COVID-19 & Medical Schools
Published on Apr 1, 2020. Updated on Sep 15, 2020.
While concerns about COVID-19 had been growing globally for months, March 11 appears to have been a watershed. On that date, the WHO formally called COVID-19 a global pandemic, and a number of universities announced suspension of their classes and their intention to convert to fully online.
By March 17, the American accrediting bodies for allopathic and osteopathic medical schools effectively required keeping medical students out of clinical settings through March 31 (since extended through April 14), with most schools immediately pulling students from their clerkships. Since that time, both groups of authorities have signaled flexibility, allowing voluntary student involvement based on local health needs. While they did not mention students’ non-clinical learning, most (and possibly all) schools have also transitioned to fully online.
What this means for schools and students is uncertain. The LCME stated that, “Should you need to interrupt or postpone clerkships or other required clinical experiences … elective weeks are available to adjust your students’ clinical training schedules without having to delay completion of these required experiences before graduation.” Many schools are working hard to develop new electives and find other creative ways to keep students learning clinically, although it appears that if COVID-19 social distancing requirements continue for months, some schools may need to adjust their requirements to ensure that residency application and match timelines can be maintained for the 2020-2021 cycle. International medical graduates face special challenges given restrictions placed on travel and being unable to take USMLE exams (Prometric testing sites are closed at least until April 16).
COVID-19’s impact on medical students
For greater insight into what medical students themselves are experiencing, on March 20, we surveyed 67 medical students in our Osmosis Medical Education Fellowship program, which included 40 students from 32 schools in the U.S. and Caribbean, and 27 students from 23 schools across 15 other countries. Of the 55 schools, the only school that had not made changes based on COVID-19 was located in Samoa, a rare spot in the world without a COVID-19 positive patient. In the U.S., students learned of changes to non-clinical learning during the week of March 9-13 and to clinical learning the following week. This was similar for students in other areas of the world, although schools announced converting non-clinical learning to fully online as early as January 31, 2020.
Exams likewise are generally being converted online and OSCEs delayed. At the time of our survey, student respondents generally had favorable impressions for how their schools were handling the situation, acknowledging that their faculty and administration were doing the best they could in an unprecedented situation. Students were especially appreciative of clear and consistent communication. Students’ frustrations derived primarily from delays in their schools taking decisive action to make changes. Despite the rapid movement to telehealth visits, 5 U.S. students and 1 international student noted telehealth being an option at their schools.
Across the sample, most students were extremely or very concerned about the toll that this would take on public health (73%) and the economy (70%) and the health of their family and loves ones (57%), but less concerned about their own academic future (34%), restrictions on their personal freedoms (27%), and their own health (18%).
When we asked how social distancing was affecting them, students would occasionally express stress or discomfort with being at home, although usually looked for a positive aspect, such as less distraction and more time for studying or spending more time with family. Strategies for coping with COVID-19 included:
Physical activity, such as exercise, walks, yoga
Mindfulness practice, such as meditation, breaks from social media
Connecting with friends and loved ones remotely
Keeping a schedule and continuing academic efforts
Pursuing hobbies, such as writing, graphic arts, music
Regulatory authorities, medical schools, and students will continue to adjust as COVID-19 forces additional changes. It is perhaps reassuring that in these early stages medical students appear to be coping relatively well and are more concerned about the needs of other individuals and society than their own interests. We should continue to support and engage these selfless acts to make sure students keep learning, find ways to contribute to the global public health crisis that are meaningful to them, and remain safe.
Student involvement in clinical settings suspended for U.S. allopathic and osteopathic schools until April 14 (based on recommendations from AAMC, LCME, AACOM, COCA), although student volunteering is not prohibited
No USMLE Step 1, 2CK, COMLEX 1, 2 CE, 3 until after April 16 (when Prometrics will re-evaluate whether to re-open test sites)
USMLE CS testing centers closed at least until April 13
COMLEX 2 PE canceled March 23 to April 6
NBME to develop remote administration of subject exams starting April 7
No change to 2020 Match
ACGME suspending accreditation activities and accelerating telemedicine requirements
ABMS signaling flexibility with leave policies that extend training period
Most recent announcements
AAMC and LCME extend proscription against student participation in clinical activities through April 14
NBME announces 7 self-assessment exams (5 CBSSAs, 1 CCSSA, 1 CCMSA) will be freely available April 3 and answer explanations will be available for medicine self-assessments April 2.
AOA and COCA announce option for early graduation for medical students
LCME announces option for early graduation for medical students
AACOM provides an update to their March 17 memorandum, indicating that students could volunteer to provide support in efforts against COVID-19
AAMC and LCME issue interim guidance for students to voluntarily support efforts against COVID-19
NBME announces customized assessment administrations temporarily suspended starting March 25, remote administration of subject exams targeted for April 7, no change to self-assessments.
ACGME announces accelerated implementation of telemedicine requirements and suspension of accreditation self-study activities, site visits, and resident, fellow, and faculty surveys
AAMC and LCME jointly call for medical schools to pause all student clinical rotations until at least March 31.
AACOM and COCA strongly support a minimum 2 week ’pause’ of medical student participation in any activities that involve patient contact.
Prometrics announces testing sites closed March 18 to April 16, impacting USMLE Step 1, 2 CK, and 3 and COMLEX-USA Level 1, 2-CE and 3, COMVEX examinations, and any COMAT administrations
NBOME announces COMLEX Level 2 PE exams canceled March 23 to April 6
USMLE announces CS testing centers closed March 16 to April 13 and temporary fee waiver to change testing region and extend eligibility period
Supporting your medical school during the COVID-19 pandemicDuring this time of crisis, Osmosis is committed to making resources accessible to students, faculty, and healthcare workers to minimize educational disruptions and maximize the capacity of the healthcare system so our communities can flatten the curve and raise the line. To learn how Osmosis can support you and your program during this difficult time, please contact us at [email protected]
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