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What the future will look like for the country’s next class of first responders

Though webinars and virtual seminars work well for certain academic paths, medical students are suffering from particular obstacles in their training, such as in testing and residency placements.

What the future will look like for the country’s next class of first responders
[Photo: Artur Tumasjan/Unsplash]

As the world has come to a complete standstill, the novel coronavirus has placed a major strain on the healthcare community, prompting a rapid evolution of medical practice.

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This has lead to droughts of personal protective equipment, loss of loved ones, and has taken a mental and physical toll on frontline responders across the globe. Yet it is in this epic moment of human history that our innate desire to help people shines through, further amplifying the very reasons why we, as doctors, chose to enter medicine in the first place.

The widespread effects of the pandemic are not limited to the front lines. Unemployment has reached an all-time high, families are struggling to make ends meet, and students and academic institutions are relying on novel techniques in order to meet education aspirations at all levels.

While webinars and virtual curricula seem like suitable solutions across select disciplines, they unfortunately do not adequately replace the educational requirements for individuals whose training and mentorship is becoming increasingly important: our future first responders.

While many senior medical students have gone on to graduate early in order to ease the burden on our medical system, many current medical students are left wondering “How will this pandemic affect my education?”

Although students of all levels are affected by the today’s uncertainty, medical students preparing to apply to postgraduate residency training programs, as well as others preparing to take the first part of the United States Medical Licensing Exam (USMLE), are perhaps the most acutely affected.

Rising senior medical students often use the summer months to complete audition rotations (“externships”) at outside institutions to demonstrate interest in a given program, to demonstrate their clinical or surgical acumen, and to ascertain if the program is an ideal fit for them. In light of implemented social distancing measures, the ability for students to complete these externships has come into question, particularly as many students face the need to make up mandatory clinical rotations requisite for graduation.

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This places programs and students at a disadvantage in getting to know one another through these quasi “auditions.” In prior years, these externships have been pivotal to the matching process for residencies. This is even more challenging for students at institutions that do not have residency programs in the specialty of interest.

Furthermore, students that have decided to pursue a given specialty (i.e. orthopedic surgery, neurosurgery, ophthalmology) later on in their medical school careers may face an additional uphill battle, particularly if they are not privy to faculty members who can serve as strong advocates during the application process.

Unfortunately, the difficulties do not stop there. The effects are trickling down to those preparing to take the initial examinations required for medical licensure. The USMLE consists of three parts, the first two of which are taken during medical school. A large percentage of students take the first portion of USMLE, or Step 1, at the end of their second year of medical school.

According to the traditional process, once Step 1 of the USMLE is complete, students start their clinical rotations. These processes are extremely mentally and physically demanding. Moreover, Step 1 is an eight-hour exam; this first part of the USMLE is a mental marathon and not easy to reschedule on a whim.

In the past few days, testing centers have cancelled a significant number of scheduled examinations—including USMLE Step 1 and Step 2—in order to comply with social distancing and optimize the safety of test takers. This is understandable, but it is certainly unnerving for students who have been studying extensively for an exam that is used integrally as part of the residency application process. The pandemic represents an unfortunate blockage on students’ highly specific academic schedule.

Despite all of today’s many hurdles, it is critical that faculty and students keep in mind we are genuinely all in of this together. Although uncertainty remains in many facets of medical education, open communication and interdisciplinary collaboration will guide our students towards their destiny on the front lines.

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Amiethab Aiyer, MD is an assistant professor and chief of the Foot and Ankle Service, in the Department of Orthopaedic Surgery at the University of Miami/Miller School of Medicine in Miami, FL. Amiethab is a cofounder of student mentorship platform “Orthomentor.

William N. Levine, MD is the chairman of Orthopedic Surgery at New York Presbyterian/Columbia University Medical Center in New York City. He has been on the faculty at Columbia since 1998 and serves in many other roles centered around mentorship and education.

 

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