Medical training, interrupted

The COVID-19 pandemic upended training for tens of thousands of medical students, residents and fellows last year.?

I’ll be discussing the impact that covid had on medical education LIVE with Stanford University School of Medicine Dean Lloyd Minor on Tuesday, Oct. 19, at 1pm ET. Click on the picture below to register and let me know what questions you have for Dean Minor.

For many students, the virus represented lost educational time. Medical schools were reluctant to expose students to covid, especially in the early days of the pandemic when there wasn’t enough personal protective equipment to go around. Clerkships and conferences were also put on hold. A number of schools even graduated students early so they could start working.?

Residents, meanwhile, were thrust onto the frontlines of battling COVID-19, in some cases because of their chosen specialties, and in others, because hospitals needed all hands on deck. They too have been at high risk of burnout and moral distress as they confronted a pandemic where they’ve had to make tough decisions, including rationing care as hospitals and intensive care units overflowed with sick patients.?

Earlier this week, Dr. Kaitlyn Dykes, a third-year internal medicine resident, shared a first-hand account of her training experience in a piece for in-House, a peer-reviewed publication for residents and fellows. You can read the piece, which was shared on LinkedIn by an oncology fellow, here:

A number of programs went fully virtual, as in-person clinics were shuttered.?

But for residents and fellows still involved in direct patient care, the risk of exposure was high, especially in certain specialities. Overall, 37.5% of residency and fellowship programs reported that they had at least one resident or fellow who had to quarantine due to covid. And in emergency medicine, internal medical and pediatrics in particular, more than 75% of programs had at least one trainee who had to quarantine after an exposure.?

Faculty in those specialties also quarantined in large numbers. Covid hit the northeast particularly hard, where 10.3% of programs had at least one resident who was hospitalized and 22.3% had at least one faculty member hospitalized with the virus.

Yet the past year and a half is also likely to spark major change, according to an August 2020 Viewpoint in the Journal of the American Medical Association. The crisis has forced medical schools and residency programs to consider the skills that new doctors will need going forward including:

• using technology and data to improve care,
• addressing health disparities that contribute to uneven patient outcomes, and
• incorporating population health management and public health lessons into practice.

“While many will remember the COVID-19 pandemic as a source of disruption, it is likely that it will also be viewed as a catalyst for the transformation of medical education that had been brewing for the past decade,” wrote authors Catherine Lucey, vice dean of medical education at the University of California San Francisco, and Claiborne Johnston, dean of Dell Medical School at the University of Texas, Austin.?

Join me Tuesday for more on this topic and what the future will bring.

#HardCases:?When the pandemic hit, physical therapists, who often work hands-on with patients, had to navigate a new reality. Telemedicine was the answer for keeping both patients and therapists healthy, but that doesn’t mean the transition was easy; 40% of rehab therapists had never used the technology and many weren’t fans of it, wrote Heidi Jannenga, a physical therapist who cofounded WebPT, which makes software for online rehab. A lot has changed since then, though, and in her Hard Cases article, she argues for why a hybrid model of care should continue to be the standard going forward – no matter what happens with the pandemic. Read it here: