With the recent spike in Delta variant cases, we are once again reminded of how COVID-19 affected our lives in those scary March 2020 days. Medical students were not immune from the craziness. Were we going fully virtual? Could we go home? What about our exams? Clinical rotations? You name it. We were worried.
Headlines were slowly transforming COVID-19 from a foreign issue to a very personal American issue. While medical students tend to do a decent job with staying up to date with current events, the full magnitude was not apparent until our daily lives were affected. I distinctly remember my Clinical Systems professor remarking very nonchalantly on a normal Wednesday morning that this was likely our last in-person class together. A day later, my school sent out an email saying we were going to “try out” going fully virtual for the next week. Obviously, our practice week turned into a new way of learning for the rest of the semester.
When it came to learning the content, we really did not miss a step because of how much of the curriculum was already remote. Medical schools in the last decade have already moved towards prerecorded lectures. At Touro, in-person classes were clicker sessions, a time when we answered clicker questions based on the prerecorded lectures; these questions were worth a certain proportion of our grade. Going fully virtual meant that clicker questions were no longer a thing, which was met with enthusiasm from students. Weekly open-book online quizzes for each class were administered instead. After some time, my school and most other medical schools went “Pass/Fail” for the semester (many medical schools had P/F curriculums by default, prior to COVID-19). The P/F change helped to account for the difficulties in adjusting to the pandemic, as well as keeping a level playing field, as exams went from "in-person and proctored" to "at-home and not proctored." In some ways, going fully virtual was actually convenient. There had already been a historical trend of second year students not showing up to classes in order to study independently for upcoming board exams. Since students were not expected to show up anymore, we were able to study independently without shouldering the guilt of not attending class and missing those clicker question points.
Third and fourth year students on clinical rotations, however, got absolutely shafted—in every school and in every state. In a mad dash to protect the students, they were dropped from their rotations. Schools attempted to create online curriculum to fill in the gaps, but you cannot learn clinical medicine from the computer. When I entered my third year rotations in July 2020, there were no more holdups, and we were allowed to go about our rotations as per usual. We were required to wear N95s and face shields for all patient interactions. Medical students were also not allowed to see known or suspected COVID-19 cases, for general safety reasons and insurance issues. However, avoiding COVID-19 patients is easier said than done. When I was on my December 2020 Emergency Medicine rotation, I would get sent into rooms for patients with abdominal pain or suspected UTIs, and they would later test positive for COVID-19. The disease came in seemingly all forms. Luckily, I was able to get my first Moderna shot in the middle of my ER rotation, which made me feel somewhat safe.
2020-2021 was the first residency application cycle that had to fully adjust to the pandemic. Fourth year medical students across the country logged into Zoom for their residency interviews—no more “seeing the hospital and getting a feel for the program.” New questions and challenges arose. Will a ring light for my webcam make my image look better? Should I get a better microphone for my laptop? Would it be advantageous to apply to several more programs now that we don’t have to travel for all these interviews? People began hoarding interview invitations, leaving lesser competitive applicants with fewer interviews. I am applying to residency during this academic year, and all signs are pointing to another year of virtual interviews.
Searching for fourth year rotations, by the way, has been particularly difficult. Traditionally, fourth year medical students are advised to visit residency programs and “audition” for their program (audition = a hyped up way of saying you’re doing a rotation at a residency program). However, the American Association of Medical Colleges published guidelines stating that we should limit “audition” rotations, specifically those that a medical student would have to travel to. Moreover, the AAMC writes punitively that “residency programs are encouraged to take into consideration if a learner exceeded the one away rotation limit during the residency selection process.” So, all the sudden, students with limited local options for audition locations are effectively being squeezed. You’re in New Hampshire but want to do rotations in South Carolina? Tough.
The list goes on-and-on for how the pandemic affected medical schools. Medical school interviews went online. Some rotation clinical sites turned away students throughout the year when cases were spiking. A board exam that tested clinical skills, which required students to travel to Philadelphia, was cancelled and may never come back. In some states, fourth year students had the option to graduate early with the idea that they may be able to start residency early and help the front lines. Life changed, in some ways small but in many ways big—and that is okay.
At the time of this blog post, I am a fourth year medical student. No medical advice is given on this website. Please subscribe to be notified of a new blog post!
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