Across the nation, medical students are graduating directly into the path of an epic health crisis. Preparations for the Cadaver Ball, at the Vanderbilt University School of Medicine, begin in the fall. Radial Grooves, an a cappella group, selects two songs to perform; the campus hip-hop and bhangra groups choreograph routines. This year’s theme was the “Roaring 2020s,” which was a relief to the class president, Varun Menon, because it meant that the only costume he needed was a tuxedo.
(Last year’s class president had the unfortunate task of tracking down a full P. T. Barnum get-up, when the theme was “The Greatest Show. ”) But plans for the event, which celebrates the “matching” of fourth-year medical students to their residencies, were cut short this year.
On March 10, students were notified by email that their match day ceremony would be virtual. The Cadaver Ball was canceled. Instead of spending the weekend eagerly comparing residency assignments with fellow students, Mr. Menon found himself in an unusual position: cheering match results outside the window of a friend, who was self-isolating after he had been exposed to the coronavirus.
“It was this unceremonious moment, but also a reminder of the power of what it means to be going into medicine at this time,” Mr. Menon said. “All the pomp and circumstance we usually do is secondary to the job itself. ” Last Friday, more than 40,000 medical students across the country found out where they will be doing their residencies, a three-year commitment at minimum and the first step in their medical careers.
But at most universities, match day ceremonies were either canceled or held virtually on Zoom. And for students, the experience was shaped by thoughts of the role they will play on the front lines of the Covid-19 pandemic. “We’re entering as the class that was minted by the pandemic,” Mr. Menon said.
“Our matches aren’t going to be a slow process of getting our feet wet. It’ll be the middle of the crisis and we’ll have to use everything we learned in medical school. It’s this immediate sense of responsibility. ” Amid the joy of students crossing the finish line of medical school, that sobering sense of reality permeated match day activities.
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“Welcome to our first-ever virtual match celebration,” Dr. Lisa Mellman, associate dean for student affairs at Columbia Medical School, said to her Zoom camera on Friday. Typically, she kicks off the ceremony in an auditorium filled with proud parents; this year, she faced a computer in a sterile office. “What an incredibly talented class this is,” she said to the screen.
“They’re ready to be doctors, doctors who are needed more than ever in this global health crisis. ” This message was heard by medical students nationwide: Their work will be sorely needed. To many, this is both welcome and anxiety-inducing. They have grown used to feeling as if they are underfoot, asking technical questions while trying not to disturb the residents at work.
Now, given the surge in hospital intakes as the coronavirus spreads, they see the essential role they will play in the medical work force. With near-daily reports from medical providers that struggle with shortages of personal protective equipment, now is a particularly challenging time to enter the field. “Our students are very excited about matching and being able to pursue their dreams,” Dr. Mellman said in an interview on Friday.
“But I would not be true to all the different emotions without also acknowledging that there’s an anxiety that some students have about beginning work at this particular time. ” A grave sense of duty has already taken hold for some students. Kendall Kiser, a fourth-year student at McGovern Medical School in Houston, did a critical care rotation earlier in March at a local hospital and saw a patient admitted who was a possible coronavirus case. There were no known cases in the city at the time, and the attending physician “freaked out,” Mr.
Kiser said. For 24 hours the staff waited for the county to determine whether they could administer a test, as hospital administrators began to re-evaluate the number of intensive care beds that had been designated for Covid-19. Witnessing the fear in his hospital superiors, Mr.
“Kiser saw firsthand the degree of responsibility shouldered by medical workers during public health crises.”
“The experience really imprinted on me the chaos from competent professionals being placed in a setting that’s unprecedented,” he said. His lessons on rotation in the I. C. U.
felt more urgent. “I was like, ‘Pay attention, Kendall. ’” he said. “As I was learning about ventilators, in the back of my mind I was thinking, ‘What if the pandemic gets so much worse and this is what I’m doing starting June 15?
’” Most fourth-year medical students will begin their residencies in early June or July. Until then, there is little they can do clinically. In Italy and Britain, final-year medical students are being fast-tracked into service, beginning their work months ahead of schedule, but no such arrangements have been made in the United States. On March 17, the Association of American Medical Colleges and Liaison Committee on Medical Education called on medical schools to suspend student clinical rotations.
Dr. Alison Whelan, the chief medical education officer of the association, said that students might be needed to provide assistance in clinical settings as the outbreak worsens, but would be called to serve only in a voluntary capacity. She added that the association continued to advise that students refrain from patient care to limit the spread of the virus, especially with current restrictions on testing. That is a public health directive that most students understand — but given their skills, some wish they could do more.
“We’re all here because we want to help, and yet we are helpless,” said David Edelman, a fifth-year student at Columbia Medical School. “How do we reconcile our reason for coming here with our inability to do anything? ” For Mr. Edelman, that question became a call to action.
Earlier this month, he helped establish the Covid-19 Student Service Corps, which coordinates medical students to support health care providers. On Sunday, the group released a tool kit listing support roles that students can play: staffing coronavirus community hotlines, providing technical support for telemedicine platforms, coordinating food deliveries for health care workers and creating educational briefings with up-to-date research and news on the virus. Some tasks, like staffing the hotline, require clinical experience. Others, like meal deliveries, do not.
The Covid-19 Student Service Corps is based at Columbia, but members say they are coordinating with medical students nationwide to establish other chapters. Mr. Edelman, like so many of his classmates, had spent recent months preparing for match day. His fiancée planned a trip to New York City from Ithaca, N.
Y. , his parents booked flights from Cleveland and he excitedly made restaurant reservations. But spending the last two weeks preparing students for a coronavirus response made the festive weekend feel less significant. Still, there was time for some levity.
Mr. Edelman began growing out his facial hair in January, what he called a “match day beard. ” He promised his girlfriend that he would shave during a Zoom conference with their families if he matched into his top choice, at Montefiore Medical Center in the Bronx. At 11:58 on Friday, he saw the email notification and pulled out his razor.
“It was so refreshing to share something silly and fun,” he said. “There was nothing else in that moment. ” Minutes later, he pulled up an email he had drafted to his faculty mentors sharing his gratitude. His chest tightened, remembering the reason that they could not be together in person.
“If it was any other time, I would have hugged these people and said thank you,” Mr. Edelman said. Instead, he fired off the message and went right back to sending emails for the Covid-19 Student Service Corps. “There’s no space to feel emotions, because there’s so much to be done,” he said.
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