Editor’s note: The opinions expressed by the author do not necessarily reflect the views of the AAMC or its members.
A few days ago, I learned that my Step 1 exam — the daylong United States Medical Licensing Examination that’s essential to becoming a doctor — has been canceled because of the COVID-19 pandemic. And that’s just one of many ways my life as a medical student has been completely upended in a short time.
Only two months ago, I was attending an art gala with hundreds of other medical students crowding the first floor of the Anderson Collection at Stanford University. Now, I haven’t seen fellow students in person in weeks, I don't dare venture into crowded public spaces, and uncertainty has become the only constant in my education.
First, on March 9, the Stanford University School of Medicine moved all its courses and exams online. A few days later it locked up its study spaces, and clerkships were suspended indefinitely on March 16. Each day, my email inbox filled with updates informing students of the evolving situation and steps the institution would take. Somehow, all the urgency seemed like playing catch-up after being blindsided. And with each new barrage of information came a sense that I couldn't possibly know what the next day would look like — let alone my longer-term educational future.
I haven’t seen fellow students in person in weeks, I don't dare venture into crowded public spaces, and uncertainty has become the only constant in my education.
I completely understand that my school needed to move to online learning. Still, I worry that certain aspects of training simply can’t be replaced with virtual conferences. For one, I’m supposed to begin my first clerkship in July, and I’m required to take a class entitled “Transition to Clerkships” in preparation. Part of the course is a refresher for essential clinical skills ranging from placing an IV line to performing a physical exam — but Zoom can only come so close to replicating an actual hospital experience.
In addition, medicine centers heavily around the patient-provider relationship. Although telehealth is great for connecting patients with providers at a time of social distancing, I worry that many care-related aspects of my education may slip away. I can’t help but wonder whether I’ll be prepared enough to start my clerkships and whether this pause in my training will ultimately have enduring effects on my ability to perform as a clinical student and doctor.
What’s more, even if the current changes don’t tangibly affect the quality of care I provide, they have already taken a shot at my confidence. It worries me that I won’t be able to prepare as much as my peers in prior years could, and I wonder about how steep my learning curve may be once I actually start clerkships. Will I know where supplies are? Remember how to place a Foley catheter? Recall the right questions to ask patients? Of course, it's possible that nerves would still eat at me even if we weren’t in the midst of a pandemic, but it feels especially tough to be stuck at home with so few ways to address them. As I complete this rite of passage in my medical training, while the world teeters on the cusp of a plague, I can’t help but feel futile.
I can’t help but wonder … whether this pause in my training will ultimately have enduring effects on my ability to perform as a clinical student and doctor.
Meanwhile, many of my peers haven’t been completely stuck at home as they engage in important activities like collecting personal protective equipment donations and recruiting volunteers to donate blood. For me, that has created a discouraging dilemma. I live with six family members, some of whom have underlying health conditions and are over the age of 60, a population that is ruthlessly targeted by the coronavirus. I’m left to decide whether to help my community or risk putting my family’s health in jeopardy. Whichever track I take, I’ll always be left with some burden of guilt.
For now, I’ve made the choice to stay home so I don’t risk becoming a carrier. I’m well aware, though, that not everybody can make that choice, especially health care workers who are desperately needed on the front lines. This crisis has forced me to contend with the risks that I will be taking — and by extension imposing on my family — as a future physician. I admit that my passion for medicine doesn’t make me immune to the fear of getting sick myself.
I live with six family members, some of whom have underlying health conditions. ... I’m left to decide whether to help my community or risk putting my family’s health in jeopardy.
I’ve instead tried to contribute remotely. In fact, along with many of my fellow students, I’ve recognized that one of the best ways we can help address this pandemic is through public health and education.
Ironically, so much of my medical training has focused on learning to settle patients’ panic when it arises, but as the pandemic spread across the country, it seemed clear that we in medicine needed to instead set off an alarm to urge preventive steps. I recently started working with a group of other students to create an email newsletter that provides busy primary care doctors with daily coronavirus updates, ranging from government news to clinical trials, that they can then pass on to their patients. I’m not sure how impactful my work really is, but the efforts help lift my spirits in a time when I crave purpose.
Still, on top of my own uncertainty as a medical student, I also face struggles that are quite personal. Recently, I applied for unemployment claims for my father, whose work had to temporarily shut down due to the novel coronavirus. As the number of cases climbs an unrelenting slope, I learn of family members who have tested positive — some of whom have been hospitalized. To see the coronavirus case and death count, and to know that I can place faces and names to some of those numbers, is haunting.
We check in on each other with more frequency and attentiveness than before. We wonder why it took a pandemic to realize we could have done this more often.
To cope, I reach out to medical school friends who can relate. Each text and phone call is a gasp for air when I sometimes feel as if I’m drowning in hopelessness and isolation. We’ve gathered around our laptops to mingle over virtual happy hours. We check in on each other with more frequency and attentiveness than before. We wonder why it took a pandemic to realize we could have done this more often.
As I try to process the quickly evolving reality that the novel coronavirus brings, I am comforted by the privilege of being in the medical field at this time. Despite taking refuge at home, I still feel intimately aware of the constant fight that health care workers face during this pandemic. Although I yearn to do more myself, I deeply admire the way the medical community has consistently faced formidable tests with impressive composure. Unsettled by the unknowns of tomorrow, I feel at least some sense of relief to be entering that community in my more-distant future.
Tasnim Ahmed is a second-year medical student at Stanford University School of Medicine. Her interests include global health, neuroscience, and women’s health. More of her writing can be found in the Scope Unplugged Blog.