USMLE Clinical Skills and debate on whether to continue with COMLEX Performance Evaluation board examinations this year.
Even the pathway to residency has been altered in the wake of the pandemic. Many schools and residency programs are encouraging students to take fewer audition rotations and to limit their out of region rotations to prevent students from acting as viral vectors between hospitals and across state lines. Most interviews will be held via video conferencing programs such as Zoom, leaving some students concerned about the impersonality of the process and their ability to fully sell themselves within a thirty-minute virtual chat. While these measures are understandable, it changes the game for this residency application season.
Overall, as someone early on in their medical career, it has been disheartening to watch the public’s distrust in medical experts and organizations such as the WHO and the CDC that has arisen in the wake of the pandemic. Disheartening, but not unexpected as fear has not been shown to be conducive to logical thinking. The changes in our society have not been easy to adapt to for anyone, whether it be the loss of employment, loss of a general sense of safety, or loss of a loved one. As I have said to many a concerned patient in the past several weeks: this too shall pass… eventually, but it will require all of us to do our part in the meantime.