Medical Education in the Time of COVID-19
Shakkaura Kemet, Dereck W. Paul
Abstract
To the Editor: The news that the University of California, San Francisco (UCSF) School of Medicine would resume clerkships and subinternships on April 1, 2020, despite the Association of American Medical Colleges guidelines warning against it, was both terrifying and exhilarating. At that point in late March 2020, the risk of transmission to health care providers remained unknown. Still, as medical students, we were eager to join our colleagues and teachers in the hospital as learners and as team members. Armed with a letter that certified our status as “essential workers,” we reported to the hospital for clerkships. In the months that followed, we took part in and witnessed our health care system’s extraordinary response to the COVID-19 pandemic. As our spring subinternships began, we watched the normal structures of medical education fall away under the tremendous pressure of the COVID-19 response. National board exams were halted, clerkship exams were administered at home, full rotations were canceled, and new ones were invented overnight. As all of health care threatened to buckle under the demand for time and resources that COVID-19 created, much of the bureaucracy of medical education disappeared. Medical training was stripped down to its essence: caring for the patient in front of you and learning in the process. We studied, not so that we could pass a test, but so that we could most effectively help our patients. We worked hard, not so that we could get good grades, but so that we could take some of the pressure off our overworked colleagues. Medical training in a pandemic has required us to be in touch with the absolute essence of what medical education is—the start of a lifetime learning how to take care of other human beings to the best of our abilities. We hope that when it ends, we can stay in touch with that essence. By having students like us continue our clinical training through the COVID-19 pandemic, UCSF honored its commitment to patient care and public service both now and in the future. Our exposure to the pandemic response ensures that tomorrow’s workforce is well trained for a changing medical landscape, and we are honored to be a part of that mission. Similar crises will surely come throughout our careers, and when they do, we will have benefited from working side by side with our colleagues and teachers during this one. We join our colleagues and educators eagerly, well aware of the Hippocratic oath we swore at the beginning of medical school and that in just a few short months, we will affirm again.