From the Office of Dr. Pedram Mizani, MD, MHSA
President & Chief Clinical Officer | acmedical.org
Former Chief Medical Resident | Morehouse School of Medicine Family Medicine Residency
Last updated: May 4, 2020 at 4:50 AM PST
PPE Breaking News: 6,000 KN95/FFP2 (comparable to NIOSH approved N95) face masks were delivered to AmeriClerkships for our Members to use during their upcoming US clinical rotations, and for donations to our affiliated healthcare facilities in need. Read more.
COVID-19 has changed nearly everything about medicine, and its understandable if you have questions. We are here to help – check out our new list of questions we have been frequently asked by our Members below, and our responses. This list is updated often, so please check back.
According to the World Health Organization, Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness. According to the Centers for Disease Control and Prevention, reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases; these symptoms may appear 2-14 days after exposure (based on the incubation period of MERS-CoV viruses): Fever, Cough and Shortness of breath.
The CDC believes that symptoms may appear in as few as two days or up to 14 days after exposure.
Thankfully, NO AmeriClerkships Members or Employees have been confirmed to have contracted COVID-19.
Absolutely! We invite you to read all of the articles we’ve published, the FAQ here, and if you still have questions, file a case and our COVID-Response Team will reply.
If a healthcare facility is accepting AmeriClerkships Members to begin their rotations during the COVID-19 pandemic, AmeriClerkships will deliver the same to each Member. However we do understand if a Member is uncomfortable to being a clinical rotation during a pandemic. As such, AmeriClerkships believes that it is our responsibility to present our Members with the most relevant facts, and allow our Members to discuss their thoughts in cases or in Dr. Mizani’s Online Office Hours, and as many pros and cons pertaining to the decision of gaining clinical experience during a pandemic.
However even if a healthcare facility accepts an AmeriClerkships Member and expects them to start on time, AmeriClerkships will leave the final decision of whether they would like to start up to each Member. If the Member decides to attend an approved clinical block, then great! If not, the we will accommodate a change without a fee, and even postpone the clinical block to the end of Membership until everything settles down.
In compliance with new COVID-19 containment policies adopted by several U.S. healthcare facilities, AND to keep you on track for the 2021 Main Residency Match by mitigating the risk of interstate travel restrictions, AND to protect the health of our patients, affiliated physicians and other healthcare workers, AmeriClerkships is requiring stricter credentialing processing. Click here for up to date details.
If you have signs and symptoms of COVID-19 (or any other infectious diseases):
- Prior to start of a scheduled clinical block:
- File a case and let us know, and we will work with you to postpone your clinical block(s), AND
- Get tested and the care you need from a qualified physician, AND
- AmeriClerkships will address every situation individually (including postponing start dates without any fees), and with the utmost attention to service, professionalism and confidentiality.
- If you have signs and symptoms of COVID-19 (or any other infectious diseases) during an active clinical block:
- Speak with your supervising attending physician, and allow him/her to evaluate your signs and symptoms, AND
- Your attending may tell you to get tested, or ask you to take a few days off and then return, AND
- The orders given to you by your U.S. licensed supervising attending physician supersedes instructions given to you by anyone else, including AmeriClerkships, AND
- File a case and let us know of what is going on, and we will work with you to postpone your clinical block(s), AND
- Any unused time will be allowed to be repeated after you feel better and decide to return to complete the clinical block you started, OR AmeriClerkships may issue a Credit on File for you to use towards most AmeriClerkships products and services (see your Enrollment Agreement for details).
DO NOT compromise containment or risk your own exposure to the virus while starting or continuing a clinical rotation
Follow all U.S. Center for Disease Control, healthcare system, hospital or clinical procedures in regards to COVID-19, and follow the CDC’s website to ensure that you have up to date information to share with your family, friends, patients, and coworkers as the situation develops.
If you have any of the above, please get appropriate care and do not work or rotate until you have been cleared by your physician and relevant CDC guidelines.
Travel wisely and stay informed
- Visit the CDC travelers and COVID-19 information website often
- Identify your travel health level, and follow the directions mentioned there
Be prepared for delays
Reside in the United States city at least 14 days prior to your scheduled start date
Although only required by some supervising attending physician, it is good practice to give all attending physician the reassurance that you have been symptom free for at least 2 weeks prior to the start of your clinical block.
Do not travel if you have upper respiratory symptoms, fever or shortness of breath
If you’re traveling from or to an area with an active outbreak after working in a healthcare setting, be aware of the risks that poses to the global community. Make sure you take proper precautions by cooperating with travel advisories, disclose your status in our healthcare system and be transparent. If you are under mandatory quarantine or are coming from a known endemic area, follow all applicable laws and regulations. We are steadfast in our commitment to our Members, therefore AmeriClerkships will gladly waive all change fees (except clinical site difference fees) for any rescheduling that may need to occur as a direct result of COVID-19.
AmeriClerkships is affiliated with healthcare facilities (teaching hospitals, clinics, same day surgery centers, teaching attending physicians, etc.) who operate completely independent of any medical schools, and follow their own stated policies which in most cases is different that those followed by US medical schools.
Despite COVID-19 pandemic, >95% of AmeriClerkships clinical sites are open, seeing patients and permitting AmeriClerkships Members to continue with their clinical blocks uninterruptedly.
Mar facilities view healthcare trainees (medical students and graduates) as assets, especially during a healthcare crisis, hence are allowing rotators to start and end without interruption. There may be some delays, but nearly 100% of our clinical blocks have been starting without interruption. The other 5% of our affiliated U.S. healthcare facilities (mainly hospitals) are employing various degrees of measures when it comes to dealing with COVID-19, with the following ranges:
- Documentation of residing in the U.S. for at least 14 days prior to the start of clinicals
- Operating room entry restrictions
- Restriction of exposure to presumed COVID-19 cases in emergency room
- Temporary hold on visiting student rotations
However in all cases, every hospital administration has been incredibly supportive and reassuring, and can not wait to get back on track.
We have learned that each U.S. healthcare facility (hospital, clinics, same day surgery centers, etc) is employing their own measures when it comes to dealing with COVID-19.
AmeriClerkships will work closely and individually with each Member, and facilities (hospital, clinics, same day surgery centers, etc) and supervising attending physician coordinate any necessary changes to ongoing and upcoming clinical rotations. Any rotations that are forced to be rescheduled to a later date by COVID-19 will not carry any associated change fees for that postponement. If your rotations are suspended due to the virus, contact AmeriClerkships right away so our team can work with you to adjust your clinical schedule.
On March 17, 2020, the AAMC released their ‘Guidance on Medical Students’ Clinical Participation‘; please read AAMC’s position, and 2 of our affiliated physicians’s responses:
- 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:
- 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.
- 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.
In response to the above, Dr. Mizani contacted an Internal Medicine Residency Program Director in New Jersey, and an internist in Chicago, both affiliates of AmeriClerkships, asking their opinion on if trainees should be removed from clinical rotations during COVID-19 pandemic.
The Program Director’s response was as follows:
“We’ve seen a lot of COVID cases already in our residency. Before a student or graduate decides to delay his/her upcoming rotation during the COVID-19 pandemic, and if that individual is not symptomatic (afebrile, no cough, upper respiratory symptoms, shortness of breath), and not considered at higher risk (older adults, people who have serious chronic medical conditions like heart disease, diabetes and lung disease), then they should consider the following:
- At our clinic, all patients are screened by phone and if they are believed to have been exposed, they are sent to a command center to be examined; they will not be brought into our clinic;
- During inpatient rounds, my residents and I gown-up and care for the patient; trainees are not required to do so, but they can if they want to gain the experience;
- The experience gained as a result of participating in a humanitarian effort during a global pandemic like this is a once in a lifetime opportunity;
- We chose to be medical doctors exactly for moments like this.”
The Internist in Chicago stated:
“We have not had any confirmed COVID cases. We heavily screen our patients, and conduct telemedicine with those who are symptomatic. I had one student who complained of some cough and body aches, but afebrile. I sent him home to feel better, and am hoping he returns back to his rotation. And if we need to, we’ll test him, but I do not believe that students should just be stopped because of what’s going on.”
We’ve implemented the following policies to ensure that your rotations continue safely and without interruption to keep up with new healthcare requirements being put into place by our clinical sites.
Effective as of March 23rd:
- All lab work submitted to our Credentialing department must be from the US, including IGRA.
- AmeriClerkships will only accept titers to show immunity of any sort; immunization history or cards will no longer be accepted as proof of immunity.
- AmeriClerkships will no longer accept PPD, or negative chest x-ray read outside of the United States; for safe measures, we will only accept negative IGRA.
- Members should allow up to 10 days to receive their titers or to get IGRA results
Effective all Clinical Block start dates of April 6th and after:
- In compliance with new COVID-19 containment policies adopted by several U.S. healthcare facilities, AND to also mitigate the chance of not being able to travel into a state to gain your scheduled clinical experience due to possible interstate travel restrictions (such as FAA’s recent halting of inbound flights to NY on March 21, 2020), AmeriClerkships is now requiring that ALL Members with upcoming clinical block start dates provide proof of physical presence in the same state as where their upcoming clinical blocks are located, and to also self-confirm that they are free of COVID-19 symptoms during the 14 consecutive days proceeding the start of any AmeriClerkships clinical block. This means if you have an April 6th start date, you must have documentation of having been residing in the U.S. by no later than March 23. Click here for more details.
- If a Member is quarantined and misses their start date because they did not arrive 14 days prior, then they will be responsible for all associated change fees, and in some cases, they may not be able to begin after they’re released from quarantine since that site may not be available anymore
We are steadfast in our commitment to our Members, therefore AmeriClerkships will gladly waive all change fees (except clinical site difference fees) for any rescheduling that may need to occur as a direct result of COVID-19.
However before you postpone an upcoming clinical block, please read “2 Physician’s responses to AAMC’s Press Release” below.
Because of the new CDC guidance lowering the number of people that should congregate in a space from 50 to 10, Prometric announced on March 17, 2020 that it will temporarily close all test centers in the U.S. and Canada until April 16, starting tomorrow. This will impact USMLE Step 1, Step 2 CK and Step 3 administrations. Step 2 CS has already been suspended until April 13. This also impacts COMLEX-USA, whose Level 2-PE exam was already suspended through April 7. All of those restart dates are subject to change depending upon new national guidance and circumstances.
If your USMLE test dates have been affected by the above, then please fill out a support case and explain your situation, and what you would like to see occur. We are steadfast in our commitment to our Members, therefore AmeriClerkships will gladly waive all change fees (except clinical site difference fees) for any rescheduling that may need to occur as a direct result of COVID-19.
There are excellent COVID-19 resources we’ve come across with excellent pool of questions and expert answers:
- How do I protect myself?
- I think I may be sick; what do I do?
- What do older adults and people with disabilities need to know?
- What are CDC guidelines for healthcare professionals?
- What are CDC guidelines for healthcare facilities?
- What are CDC guidelines for health departments?
- What are CDC guidelines for laboratories?
- What government agencies are doing in response to the Coronavirus?
Share your experience with how healthcare facilities are dealing with COVID-19 and student clinical rotations
Share what other healthcare facilities are doing so we can help AmeriClerkships Members prepare against COVID-19. For our members currently rotating, or for those of you still working in a healthcare setting, what have your facilities’ response been? We want to hear from you so we can share your experiences with our network of physicians and alumni to spread awareness in our niche of the medical industry.