Match Day Celebration Will Be Clouded With Coronavirus Concerns

The national tradition known as Match Day is normally a festive celebration for medical students and graduates, who tear open envelopes on stages across the country while hundreds of friends, relatives, and faculty members cheer.

On Friday, as more than 40,000 medical students learn where they’ll spend the next three to seven years training as residents, Match Day 2020 is likely to be tinged with worry. As they celebrate the next milestone in their careers, they’ll also be contemplating their role in battling the Covid-19 pandemic.

At noon, Eastern time, students will open emails, rather than envelopes, and are likely to be doing so at home and sharing their news with selfies on Twitter.

You bring your #Match results, we’ll bring the hype! Come join us if you’re looking for a way to celebrate #MatchDay2020 virtually. Sign up here - https://t.co/wGn0SRHvdk pic.twitter.com/4Yk7OEGsQI

— American Medical Student Association (AMSA) (@AMSANational) March 19, 2020

“Match Day is the single most defining moment in someone’s medical career, and the atmosphere is usually electric, with a lot of joy and excitement,” said Bruce T. Liang, dean of medicine at the University of Connecticut School of Medicine. “We’re sorry we can’t celebrate with them this year as we’d like.”

He said he hopes that by the time residencies begin, in late June or early July, “we will have peaked, and the infection will be on the way down.” Some medical experts are predicting, though, that the crisis could extend many more months.

Residents, or doctors in training, often spend 80 or more hours a week in teaching hospitals, which typically treat some of the nation’s poorest and sickest patients. It’s a stressful time under normal circumstances.

This year, residents may be working even harder as the nation’s aging pool of physicians is exposed to infected patients and may need to self-isolate. That wouldn’t have been as big a concern a few weeks ago, when the widespread assumption was that younger people who contracted the respiratory disease would bounce back quickly.

But this week the U.S. Centers for Disease Control and Prevention reported that nearly 40 percent of patients sick enough to be hospitalized were ages 20 to 54, although most deaths involved older patients. That added to the worry of medical trainees who might be returning home after their shifts to care for children.

Mary Altaffer, AP Images

Compounding the problem is a nationwide shortage of face masks and other personal protective equipment at a time when sick patients are filling hospitals.

David J. Skorton, president of the Association of American Medical Colleges, said the coronavirus outbreak had exacerbated worries about an impending physician shortage as baby-boomer physicians retire and the number of training spots for medical residents is limited.

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“The problems that are longstanding tend to come out in bold relief when the system is stressed more,” he said during a webinar on Thursday.

On Tuesday the association strongly recommended that medical schools suspend for at least two weeks any activities that involve patient contact. That effectively put clinical rotations, which medical students perform starting in their third year, on hold.

“We also recognize that the interruption raises concerns for students about their role on the health-care team and ask all institutions to commit to the reintegration of students as soon as is appropriate, to find appropriate ways to meet graduation requirements and educational objectives, to open dialogue with students, and to engage them in creating solutions,” the group’s statement says.

Some medical schools have been reassigning students to phone lines, checking in with coronavirus or postoperative patients after they’re released from the hospital, or checking in with ill physicians. It’s not clear when many will be able to continue their hospital rotations, so telemedicine options are becoming increasingly important.

If the surge in cases continues and not enough doctors are available, “there may need to be a rethinking of how to use medical students, bringing them back to the front line,” Alison J. Whelan, the association’s chief medical-education officer, said during the webinar.

Medical schools that have relied on standardized patients, or actors pretending to be sick, are having to come up with alternatives. Meanwhile, medical deans have been fielding calls from parents of medical students worried about their children’s safety.

David D. Henderson, associate dean for multicultural and community affairs at the University of Connecticut medical school, said that while student safety is important, so is sending the right message to the nation’s future health-care work force.

“While it is important to try to protect students, we also should help them understand that providing care to patients does sometimes require placing oneself at risk,” Henderson told the American Medical Association’s news service.

He said he’d heard that some schools were considering restricting student involvement with patients who have Covid-19. “I am not sure such broad bans send the proper message about our basic responsibility to patients,” he said.

One medical trainee who asked not to be identified, given the sensitivity surrounding the coronavirus outbreak, said he’s worried about a shortage of N95 face masks that protect wearers from airborne particles. It’s still unclear if being in the same room with an infected person can make someone sick, or if infection requires some kind of direct physical contact, say with droplets from a cough or a sneeze.

“We’ve all pretty much accepted that we’re going to get it in the coming months,” he said of Covid-19. “We’re seeing sick patients all the time. We’re mainly concerned about not giving it to our patients. That’s our first priority.”