Coronavirus Halts Clinical Training For Med Students

Apr 2, 2020

UNC Medical School's PPE 'donning and doffing' team, students who monitor doctors, nurses and other health care workers to make sure they properly put on and remove protective equipment used to treat COVID-19 cases. From left to right: Ryan Searcy, Edward Diaz, Neal Bartl, Diana Dayal, Austin Lucke, and, kneeling in front, attending physician Dr. Howard Choi.
Credit Courtesy of Diana Dayal

Just a few weeks ago, Diana Dayal was hitting the books hard, preparing for the first of two medical licensing exams. The fourth-year UNC Chapel Hill medical student's clinical knowledge test had been scheduled for March 19.

"That's one not happening," Dayal, who wants to go into emergency medicine, said with a chuckle. "And then the other one was scheduled for mid-April."

The exam sites have been closed to contain the spread of coronavirus. And clinical skills tests, which involve the use of actors posing as patients, have also been postponed indefinitely.

My primary concern is just what's going on right now, in terms of the COVID crisis in the United States, and figuring out any way, you know, that I can play a part. -Diana Dayal

These licensing exams are critical steps for med students like Dayal. Typically, the exams must be completed before applying for a residency program.

While many medical students who graduate this year have already taken these licensing exams, those who have not will not have to complete them before starting in North Carolina residency programs this summer. The state Medical Board waived the requirement saying it would certainly help in the fight against the pandemic.

For Dayal, disruptions to her medical education are not her main concern.

"My primary concern is just what's going on right now, in terms of the COVID crisis in the United States, and figuring out any way, you know, that I can play a part," she said.

Medical schools, under the guidance of the American Association of Medical Colleges, have suspended clinical training and hospital rotations for their students, preventing them from engaging in direct patient care. That is primarily because of the tight supply of personal protective equipment, the gloves, gowns, and masks that doctors, nurses and other health care workers desperately need to keep from contracting COVID-19 or further spreading the virus.

So there is no rounding right now for med students at UNC, Duke, Wake Forest, or East Carolina University's Brody School of Medicine.

Still, Dayal and other students are not totally relegated to the sidelines. For example, she is part of a team of med students monitoring doctors and nurses as they enter and exit COVID-19 care areas at UNC hospitals.

"One thing that we make sure is that the gown is really gently removed and carefully disposed of," she explained.

Dayal said a common mistake among docs and nurses is taking off their protective gowns too vigorously, which can spread virus particles.

She is also part of a group of med students participating in a pilot program at the Durham V.A. hospital, helping screen incoming patients for COVID-19.

Like Dayal, Matthew Fordham is also in his fourth year at UNC Medical School. The aspiring internist volunteers at a free clinic run by the UNC Student Health Action Coalition, a 50-year-old program that provides health care to under- and un-insured patients.

UNC medical student Matthew Fordham, 25, working at home. The student-run health clinic he volunteers at is piloting telehealth visits to help patients while the facility is closed down during the coronavirus pandemic.
Credit Joshua Ewy

"We have our own pharmacy that dispenses free medications on site, we have mental health care visits," he said.

Under normal circumstances, the clinic is open every Wednesday night at the Carrboro Community Health Center. But life amid COVID-19 is anything but normal. So the free clinic is adapting. Fordham said it just piloted its first telehealth visits, though language barriers for Spanish-speaking patients and internet access sometimes pose a challenge.

"The goal of these visits is to try to keep our patients on their medications, manage chronic issues and keep folks out of the emergency department," Fordham said.

As fourth years, Fordham and Dayal have already completed their advanced clinical training, doing rotations in different departments of the hospital. But this year's third-year med students won't get the chance to do their rotations until the suspension of such programs is lifted.

"We need to get them back into the clinical environment where they learn the basics of how to deliver babies and how to care for the geriatric patient population and so forth," said Dr. Julie Byerley, Vice Dean for Academic Affairs at UNC's School of Medicine. "But with the attention being diverted, of their teachers, to virus management, right now is not the optimal time for their education." 

Dr. Mark Stacy, Dean at ECU's Brody School of Medicine, said for now he can't imagine that any graduation or residency start date will be delayed. But if the coronavirus curve isn't flattened and there's another wave of infections as public health experts predict, Stacy said all bets are off.