It’s an interesting time to be a medical student.
From the perspective of a fourth-year medical student who recently matched in otolaryngology, the COVID-19 crisis is both frustrating and terrifying. The lack of central organization of the United States’ response means that each medical school is making decisions somewhat independently while governing bodies race to amend their guidelines. The situation is evolving so rapidly that I expect whatever I write now in early April to be drastically out of date by the time this is published.
As I write this, most students can’t do anything to help … yet. In New York state, fourth-year medical students months away from graduation are being called to work in hospitals where too many healthcare providers have been forced into self-isolation. In my own state of Illinois, some eligible fourth-year students now have the option to graduate a month early, allowing them to assist the workforce in a limited role if it becomes necessary. It may be only a matter of time before other places follow suit.
At the current moment, my presence in the hospital would use up already-scarce personal protective equipment on someone without a medical degree. After graduation, though, I will become an essential member of a healthcare team at a time when the learning curve is perhaps steeper than it has ever been. It’s an interesting dichotomy: a dreaded inevitability looming on the horizon that can’t come soon enough.
Of course, COVID-19 is affecting all of us differently. There are three younger classes of medical students whose lives have also been impacted by this crisis.
Pre-clinical students were already spending much of their time studying alone or in small groups. While the pandemic is likely to change the way they spend free time and unwind from hours of memorization, it’s less likely to drastically alter their education. COVID-19 may, however, impact the timeline of Step 1 administration for second-year students as many testing centers around the country shut their doors for the foreseeable future.
Third-year students, in my opinion, have it the worst. Core clerkships are being converted into home lectures that simply cannot replicate the wide breadth of medical knowledge and experiences gained in the hospital. Step 2 CS is being temporarily suspended. Worse still are the canceling of away rotations and sub-internships, which are critical to many students applying to competitive specialties like otolaryngology, and the likely reduced quality of letters of recommendation due to less time for faculty. Even home-based sub-internships may be canceled. How are students supposed to form meaningful relationships with faculty when they aren’t even allowed near the hospital?
After graduation, though, I will become an essential member of a healthcare team at a time when the learning curve is perhaps steeper than it has ever been. It’s an interesting dichotomy: a dreaded inevitability looming on the horizon that can’t come soon enough. —Emma Martin, fourth-year medical student
As for fourth-year students, much of our inconvenience is emotional, not career derailing. Our education is mostly complete, our requirements mostly fulfilled, but our graduation ceremonies? Canceled. Our Match Day celebration? Canceled. Induction ceremonies for national honors societies? Canceled. These are once-in-a-lifetime special events that those obtaining medical degrees have the privilege of experiencing, the culmination of four years of incredibly hard work.
I had my own “Match Day ceremony” in jeans at my apartment with my roommate, another fourth-year medical student. My parents were able to drive in from the Chicago suburbs; my roommate’s parents were under shelter-in-place orders in a different state, so they were unable to fly in as planned. This was the case for many of my classmates as well. Virtual toasts over Zoom were essential for Match Day celebrations across the country.
From a purely selfish point of view, I was looking forward to using April and May to relax, reset, and recharge. Knowing that the most challenging years of my life are just around the corner, part of me still wants to use this free time as a vacation of sorts to ensure that I start residency well rested and relaxed. However, with the global situation changing by the hour, my abundance of unscheduled time doesn’t seem relaxing at all. Instead, I sit at home itching to help.
This seems to be a sentiment shared by many of my classmates across the country. In many major cities, medical students have begun organizing teams to address the pandemic in diverse ways. Multiple medical schools in Chicago, for example, have consolidated their efforts into the COVID Rapid Response Team (RRT). The COVID RRT offers childcare and meal preparation for healthcare providers, gathers PPE from the community for redistribution to hospitals, and assists at local food pantries, among other focuses of the team’s efforts.
Most medical students chose this career path because we are the kind of people who want to help in situations like this. It’s frustrating to watch hospital conditions deteriorate while knowing we cannot directly relieve healthcare workers. Instead, we must focus on what we can do. Clinical activities may have ceased for the time being, but medical students’ efforts to help their schools and communities have not.
As I look ahead to residency, I hope I can use this situation as a learning opportunity while maintaining my own health as best I can. As an otolaryngology intern, I may not spend as much time in the ICU as my colleagues about to start their internal medicine residency, but I know I will regularly participate in aerosol-generating procedures. I will never again take for granted the fluid-shield face masks that used to be readily available for a patient needing tracheostomy care. Starting residency during this crisis will bring gratitude to each and every day of my practice once we make it past this. Until then, I look forward to my first day of work with apprehension, fear, and—despite all that’s happening—unchanged excitement.
Emma Martin is a fourth-year medical student at the University of Illinois at Chicago, where she will also be doing her otolaryngology residency.