hands on keyboard of laptop computer.

How Preclinical Medical Students Have Embraced Advocacy Amid Virtual Education

By Tarika Srinivasan

On February 28th, 2020, after an hour of incessantly refreshing my email inbox, I received an acceptance letter to my dream medical school. That same day, a conference in the city I would soon call home became the superspreader nexus from which up to 300,000 COVID-19 infections have been traced.

The ensuing months, which were meant to be an exercise in pomp and circumstance, were marked by a steady stream of anxiety, frustration, and disappointment associated with virtual learning.

As first-year medical students, it is hard not to feel that we comprise the bottom rung of a long, rigid hierarchy. We are fully aware of the limited role we play in this pandemic; we lack the useful clinical skills of a final-year medical student or an employed resident. Our presence in the hospital is more of a liability than an asset.

We witnessed classes of fourth-years graduating early to serve on the front-lines of the spring first wave (though reception to this call of duty ranged from appreciation to apprehension). We imagined that in a few short years, we too might be deemed so “essential” that folks would be clamoring to have us serve on the wards.

But, despite our limited skills, we preclinical students decided we could not simply wait in the wings for our cue. Though we were dedicated to the didactic portion of our curriculum, we were itching to be involved in the action. Thus, we sought to expand the scope of what medical students could do during a pandemic.

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Hourglass

A Medical Student Reflects on the Value of Time During the COVID-19 Pandemic

By Jess Ma

He passed away on the 107th day. After I got home in the evening, I wrote down everything I could remember about him in my journal. For many days after his death, I often dreamed I was standing in that fluorescently bright ICU room. In the dreams, I would be watching him, and then he would wake up and start speaking to me, with those bright blue eyes glittering with animation and life. I always awoke feeling a little unsettled, not by his death, but rather by the fact that I knew so intimately the ways in which he was kept alive, and yet nothing about the life he lived until just hours before his final breath.

He was an existing patient on the unit when I joined the surgical ICU team, and for 10 days I followed him, tracking how every organ system was doing each day. Everyone on the team knew there was only one way this would end; his quality of life had deteriorated so rapidly since the early summer, after a bout of necrotizing pancreatitis and multiple tragic complications; he was barely able to interact with his own body, much less his environment, and his life was propped up precariously by every possible machine that could perform the function of a vital organ. For him, no medical intervention would add more significant chapters to his story. It was just a matter of when his daughter would be ready to close the book.

Because of the pandemic, visitors were only allowed after 12pm each day. When his adult daughter came to visit each afternoon, I was told to avoid intruding on their cherished private time together. I only ever really saw her shadow behind the drawn curtain as I walked past the room; and I knew that one of the surgeons on the service (a group of surgeons rotated between trauma, acute care, and surgical ICU) would routinely give her calls or meet up with her to discuss how her father was doing, even on days he had off. Surgeons are not generally thought off as doctors who can spend a lot of time just talking to patients – after all, in the time he spent on one of those daily conversations, he could complete an appendectomy. Though neither he, nor the rest of the team, could offer a magic solution, what he offered was crucial – his time.

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A patient is seen in the intensive care unit for the coronavirus disease (COVID-19) in Thoracic Diseases Hospital of Athens in Greece on November 8, 2020.

Learning During the COVID-19 Pandemic: The Importance of Humanism in Medicine

By John C. Messinger

On March 17, 2020, in the first days of the COVID-19 pandemic in the United States, the Association of American Medical Colleges (AAMC) released a statement strongly urging medical schools to pause all clinical rotations and patient-facing activities.

While there was a clear necessity to limit student participation as a means of reserving PPE and creating a safe environment for patients and health care providers, restricting medical students from clinical settings has drastically changed their education.

As a first-year medical student removed from training at the time of this announcement, my greatest fear has been that these changes will alter my approach to care for patients.

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