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Neurosurgery Rotation and Application Changes Due to COVID-19: A Medical Student Perspective (Part II)

By COVID-19, GMENo Comments

The COVID-19 public health crisis upended many norms in medical education. Most of medical school is built around significant in-person contact. During COVID-19, educators and students have had to adapt to the changing times to protect public health. Perhaps the most strongly affected individuals are those who applied for the 2021 match. Students and program directors alike were in an unprecedented time — trying to find the right resident “fit” without away rotations and in-person interviews. As an applicant to neurosurgery, I was looking forward to learning how different programs operate compared to my home institution while also furthering my education in my field of interest. While COVID-19 significantly affected this plan, the pandemic also allowed for changes and innovations to the neurosurgery match — some of which may persist beyond the 2021 match cycle.

Home neurosurgery rotations were extended to eight weeks due to the limitations of away rotations. I was fortunate enough to rotate at a high-volume academic program, and I felt that I had excellent exposure to the field. I also became more familiar with the residents, faculty and program at my institution. To accommodate canceled away rotations, I attended virtual sub-internships and Zoom happy hours for programs that I had previously applied to for away rotations. Additionally, I scheduled phone calls with individual residents at these programs, which proved incredibly helpful and insightful. Finally, I built a Twitter profile, which was a great avenue to virtually connect with other applicants and faculty.

The most significant impacts of this cycle may be felt by those in states with few neurosurgery programs in their area. Obtaining letters of recommendation — considered “make or break” during the match — is undoubtedly a challenge for applicants without home programs. Standing out as an applicant — even with a home program and stellar letters — was also a challenge during this cycle. There is certainly a unique pressure to beef up “on-paper” qualifications such as the United States Medical Licensing Examination and publications. For applicants — particularly those without home programs — focusing on getting to know your programs of interest virtually was helpful. The residents I interacted with were more than willing to share their stories and highlight as much of their program as they could over a phone call. It was also helpful to hear more about their surrounding area. These conversations were a great way to get to know new people in an era of limited in-person contact.

The COVID-19 era has ushered in a disruption of the neurosurgical match. Finding meaningful connections during this time was a logistical hurdle for every applicant — particularly those without home programs. I focused on building as many connections virtually as possible — and fortunately, there were plenty of opportunities. I think that some of these resources, such as the virtual sub-internship or neurosurgical education webinars, are great resources that should continue in post-COVID-19 match cycles. While we live in a unique time, I find that the sense that “we’re all in this together” has persisted through my virtual and in-person interactions with others in the field. We are, after all, made to be resilient to the many trials of medicine — both the expected and unexpected ones.

Editor’s Note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtags #Match2021 and #NeurosurgeryMatch.

Somnath Das
Medical Student
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, Pa.

Life as a Medical Student During the COVID-19 Pandemic

By COVID-19, Faces of Neurosurgery, Guest Post, HealthNo Comments

The COVID-19 pandemic has caused sweeping systemic changes to the landscape of medicine and society as a whole in the few short months since the virus arose. The pandemic has impacted all medical specialties, and those still in training have experienced significant disruptions to their education. Medical schools were quick to respond to the spread of the virus to keep medical students safe. The first warnings from the University of Rochester School of Medicine and Dentistry (URSMD) administration came in early March — students were informed that those who intended to travel during spring break might be required to quarantine upon their return. At the time, the magnitude of the impending pandemic was unknown, and social distancing measures were still on the horizon.

Initially, physical classes were canceled until late March, by which time any students who had traveled to a COVID-19 hotspot would have completed a 14-day quarantine. The plan was to resume regular classes and clinical experiences following this disruption. However, it became clear within a matter of weeks that this would be impossible. For the safety of students, faculty and patients, it was eventually decided that all physical classes and clinical experiences would be canceled for the foreseeable future. Students at all levels were placed in an uncertain position as it became increasingly clear that in-person learning would not be possible for the remainder of the year. This uncertainty fostered fear and anxiety among students — many of whom were also dealing with the stress regarding their safety and that of friends and family.

For preclinical students like myself, we have been utilizing remote learning for the remainder of the year, which has been a significant disruption to our training. In particular, clinical learning has been impaired due to the difficulty of mastering medical history taking and physical exam techniques over Zoom instead of in-person practice with classmates and standardized patients. Another challenge has been coordinating exam proctoring for students who are in different time zones. Some students who have been planning summer research at other institutions or projects involving clinical or volunteer work have had their plans canceled.

Second-year students have been particularly concerned about the logistics of their upcoming United States Medical Licensing Exam (USMLE) Step 1 exams, given that social distancing measures preclude the use of physical test sites. Third-year students have been unable to complete their clinical rotations and have experienced considerable stress due to the ongoing uncertainty in scheduling away rotations for their fourth year. Fourth-year students have had their graduation and Match Day celebrations converted to online events. Graduation has also been moved up. Depending on their specialty of choice, some newly minted physicians have been called upon to begin their residency training early to respond to the COVID-19 pandemic.

Many student doctors have been frustrated because they are unable to contribute to patient care during this crisis. It has been challenging to find ways to help without potentially compromising patient safety. Despite these challenges, medical students at all levels and from all over the country have stepped up to do what they can to support the medical community during this crisis. During the initial stages of the pandemic, students volunteered their time to provide childcare for physicians called to the front lines and organized efforts to produce personal protective equipment (PPE) for health care workers. Additionally, students have made an effort to publicize clinical trials that need healthy volunteers, and the University of Rochester Medical Center (URMC) has initiated a program to recruit volunteer lab techs to help with COVID-19 research. The administration at URSMD has also sent out a request for medical student volunteers who might be called upon to assist in patient transport, ventilator preparation, and supply transport, as well as serving as respiratory care assistants if needed.

Medical education faces challenges moving forward. At this time, it is unclear when or if in-person education can resume. There have already been substantial efforts to promote methods of distance learning for medical students and residents, including Zoom-based lectures and an increased emphasis on online resources. However, this leaves something to be desired for hands-on clinical education, which does not lend itself well to remote learning. It is not clear when clinical rotations can be safely resumed, or when students will once again be able to schedule away rotations. The uncertainty surrounding away rotations is of particular concern for those students who are preparing to apply to residency in the coming year. It also remains to be seen how this crisis will affect the residency match process in the future. Many students have also had research or volunteering opportunities canceled due to the pandemic, and the future of USMLE board exams remains in doubt for the time being.

As a whole, medical educators and students have risen to the challenge of COVID-19. Medical educators have dedicated extra time and effort to minimize disruptions and to maximize students’ learning experience. Many medical students have helped their communities wherever possible and are responding admirably to the unprecedented disturbance in their education. Reactions like these foster hope that both students and educators will continue to work tirelessly to respond to crises as they arise.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #COVID19.

Stephen Susa
First-year Medical Student
University of Rochester School of Medicine and Dentistry