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Medical students adapt to unique challenges posed by lack of in-person learning

The outbreak of COVID-19 has impacted medical school students at the David Geffen School of Medicine in more than a few ways. Students now find themselves with extended examination periods, analyzing cadavers online and worrying about the states of their residencies. (Daily Bruin file photo)

By Sarah Nelson

April 16, 2020 9:19 p.m.

As medical school students participate in Zoom classes, some have begun to question the outcome of their training and their preparedness to practice medicine in the real world.

Because of the shutdown of schools and nonessential businesses following the outbreak of COVID-19, hospitals and medical schools imposed restrictions on who would be allowed to continue involvement in day-to-day hospital activities.

In a statement issued by the Association of American Medical Colleges last month, medical students are not permitted to engage in direct patient care, unless there is an urgent need. The deans of the David Geffen School of Medicine held their own town hall to discuss medical school student outcomes and to determine how best to move forward.

First- and second-year medical students spend much of their time in the classroom, with added opportunities for physician shadowing and preceptorship experience, where students are assigned to a doctor who trains and mentors them throughout the year, said Simone Renault, a third-year medical student. Third- and fourth- years are mainly in the hospital.

First-year medical students, currently studying the interaction between muscles and skeletal structures, have had to adjust to online anatomy class. Medical school anatomy classes demand accurate recognition of muscles, structures and bones on cadavers in in-person lab session settings.

Elena Stark, an anatomy professor at the School of Medicine, has transitioned anatomy instruction online using detailed images of cadavers in her lessons. Optional anatomy labs will also be made available at the end of summer or the beginning of fall, said Vice Dean for Education Clarence Braddock.

In their first year, medical students are also matched with preceptors, practicing physicians in Los Angeles County willing to participate in elective mentorship and shadowing, said Mariam Khan, a first-year medical student at the School of Medicine.

However, preceptorship and clinical skills assessments have since been moved online, Khan said.

“There is so much to be taken away from in-person learning and the ability to be supervised and corrected in real time,” Khan said.

Second-year medical students did not experience the same transition to online learning, as they are preparing for the United States Medical Licensing Examination Step 1.

“We finished our curriculum as the crisis began to pick up, and have since entered our dedicated period of study for the board exam,” said Ameen Chaudry, a second-year medical student.

However, the closure of proctored testing centers has led to uncertainty for second-year students. In response, UCLA faculty voted to extend the deadline to take the test for a full year, Braddock said.

After Step 1 board exams are completed, students enter their third year of medical school, centered around clinical rotations and direct patient care.

Second-year students are tentatively slated to start clinical clerkships in mid-May. Clinical rotations have transitioned online, while patient care has been suspended as no medical students are permitted in health care settings at this time.

Teaching faculty at the school of medicine have videotaped different surgeries, and made them available to small groups of students to gain unique clinical experience, Braddock said.

Faculty are also incorporating the study of SARS-CoV-2, the virus which causes COVID-19, into the third-year curriculum, lecturing online about the ways it is impacting patient care medicine, Renault said.

The current third-year class had nearly 10 months of clinical experience prior to the COVID-19 closure. These students will have the opportunity to engage in online learning activities in a variety of medical specialties, which will be carried over to course credit, Braddock said.

Third-year students are primarily concerned with how they will continue to learn about clinical practices and how future residency programs will assess them.

“Medical school is very regimented, with little flexibility,” said Elyse Conley, a third-year medical student. “With the nationwide closure of medical schools, I have a lot of uncertainty around what is going to happen for (my) fourth year and how that’s going to impact my choices for residency moving forward.”

Many fourth years have completed graduation requirements, and those who wish to graduate early will be able to do so, Braddock said.

Despite the ongoing pandemic, fourth-year medical students have matched into residency programs. UCLA held a virtual match day last month where students opened envelopes via Zoom, sharing where they would be spending their medical residencies. Medical residency programs allow students to become certified physicians in the specialty of their choosing, and usually range from three to seven years, depending upon the specialization.

Chris DeMatteo, a fourth-year medical student, said he had planned to finish his coursework early in the year and complete requirements by March.

DeMatteo, who has matched into Mount Sinai Hospital in New York City for his residency, said he is extremely excited to begin but remains nervous because of COVID-19’s impact on the city.

“Although I plan to get (to New York) in mid-June to start my residency on July 1, I am watchful as to any changes in that timeline,” DeMatteo said.

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