Furthermore here at AmeriClerkships Medical Society, we are certainly humbled by the selfless acts of millions of healthcare providers who are on the frontlines of treating COVID-19 cases worldwide, and want to thank you all for keeping us safe. This article is meant to provide AmeriClerkships Affiliated Attending Physicians our position on COVID-19 as it pertains to AmeriClerkships Members who enroll in clinical rotations in order to graduate from medical school, or to secure the required amount of US clinical experience and letter of recommendation prior to September 15, 2020 (for the 2021 residency Main Match).
AmeriClerkships Medical Society has not stopped its clinical rotations at this time. We certainly are in unprecedented times, however to be involved and exposed to these exact times are also the precise reasons why most (definitely not all) medical students elected to attend medical school in the first place (read ‘Medical students can help combat Covid-19. Don’t send them home‘). Every large-scale disaster renews discussions of the proper role of healthcare workers in an emergency response, but too often, these discussions overlook the potential role a (final-year) medical student plays.
We are mindful of:
- Certain AmeriClerkships affiliated hospitals, clinics and medical schools who have decided to temporarily pause student clinical rotations (most do so because they view students as non-essential, temporary individuals who may not be well-trained in disaster response, and pose a risk to him/herself or the patient), AND
- AAMC’s recommendation for a 12-day pause on all student clinical rotations (in order to 1) for the medical education community, including learners, to develop appropriate educational strategies and alternative clinical experiences to best assure safe, meaningful clinical learning for students, and 2) help with current concerns about the availability of personal protective equipment).
- While students who are still in training can pose risks to themselves and to others, history demonstrates they can serve with distinction in disaster situations, AND
- With appropriate training and supervision, medical students can be used not only to leverage available professional resources but can effectively sustain interpersonal aspects of patient care in mass casualty situations.
- Medical student training to respond to these unfortunate [disaster] scenarios should be of the upmost priority, AND
- Their involvement can be used to provide much-needed human resources, and previous studies have shown that early involvement is essential in building a strong foundation and adopting a life-long passion for the topic.
We must also note that:
- Most healthcare facilities are utilizing telemedicine to screen patients for COVID-19, and divert them to centralized command centers or ERs who are better equipped to handle these cases, AND
- Preceptors (MD and DO) are not dismissing medical students & graduates from clinical rotations; in fact, every physician I have spoken with encourages medical students to be on-site and not miss the learning opportunities that COVID-19 pandemic is presenting, AND
- Preceptors are telling medical students & graduates to shadow when faced with a presumed or confirmed case of COVID-19, AND
- Although naturally concerned about their well being, all medical students & graduates are aware that more likely than not, they will be faced with having to be on the frontlines of medicine during a disaster sometime in their lifetime, hence do want to be exposed to medical disaster response as students, but in varying roles, AND
- Although it may not be your traditional classroom, clinicals and emergency rooms and hospitals are learning environments (arguably better than classrooms) equipped with highly dedicated physician preceptors are trained to provide educational settings which are safe and meaningful when it comes to clinical learning experiences, AND
- It is not recommended for medical students to come in contact with, or enter isolation rooms of patients diagnosed with or even suspected of ANY infectious diseases during this pandemic. Medical students are expected to observe from afar in these situations and therefore, we do not recommend that the shortage of Personal Protective Equipment (PPE) be used as a reason to stop clinical rotations, AND
- Per WHO, for asymptomatic individuals, wearing a mask of any type is not recommended. Wearing medical masks when they are not indicated may cause unnecessary cost and a procurement burden and create a false sense of security that can lead to the neglect of other essential preventive measures, AND
- Per WHO, in areas of patient transit (e.g., wards, corridors) where staff and healthcare workers do not come in contact with COVID-19 patients, no PPE is required, AND
- As for conflicts of interest, there are none: Tuition and fees have already been paid by all medical students, and it would actually be much cheaper and quicker for AmeriClerkships Medical Society to simply remove students from clinical rotations and take a back seat while COVID-19 runs its course.
Therefore, we at AmeriClerkships Medical Society do not take the critical decision to stop a medical student’s clinical exposure and education during times when the greatest amount of critical and disaster medicine can be learned lightly, and do not believe that the decision rests solely with AmeriClerkships. We believe this is a highly individualized and life-altering decision which must be tailored to each clinical setting, and can only be made by the on-site and immediate preceptors of each student at each clinical site, and the trainee him/herself.
Who are ‘willing and qualified’ individuals? Final year medical students and medical graduates who do not want their clinical education interrupted, AmeriClerkships will support them throughout the COVID-19 pandemic by not discouraging their decision, and we deem them as ‘willing and qualified’ if they meet the following four criteria:
- Not high risk (CDC), AND
- Remain asymptomatic (CDC), AND
- Do not want their clinical education disrupted, AND
- Are in their final year of medical school (or medical graduates already)
Furthermore, we are encouraged to see nearly all of our physician supervisors, clinical sites and hospitals amending their existing COVID-19 (and other disaster/terrorist response) protocols to include medical students & graduates who meet all 4 of the above criteria, and look at this as a once in a lifetime opportunity to help our soon-to-be physicians develop their critical knowledge and practical skills in the realm of an ongoing disaster, and to even provide the groundwork and opportunity for further study of the effects of incorporating medical students into various roles on disaster medicine response teams (Verson et. al.).
Contact the AmeriClerkships 24 hour ‘COVID-Response Team Physician Hotline’ at +1(949) 579-8089.