February 02, 2021

Adapting Medical Education in the COVID-19 Era

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After the COVID-19 pandemic reached Alabama, medical education leaders at the School of Medicine quickly regrouped to enable students to continue their training. “Everybody has been incredibly impressive in their performance,” says Craig J. Hoesley, M.D., senior associate dean for Medical Education. “There’s some fatigue, but our people have adapted and handled it well.”

In mid-March, at the recommendation of the Association of American Medical Colleges, medical students were removed from clinic work, and all classroom instruction was shifted online. Meanwhile, most residents continued to work regular shifts but were limited in their ability to closely interact with patients, a key component to their training.

Still, faculty never stopped teaching, learning, and helping. Because now more than ever, Hoesley says, it is important for UAB to continue training the physicians of tomorrow. “Alabama is a medically underserved state, and for us to slow down the pipeline of physicians coming out of our schools would impact the health care workforce down the road,” Hoesley says. “We had to very rapidly put together an effective curriculum for both the clinical and pre-clinical students, so their progression through medical school wouldn’t be impeded.”

This included the creation of a course in disaster medicine, conducted in partnership with the Federal Emergency Management Agency and the Center for Domestic Preparedness in Anniston. “We wanted to do something that would engage the students to learn from this experience,” Hoesley says. “Our emergency medicine physicians helped develop an online disaster medicine course that many of our students took. They learned about ways to manage a pandemic, as well as the principles around the epidemiology of epidemics and infectious diseases.”

With clinic work on hold, many medical students volunteered for efforts that were not part of their official classwork. This included organizing blood drives and PPE drives, calling patients to schedule and report the results of COVID testing, working as contact tracers, taking meals to senior citizens concerned about venturing out, and even supporting faculty who didn’t have access to childcare.

Though it was three months before the students could return to clinic duty and some in-person classroom instruction in June, Hoesley says they still received a valuable education during that time away.

“Our students understood why they needed to come out of the clinic in March, but they also wanted to help,” Hoesley says. “They had to deal with this disruption in the curriculum and continue to meet their learning objectives, but at the same time they were fully engaged in ways to safely support our efforts to deal with the pandemic in our community.”

“From many of the students I’ve talked to, if anything this has really strengthened our resolve to be part of the medical community,” says fourth-year medical student Graham Kirchner. “It’s really been affirming to see how practitioners individually and the medical community as a team have come together to support patients. It’s been a positive affirmation in my choice of a career, to see the kind of impact we can have.”

Residents also had to quickly adapt to a new way of treating patients. Along with an increased use of masks and other PPE equipment (as well as social distancing as much as possible with co-workers), there has been a reduction in the ability of residents to offer hands-on treatment.

“To minimize exposure, a lot of times we talk with patients through the window instead of going into the room,” says Salmaan Kamal, M.D., an internal medicine resident. “It’s been a challenge to not connect with patients each day. That’s been the biggest change.”

One thing that has not changed, however, is the school’s commitment to educating medical students and treating patients. “I’ve been really proud of how my co-residents and UAB leadership and medical staff have approached this pandemic,” Dr. Kamal says. “Everybody has been willing to help and put in extra hours, sometimes without knowing how long they’d have to do that. Everybody at UAB has really responded and stepped up.”

– Cary Estes