My name is Laureen Chan, and I’m currently a second-year medical student (MS2) at SUNY Downstate. The pandemic has affected our livelihoods in countless ways, and medical school is no exception. Here, I’ll talk about what it's like to be in medical school during the COVID-19 pandemic.
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Each morning, I open my Mac to start the day of classes and re-emerge at 5 PM, blurry-eyed and plagued with a pounding headache. A constant slew of COVID-19 updates bombards my school email. Telehealth practice sessions have overtaken physical exams for the past six months and counting.
This is just a part of the new norm as a medical student.
At The Start Of Quarantine…
My school shifted to remote learning at the end of March, which coincided with the end of my third unit (my school’s curriculum is split based on organ system-based units), microbiology and infectious disease. Thus, my last unit of the year (gastroenterology, reproductive health, and endocrinology) was suddenly entirely online.
And it was….quite interesting. Mostly, it was unorganized since faculty scrambled to build a learning structure that was never done before with no preparation.
Many things ended up being “independent learning,” technical difficulties were common, and our exams were somewhat messy. Imagine running a race, and you were in an endless cycle of being in third, then fourth, then fifth, and then...finally, third again!--it felt like that. Nevertheless, my first year came to a conclusion without much issue.
The first three months of quarantine (and the last three months of school) were perhaps more about adapting and learning so that we could have a smoother remote platform next year.
New School Year, Still COVID-19
Academics: What’s Different About How We Learn?
1. (Almost) Everything Is Virtual Learning
Different schools use different methods, but there is always some remote learning involved. Most schools have at least implemented a hybrid system for first-year medical students (MS1). Some things (e.g. pre-recorded lectures) are remote, but other things (e.g. anatomy) are in person.
MS1s at our school employ a hybrid system in which problem-based learning (PBL) and clinical sessions (CS) labs are in person and other classes (lectures, histology, pathology, anatomy, etc) are remote.
I think a hybrid system is great except for virtual anatomy. Hands-on experience anatomy is valuable because it allows students, especially MS1s with no prior exposure, to understand and feel the orientation of organs and structures within a body.
Furthermore, because different cadavers are used for testing, students must truly understand that spacing. In my experience, seeing so many small structural variations between bodies initially challenged me but eventually helped me reinforce specific anatomical rules and trace connections.
That is the one difference I notice in our new remote learning platform: typically, only cadaveric pictures of perfect “textbook” anatomy are shown. Sometimes, exams are made up of recycled pictures which means anatomy has boiled down to pure memorization.
We also have more exposure to colored diagrammatic pictures! With the anatomy lab, we were constantly looking at cadavers and their three shades of brown: so seeing so many red arteries and blue veins is jarring.
Fortunately, the school’s faculty have been able to balance this lack of hands-on experience with thorough lab talks and clear faculty-made videos tailored to our dissectors. Through the grapevine, I’ve heard that some schools have implemented shift-schedules for first years, allowing some hands-on anatomy experience.
My school’s MS2s are entirely remote, which makes much more sense since 90% of anatomy was done last year. At this point, I’m familiar with how I should think about the body and how to distinguish basic structures (e.g. veins vs. arteries vs. nerves).
Another added bonus is the flexibility that comes with remote learning: I can even choose when and where to attend class (only where if it’s a mandatory class). The one big downside to remote learning is staring at a screen nearly all day. Aside from classes, I also use my computer to review and take breaks--so it's a difficult balance.
Overall: Love the flexibility that comes with streamlined remote teaching, but hate the screen time.
2. Buffing Up My Time Management Skills
I never knew how much time trivial things took up. With remote learning, I’ve been much more efficient with my time. I no longer had to spend time getting ready, commuting, walking to get food, and so on. Instead, I used the time to actually develop healthy habits. Morning, I run for a mile, shower, make breakfast, and turn on my computer.
Also, using Zoom allowed people to be more time-conscious as well: things began and ended more on time.
I realized I have amped up my productivity, partly due to a predictable routine. Whereas I was always exhausted after the day ended from commuting (thus spending more time to recuperate), I was less exhausted after class and needed less time to relax at the end of the day. Before, coming home incredibly late caused me to push agenda items every day for later and weekends were always for catching up.
I leave home at the top of the morning and only return to go right to sleep. Now, I am more on top of my school life, review, and daily errands. I still procrastinate, but it feels more manageable.
Who knew so much of my time and energy were unintentionally spent on frivolous things?
Overall: Love the new routine I have. It can get boring, but I’m less stiff and groggy, and have more energy!
Bonus: my parents finally see that yes, I do spend so much time on schoolwork, and nag me less about chores since I actually have time to do them.
3. More Engagement With Professors and Classmates
Okay, this sounds counterintuitive but hear me out. During in-person classes, it always felt disruptive or embarrassing to ask questions. Furthermore, sometimes professors don’t hear you or see your raised hand immediately.
With Zoom, class engagement provides multiple benefits. One, professors want to be reminded that someone is listening to them, so engagement is encouraged. Two, it’s easier to directly ask a question because it’s easier to interject via a mic and a screen makes me feel more at ease funnily enough.
Lastly, chat boxes allow you to get quick answers and confirmations from other students and professors (if there are multiple) without disturbing the main speaker!
Overall: Better engagement. One con is the lack of true face-time--students are just names on mute.
Final Thoughts On Remote Learning
Below, I summarized the main differences that stuck out to me. Admittedly, I’m fortunate to have experienced traditional classes for half of my pre-clinical years.
I definitely commend the faculty and school administration for adapting so quickly to the ever-changing landscape of the crisis and for their dedication to giving their students the very best. *applause*
Remote Learning: Like it or Hate it?
Pros
No more commute! I spend three hours every day taking the train
More efficient time management and flexibility with learning
Better opportunities to engage if I have question
More practice with telehealth skills--a growing part of our healthcare
Cons
Don’t see people from school
No hands-on physical exam classes. I just read a manual, memorize, and hope for the best.
Are Extracurricular Activities Still Important?
In an effort to maintain a sense of normalcy and push forward, extra-curricular activities are continuing but slowed down. We’ve been forced to be creative.
For instance, the crux of many extra-curricular activities is really the pizza (I mean the content’s great but usually free food draws in crowds). Without it, we have seen a slight decrease in student participation for some activities. Instead, a club I’m part of is playing with the idea of GrubHub vouchers for participants.
Zoom and its breakout rooms functionality have been a godsend in organizing club affairs and welcoming the first years to potential activities. In-person events will require adherence to additional guidelines and often take longer to plan but will definitely be just as fun when we can have them!
Again, the school administration has been playing a crucial role in balancing engaging student activities with the realities of our situation, major kudos.
On Research And Resumes
Perhaps what worried medical students from my year the most (academically) is the reduced research and clinical opportunities, especially for the past summer. The summer between first and second year is lauded as “the last true summer” we’d ever get. Some people desperately wanted to travel. Some saw it as prime time for research (something medical students need for their resumes to residencies, especially competitive ones).
Admittedly, I felt a sense of relief in a way. Since my research project was pushed to the fall semester, I thought this would be a great time to try other things as well. Ultimately, I landed a grants internship with an amazing and innovative medical reference company MDCalc (the standard app for emergency medicine clinicians!).
This was different from the usual grind and studying. I worked with a great mentor in developing the business' foundation for applying to grants. Also, it was super cool to learn about the new projects MDCalc is working on! Working with a start-up allowed me to learn new skills, experience the dynamics of a small business, and see a different side of medicine--a silver lining of our new normal.
Some doors close while others open. I’ve learned to take things in stride.
Hanging Out During COVID-19?
When the quarantine started, no one was allowed to have a social life beyond FaceTime and take-out anyway so there wasn’t much hanging out to do until restrictions were modified.
When you enter medical school, you spend so much time around school that it becomes your academic AND social life. Seeing your friends outside of school is still possible, you just have to adhere to proper guidelines (6 feet apart, masks, dining out or take-out).
COVID-19 Reinforced My Aspirations
Without a doubt, COVID-19 tested the abilities and resilience of healthcare workers all across the nation. Naturally, my first thought as an aspiring emergency physician was “am I willing to take all this on?”
We pledged the Hippocrates oath in the first week of medical school and will do it again at graduation. Medical students are told throughout our education that we are the future, and we have the health of many in our hands.
But when COVID-19 initially hit, I was filled with a sense of fear, an instinctive desire to shirk from responsibility---doctors were the frontline soldiers, their lives were on the line. Crazy patient volumes, a shortage of clinicians and equipment, and an overall sense of doom masked with a “we can do this” hopefulness.
MS4’s from many medical schools argued with their school administrations, pressing for early graduation so that they could fill the ranks early. Rumors of fresh interns passing away just shortly after obtaining their degrees were scary. My grandfather passed away two months into quarantine from COVID-19 complications.
Conclusion
Slowly, the reality of my profession hit me. Was I willing to potentially lose my life pursuing something I’m passionate about?
After much introspection, I realized: yes. I truly could not see myself not pursuing medicine. Before entering school, I was very hesitant about medical school and tried different internships (including one in investment while I was applying to medical school!). After my first year, I realized I cannot see myself doing something in another field, even if it wasn’t pure clinical work.
Should another crisis hit us again, I want to contribute to the effort in beating it.
Most importantly, I believe the pandemic taught us the importance of proper leadership, how similar situations should be handled (or what NOT to do), and what our medical system’s strengths and weaknesses are. I witnessed the importance of public education and how we could prevent essential workers from being martyrs.
The COVID-19 crisis indubitably gave aspiring clinicians a reality check about their goals and taught us more than we could from the textbook.
*** At the time of writing this piece, all education was remote. Now Student Doctor Chan's program has adopted a hybrid format.
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