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Medical students, administration reflect on challenges and changes in the midst of pandemic

Students and faculty at the University's School of Medicine struggle most with changes in social interaction and hands-on learning

<p>While COVID-19 has put a stop to clinical experience with patients for most medical students, the University's medical curriculum allows for students to make up for lost time whenever it is safe for students to return to hospital settings.</p>

While COVID-19 has put a stop to clinical experience with patients for most medical students, the University's medical curriculum allows for students to make up for lost time whenever it is safe for students to return to hospital settings.

With classes having moved online, the virtual change has not just shifted the undergraduate experience, but also that of medical and biomedical graduate students. While some students are more used to remote learning, others have to complete alternatives to their clinical or laboratory work, as well as adjust to summer research cancellations. Students and faculty alike also struggle with lack of social interaction that is now necessary to prevent the spread of COVID-19. 

Unlike the undergraduate experience, the activities of medical students vary dramatically from year to year. In their first year, medical students are focused on classroom learning. According to Medical student Joey Michel, many professors recorded their lectures even before the switch to online learning. He said that the curriculum and schedule for first years has remained “business as usual” for the most part, but certain classes — especially involving dissections — are particularly challenging online. The biggest change for Michel has been socially. 

“For me, at least, and for many of my classmates, the switch was not too disrupting,” Michel said. “It was more like not being able to go to the library and study with people. That's the thing that's been harder for people.”  

However, upperclassmen medical students who have taken their first board exams spend much of their time in wards, interacting with patients, physicians and hospital staff. Medical student Courtney Duckworth said that she and other upperclassmen were pulled from the hospital two weeks after they had started on the wards. While it is frustrating to not be able to apply their knowledge to help patients, Duckworth explained, she understands that there are risks with having medical students continue in the hospital. 

“It's like we suddenly feel very useless,” Duckworth said. “Of course we understand why we can't go in, because as nice as it would be to have medical students helping, we're also vectors and we could be carrying the virus and increasing the risk for our patients.” 

Instead of working in the wards, upperclassmen have been completing specialized seminars on topics such as pandemics throughout history and high-value care, which focuses on maximizing the patient’s time and resources at a hospital. Duckworth said that she believes she can make up time in the wards during her fourth year, if classes resume in-person in the fall. 

“I think everyone's a little concerned about [lost clinical time],” Duckworth said. “But at the same time, I think that U.Va. has a really flexible curriculum in the fourth year, which will provide a cushion for us to have a little more time to learn before we have to take on the responsibilities of becoming a doctor.” 

Another reason for pulling students out of clinical environments is the raised demand for personal protective equipment, explained David Wilkes, dean of the University’s School of Medicine. If there is a national shortage, Wilkes said, then it would be advisable to provide that equipment to physicians and clinical staff. 

Wilkes also said that fourth years are scheduled to graduate on time and there is space in the fourth year to complete required hours in the hospital if students return in the fall. He echoes Michel’s sentiment that the biggest challenge for students and faculty is lack of social interaction. 

“The actual online or digital learning format, I don't think that's really a challenge,” Wilkes said. “A big challenge is that we're social individuals … All the remoting that everyone is doing, I think that gets tiring after a while. It's a different set of stressors that I think all of us are learning to adjust to.” 

Graduate students in the biomedical sciences have also felt a large change in pursuing their degree. Patrick Grant, associate dean for Graduate and Medical Scientist Programs, explained that research is a heavy part of the graduate student experience, and since the shift online, students have been unable to continue in the lab. 

“One of the most difficult aspects of this whole situation is to have our students out of the labs for their safety,” Grant said. “I fully support that, but, of course, from their perspective it is stressful because it's putting them in some respects behind in their trajectory.”

According to Grant, for students whose research is already based in bioinformatics and computation, the shift to remote research is not so disruptive. However, students whose projects are not easily transferable to remote work have been participating in newly offered workshops on computational methods, meeting with their mentors and lab groups and writing research proposals and papers. 

In addition, the School of Medical usually offers a 10-week internship program for undergraduates around the country interested in the biomedical sciences, which had to be canceled. 

“It's particularly an opportunity for underrepresented students to get some hands-on research experience, and we unfortunately had to cancel that whole program this summer,” Grant said. 

Opportunities for medical students to engage in in-lab research has also been canceled for the summer, said both Grant and Michel, which affects students’ future residency applications as well as financial situations. 

“A lot of us want to do research over the summer because it helps us with residency applications in the future,” Michel said. “It also allows you to get funding so that you're not living without any money over the summer. And a lot of those projects are canceled because they were basic science lab research or clinical trials where you're interacting with patients.” 

In response to these limitations, medical students have created a website that consolidates volunteer opportunities, creative projects and educational resources to help communities in and outside of Charlottesville. This allows especially third- and fourth-year medical students who cannot work in the hospital opportunities to help out. According to Duckworth, this helps students reflect on this time away from their normally scheduled studies. 

“Especially as a training doctor it's kind of surreal to be training in a time like this,” Duckworth said. “It's really special to be able to see how people's backgrounds and their challenges are coming together to lift a whole community.” 

In the future, Wilkes sees potential changes coming to the medical school’s curriculum, especially in the arena of the accessibility of medical resources and telemedicine. 

“I definitely think that we'll see an addition of teaching our students how to practice telemedicine,” Wilkes said. “If there's been a good that has come out of what we're seeing now [it’s] that we have the ability to really utilize telemedicine to reach folks that we otherwise would not have had access to.” 

Grant hinted at the possibility of Zoom and streaming being utilized more actively in graduate programs even if students return to Grounds, for students who cannot attend in-person lectures or for family members to watch thesis presentations remotely. 

“I think as people become much more comfortable with this way of presenting their work and interacting, and with the technology involved as well, that you could imagine it might become more commonplace,” he said. 

Going forward, Duckworth believes that clinicians will have to be more conscientious of public health and that the image of clinicians has changed in the public eye. 

“I think that as clinicians we're going to have to be very educated on what's going on with an outbreak,” Duckworth said. “It's also interesting to see how the public is perceiving doctors and medical professionals … Now, you know, medical professionals are being perceived as heroes and it's a lot to live up to.” 

Michel also thinks that this pandemic has made both the general public and medical students realize the collaborative effort involved in healthcare.

“Societally, people are very aware of how vital the services that occur in hospitals are right now — the work of nurses and your allied health care professionals who are not physicians, but they're working just as, and often more, intensely in these situations,” Michel said. “After all this, man, it is a team, team, team sport.” 

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