One highlight of David S. Edelman’s medical training at Columbia University was providing free medical care to homeless and uninsured patients in the basement of a Harlem church. That was before the coronavirus pandemic turned the world upside down.
In mid-March, Columbia’s medical school, like others nationwide, pulled fourth-year medical students from their rotations in hospitals and clinics. The goal was both to keep them safe and to protect the rapidly diminishing supply of respirator masks and other protective equipment.
As colleges and universities have struggled to devise policies to respond to the quickly evolving situation, here are links to The Chronicle’s key coverage of how this worldwide health crisis is affecting campuses.
As the number of cases of Covid-19 in New York City threatened to overwhelm its hospitals, sidelined students just months from graduation were growing increasingly frustrated.
“We wanted to help people, and we were told we couldn’t anymore. I saw all this emotion and energy, and wondered what we could do,” said Edelman, a fifth-year student who will graduate next month with medical and public-health degrees.
So he and a classmate teamed up to create the Covid-19 Student Service Corps to coordinate safe service-learning opportunities for students in nearly a dozen of Columbia’s schools and programs.
The volunteer jobs are collected in a tool kit that’s been shared with more than two dozen medical and public-health schools around the country, Edelman said, and some are creating chapters of their own.
“We established it on March 15 and, by the end of the week, had more than 700 volunteers,” Sarah Soo-Hoo, a fourth-year Columbia M.D./M.B.A. student, said of the Columbia effort. They’re up to nearly 1,200 interested students now, with about 800 of them assigned jobs. Meanwhile, the number of confirmed Covid-19 cases in New York City has grown to more than 57,000, with more than 1,500 deaths, as of Friday morning.
As members of the service corps, some medical and nursing students call patients who have been released from the hospital to monitor their symptoms and refer the most serious to clinicians. Fourth-year medical students help teach first- and second-year students when their professors are pulled from the classroom to patients’ bedsides. Others help investigators research and disseminate the latest findings on Covid-19. Engineering students plan to pitch in by helping manufacture respirator masks and other protective equipment.
Natasha Z.R. Steele, a fourth-year medical student at the University of Washington, said she read about the Columbia effort at a time when she, too, was frustrated at having been pulled out of hospitals and clinics in coronavirus-ravaged Seattle.
“Being in New York and Seattle provided unique and parallel venues for medical students to get involved,” she said. After speaking with Edelman, Steele and some friends began organizing a Washington chapter of the Covid-19 effort.
Steele, who will begin a residency in internal medicine at Stanford University in June, said a big focus would be on keeping soon-to-be medical-school graduates as current as possible on the rapidly changing crisis they’ll be dropping into.
“We are entering the biggest transition in our professional lives during a global pandemic when the learning curve will be incredibly steep,” she said. “We want to be as ready as possible.”
Medical students at the University of North Carolina at Chapel Hill have also coordinated with administrators to create a Covid-19 student-service chapter that links students across the university with community partners.
There’s no shortage of gung-ho medical and nursing students who can’t wait to don their protective masks and join the front line. But others aren’t quite as eager to leave the relative safety of the supporting roles they’re currently filling, Edelman said.
“Some are saying, ‘I’m young and healthy — let me help people so others don’t have to,’” he said. “Then there are others who aren’t saying it out loud, but they’re asking themselves, ‘What if I’m pregnant or live with a grandparent or parent who has a chronic illness?’ There are students who are like, ‘Put me in, coach,’ but there’s a lot of trepidation.”
Regardless of which roles they’re filling, the lines between medical students, residents, and faculty members are likely to continue blurring during the pandemic, he said. “It’s almost like the crisis has flattened the hierarchy. Everyone is like, ‘All hands on deck.’ It doesn’t matter who I’m next to. We trust each other.”
On March 17 the Association of American Medical Colleges and the Liaison Committee on Medical Education called on medical schools to suspend student clinical rotations. Within weeks, schools had started announcing plans to graduate students early so they could jump right into residencies that usually start in June or July.
At least 11 medical schools have indicated that they’ll graduate their entire fourth-year classes early, and at least 11 more will offer that option to some students, according to Alison Whelan, the association’s chief medical-education officer.
The American Medical Association this week issued guidance to ensure that medical students being sent to the front lines are protected with safety gear and supervision and that the decision to care for Covid-19 patients is voluntary. It outlined support roles that medical students can fill, but acknowledged that some hospitals might be so desperate for workers as patient loads increase and doctors fall ill that they’ll need to enlist students in caring for patients.
Citing the urgent need for new physicians, Columbia joined the list of programs that will graduate medical students in mid-April, a month early. Students are being offered temporary employment at NewYork-Presbyterian Hospital to help with the Covid-19 pandemic until their residencies begin.
Edelman said he was torn when he learned that he’d have the opportunity to work in the hospital earlier if he wasn’t overseeing his growing student-services corps.
“I’ve been here for five years and wanted to be a doctor much longer than that,” he said. “How do you say no to being a doctor?” But running the student-service corps, he said, with its interdisciplinary focus and expanding national reach, will give him the opportunity to make a bigger difference, he said.
“This ridiculous volunteer machine we pulled together in 13 days,” he said, “has the potential to help so many more people.”
