A group of medical students (Marie Walters, PhD, MPhil, MD1; Taiwo Alonge, MD, MPH2; and Matthew Zeller, DO3) recently published an article in Academic Medicine describing the challenges medical students have navigated during the pandemic. They noted that while some pandemic-era challenges were unprecedented, long-standing issues were also brought to light, and that medical schools can use learnings from this period to implement reforms that promote mental health and wellbeing within the medical student population.
Below are the authors’ recommendations. You can find the full article here.
Improving Communications: The pandemic and the “intensified sociopolitical conflicts” affected students’ wellbeing and academic focus, and amplified the need for timely and transparent communications. The authors recommend that administrative leaders partner with student government to provide information, facilitate frequent and consistent town hall meetings, and incorporate the CDC Crisis Emergency Risk Communication (CERC) guidelines into communications.
Adapting Preclinical Education: Prior to the pandemic, medical schools required students to attend daily, in-person activities that made follow through on any personal commitments difficult. The move to online learning provided flexibility, but it created a lack of differentiation between school and free time. It also created uncertainties around the curriculum’s ability to properly train and assess students in preclinical skills (e.g., physical exams, dissections). The authors recommend that schools maintain flexibility by making recordings of learning activities accessible to all students, provide discounts for proprietary study materials, remove attendance requirements and associated limited access to course materials, and continue to promote virtual networking spaces.
Enhancing Support Services: An increasing number of medical students reported signs of burnout and some students, from communities more heavily impacted by the pandemic, were unable to return home for funerals or to assist with caretaker responsibilities. Student isolation made it difficult to find support from community, mental health, or wellbeing services. The authors recommend that schools put in place formal mental health checks for students, increase access to mental health support, and, should purely virtual learning need to occur again, offer virtual group clinical opportunities and study sessions.
Adapting Clinical Education: Pre-pandemic, many schools followed “rigid time-based curricula” that lacked flexibility to accommodate students’ outside lives. Students were expected to work while sick, and faced “blackout” days when they were not allowed to request time off. The authors contend that this rigidity is harmful to those who are “already disadvantaged due to financial, health, or social factors,” and recommend that medical schools continue the flexibility that the pandemic necessitated. The authors also say that schools should move to “individualized and flexible competency-based curricula” and/or allow students to make up missed mandatory activities.
Addressing Racialized Trauma: The pandemic provided a clear view of the disparities in healthcare and criminal justice, and created a period of trauma for students, particularly those identifying as Asian-American, Black, or Brown. The authors recommend that schools take a proactive approach to acknowledging current events and injustices in a timely and empathetic manner, noting that this should not just come from diversity offices, but by medical school leaders.
Empowering Medical Student Activism: During the pandemic medical schools spoke out on structural racism, which amplified activism among medical students. Racially minoritized students took a larger role in this activism. This may have harmed racial minorities compared to non-minorities by taking away time to study or enhance their medical CVs in order to do critical activism work. The authors recommend that medical schools take more tangible action to promote diversity, such as increasing funding for DEI efforts, changing institutional policies to promote internal equity, and creating relationships with expert consultants or community leaders. The authors say that schools should also ensure, to the extent possible, that students engaging in activism are not harmed by spending time on these efforts. Additionally, schools should create strategic plans to improve on DEI measures with clear short-term, incremental, and long-term goals.