COVID-19: How the virus is impacting medical faculties

Like almost every other aspect of American life, the COVID-19 pandemic presents a number of unique challenges for the institutions charged with training the next generation of doctors. Some measures, such as school closings, can be mitigated with digital technology. Other aspects of medical school, such as clinical training, are more difficult to continue in these circumstances.

The AMA and the Centers for Disease Control and Prevention (CDC) are closely monitoring the global COVID-19 pandemic. Learn more at the AMA COVID-19 Resource Center and consult the AMA Physician’s Guide to COVID-19.

A recent discussion in the AMA Accelerating Change in Medical Education Community (registration required) looked at the challenges of the pandemic for students and faculty members and how some schools are dealing with the situation. Here’s a look at what faculty members had to say in this discussion, and where things stand with some key aspects of medical education.

Clinical trainee lawyers

Clinical trainee lawyers

The main clinical traineeships usually take place in the third year of the medical faculty and last between four and eight weeks in around half a dozen disciplines. This is often a medical student’s most significant exposure to patients.

On March 17, the Association of American Medical Colleges (AAMC) requested a two-week hiatus from activities where students interact with patients and effectively put clinical rotations on hold.

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Regarding the potential impact of postponing rotations, the Medical Education Liaison Committee (LCME) gave this advice to faculty members: “From the national data you submitted, LCME knows that most of our medical schools have multiple elective weeks (or) months in last year or in the last phase of the curriculum. Should you need to interrupt or postpone the internship or other required clinical experience due to the real and important pressures and stresses of the clinical environment, these optional weeks are available to you to adjust your students’ clinical training plans without first delaying the completion of these required experiences must graduation. “

Path rotations

Path rotations

Outward rotations typically offer medical students late in their education the opportunity to be exposed to a variety of subject areas and institutions. The AAMC encourages medical schools to help find “local alternatives” for students planning rotations in the coming months. The organization also recommends that medical schools postpone rotations for students coming from other medical schools.

While most schools appear to be following AAMC advice, one participant in the discussion noted that students have concerns about how the lack of out-of-home rotations might affect their residency requests.

“I worry that students may feel trapped between the perceived or explicit expectations of their schools and those of the residency programs, while public health and personal safety fall somewhere in between,” said Dr. Daniel Corson-Knowles, director of the Phase 3 curriculum at Indiana University School of Medicine.

A National Board of Medical Examiners (NBME) subject examination – commonly referred to as a shelf examination – is often conducted with every rotation of the traineeship. The NBME Vice-President recently issued a statement on the status of these exams, which are given in person to large groups.

“We are aware that the preparation and execution of planned examinations in medical schools during [COVID-19] The outbreak creates uncertainty for everyone, ”said Agata Butler, Vice President of NBME. “NBME works actively with our service providers to coordinate the operational plans. We are also examining all possible options for providing reviews and we are sure to see this as an urgency. “

So far, the NBME has suspended an examination under its roof. The Clinical Skills portion of the United States Medical Licensing Exam, Step 2, was suspended on March 16.

The teachable moment

The teachable moment

Panellists generally called for student safety to be a top priority in any educational decision, but were also concerned about sending the right message.

“While protecting students is important, we should also help them understand that sometimes caring for patients involves putting themselves at risk,” said Dr. David Henderson, Associate Dean of Multicultural and Community Affairs at the University of Connecticut School of Medicine and Dentistry, one of 37 member schools of the AMA Accortating Change in Medical Education Consortium.

“We recall the reluctance of some providers to treat HIV-infected patients at the start of the epidemic, and we are considering the message that we may send students about the obligation to treat all patients, with the right precautions and protection, regardless of course, of course Type of illness while we shape education policy. I heard some schools are considering limiting student involvement with patients with COVID-19. I am not sure that such blanket bans convey the right message to patients about our fundamental responsibility. “

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Kim Lomis, MD, the AMA’s vice president for innovation in basic medical education, agreed.

“It’s important to recognize that clinical students are more than learners – they play an important role in delivering care,” said Dr. Lomis in a statement. “As the US healthcare system responds to this challenge, we can count on our talented, dedicated students as a critical element of our workforce. We have prepared them for it. “