COVID-19 Quarantine Can't Contain Medical Student Creativity

How medical students across the country got creative and stayed involved despite widespread clerkship interruptions

Smooth seas don't make skilled sailors, and medical students across the nation have been learning that the hard way. The dynamic COVID-19 situation continues to throw a major wrench in the traditional flow of medical education, especially in light of nearly universal clerkship interruptions for third- and fourth-year medical students.¹ Despite this, and recognizing the critical needs of a health care system stretched to its limits, thousands of medical students have stepped into the arena to make a significant impact on local, regional, and national response efforts in a variety of creative and innovative ways.

As one of the first cities in the United States to confirm a travel-related case of COVID-19,² Chicago, Illinois, and its highly populated medical district continue to battle hundreds of active and suspected coronavirus infections each day. Led by medical student leaders from Rosalind Franklin University, University of Illinois Chicago, and Northwestern University Feinberg School of Medicine, medical students from all 7 Chicagoland medical schools teamed up to create the COVID Rapid Response Team - Chicago (CRRT-Chicago) -- mobilizing hundreds of medical students to fill a multitude of critical needs. Within their first 72 hours of operation, more than 500 students across multiple health professions had signed up to help -- not only medical students, but nursing, pharmacy, physician assistant, podiatry, MD/PhD, and other health care graduate students as well. Led by their Executive Strategy Team, CRRT-Chicago has organized and deployed teams to allocate and distribute personal protective equipment (PPE) to frontline health care workers at numerous Chicago hospitals and clinical sites; organized blood drives; assisted with laboratory testing and telemedicine triage; organized food drives and social support efforts for health care workers; coordinated remote tutoring opportunities to assist quarantined high school students; advocated to public officials on behalf of vulnerable populations including low-income families, immigrant communities, incarcerated persons, and the homeless population; and developed a social media presence in their own right by creating the hashtag #GetMePPE and promoting through the twitter handles @GetMePPEchi and @covidRRTchicago. 

Medical students in New York -- the state with the highest volume of COVID cases in the United States³ -- have also been contributing since the beginning. "As future emergency medicine physicians, all we want to do is get into the thick of it and help out," says Shelby Wood, a fourth-year medical student from St. George's University School of Medicine, who has been collaborating with classmate Sergio Camba and the President of the American Academy of Emergency Medicine (AAEM) New York state chapter to address needs in the tri-state area and surrounding communities. "We understand that it's just not feasible [to continue clerkships] right now, so we want to do what we can on the sidelines to support our health care staff who are putting their lives on the line every day to help others. We can't wait to join them next year!" Together, they have coordinated for volunteer medical students to provide childcare, pet care, and grocery shopping assistance to emergency department health care workers throughout New York state.

Community engagement has been prioritized across the country, as medical students from University of Mississippi Medical Center (UMMC) have held an ongoing COVID Response Food Drive for more than 2 weeks. Students have partnered with larger organizations such as Peoples' Advocacy Institute and the Boys and Girls Club of Jackson to run what is now a city-wide operation. Hundreds of families in the Jackson area have received groceries as a result of this initiative, with thousands of dollars' worth of food distributed throughout the community to homes experiencing hardship. UMMC student leaders continue to broaden their impact by assembling COVID Care Kits, which include basic hygiene items such as toilet paper, disinfectant, hand sanitizer, and more, to ensure the economically disadvantaged in their area can maintain preparedness in these difficult times.

Rich Dowd, a fourth-year medical student from Ohio University Heritage College of Medicine, has contributed to similar community engagement initiatives throughout Columbus, Ohio. Alongside his classmates, Mr. Dowd has coordinated local blood drives, food pantry volunteering, tutoring opportunities for quarantined high school students, and pet care and childcare assistance for local healthcare workers. Brendan Miccio, a third-year medical student from Lake Erie College of Osteopathic Medicine, has led similar efforts in Pennsylvania. "I wanted to do my part in my own community," states Mr. Miccio, who has also been coordinating childcare and pet care support along with errands for local elderly communities. "It's been an incredibly rewarding experience thus far, serving as a reminder that service is just one of those deeply rooted values all throughout the medical profession."

Some medical students have found ways to continue providing direct clinical assistance as well. Nathan Hersh, a third-year medical student from Philadelphia, has seen a shift in perspective among his peers who have had USMLE Step 1 examination dates delayed and who have begun assisting with transfers of care for COVID-19 and non-COVID-19 patients alike. "I was struck that, despite spending weeks enveloped by full days of stressful Step 1 studying, as soon as Prometric announced its closures there were scores of students immediately ready to shift gears and help healthcare workers practically that same day."

Fourth-year medical student Lenexa Morais, from the University of Texas Medical Branch (UTMB) in Galveston, TX, describes her institution's interprofessional approach to identify and assist vulnerable populations in the Galveston County Health District. "Our team is made of about 200 medical students, nursing students, physician assistants, and UTMB staff, led by our Global and Community Health program," reports Ms. Morais, who has been contacting nursing homes, assisted living centers, and faith communities about COVID-19 preparedness as well as reaching out to high-risk populations including dialysis and immunocompromised patients. "Students are integral in the healthcare system and I am happy to volunteer my time to help our community. I hope we can continue protecting our physicians and staff through public health education and prevention, and decrease the burden on our health care system."

In the Pacific Northwest, medical students from Oregon Health Sciences University (OHSU) recognized significant reductions in substance abuse and recovery resources that had left members of their surrounding community especially vulnerable to addiction-related health complications. They addressed this need by creating a detailed capacity and needs assessment system, providing real-time information and updates to local safety net programs to ensure that individuals affected by substance use disorders (SUD) did not experience significant barriers when attempting to access essential SUD resources during this time.

Medical student productivity has extended into academia as well, as a student collective from Harvard Medical School developed and released 5 clinically relevant COVID-19 learning modules⁴ targeted to their student peers and fellow clinical trainees. 

Even organized medicine has been impacted in a significant way, as student leadership from the American Medical Association Medical Student Section (AMA-MSS) discuss the activity and productivity of their national network of medical students. "It has been incredible to see the level of collaboration amongst medical students in response to the pandemic," says Drayton Harvey, MD/PhD candidate from USC Keck School of Medicine and Chair of the AMA-MSS Committee on Legislation & Advocacy (COLA). Mr. Harvey has collaborated with colleagues from around the nation to develop a comprehensive student guide designed specifically to inform and assist medical students interested in community organizing during the COVID-19 pandemic. "We hope that this guide helps inform students how to approach their school's administration about medical students being helpful during the crisis. Many of us got into medicine to fight for our patients and colleagues, which has led students from across the country to join together to provide relief for our health care workers and the most vulnerable members of our communities." 

When medical students who have been conditioned to grind for hours on end in an academic or clinical environment suddenly find themselves with time to ponder larger initiatives, as has happened across the nation due to widespread social distancing and quarantine, amazing things can happen. These ambitious medical student leaders, through projects both direct and remote, are perfect examples of necessity sparking innovation. With each in-person initiative, the emphasis is placed on student safety and wellness to prevent unintended exposure, while also finding novel ways to continue using their medical education -- and in many cases, extensive prior work experience -- to provide critical support to their local, regional, and national health care systems at this unprecedented time. Such initiative shines a positive light on the future of medicine beyond the COVID-19 pandemic, knowing these altruistic, motivated, and effective student leaders have a full career ahead of them to continue impacting the medical community in such meaningful ways.

References

1. American Association of Medical Colleges. Interim Guidance for Medical Students' Voluntary Participation in Direct Patient Contact Activities: Principles and Guidelines. Published online March 23, 2020. Accessed online on March 26, 2020. 
2. Elwood P, Crews J. Chicago woman infects husband with coronavirus, US issues travel warning. WGN-TV. Published online January 30, 2020. Accessed online March 27, 2020.
3. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020. pii: S1473-3099(20)30120-1. doi: 10.1016/S1473-3099(20)30120-1.
4. Harvard Medical School. Medical Student COVID-19 Curriculum. Harvard Medical School. Published online March 15, 2020. Accessed online March 26, 2020.