Paul L. Caron

Tuesday, April 7, 2020

NY Times: One Final Step For 52 Medical Students, Eager To Join The Fight Against COVID-19

My daughter Jayne (pictured in the lower right box above) is one of the 52 students featured in this New York Times article, One Final Step for 52 Medical Students, Eager to Join the Fight:

In a stirring, ragged ritual, the students took their oaths as new doctors early, volunteering in the war against Covid-19.

From dorm rooms and apartments, 52 medical students watched video of themselves roll across their screens. Miles away, their proud families followed online. Gazing into webcams, the students pledged the Hippocratic oath in frayed unison, dozens of different starts and voices, all coming to the same point.

They could get on with doctoring.

On Friday, a virtual graduation was held over video chat for nearly half the 2020 class at New York University’s Grossman School of Medicine. They were two months ahead of schedule. That moment will be repeated in some form at other medical schools in the coming days.

The more ragged the ritual, the more soul-stirring its core: Young people were stepping up to join others already serving at an hour of crisis, little different than soldiers being deployed in war. ...

Celebrate the students today. Remember, too, that they stand as proxies for an entire caste of the essential: doctors, nurses and technicians, of course, but also those who drive buses, pick up garbage, save lives in ambulances, stock grocery shelves, deliver mail, push bins of dirty sheets down corridors, keep the electricity grid humming and the sewer system flowing, and figure out how to make space in hospitals when none is left.

Among unnamed others. ...

The students were pulled out of hospitals last month when the disease took off, and would have little to do until summer when they will begin a year as interns at hospitals around the country. ...

[T]he school surveyed the class of 120 to find out how many wanted to begin a short-term stint of work in New York right away, backstopping doctors treating coronavirus patients. Within 12 hours, Dr. [Steven] Abramson said, they had enough volunteers — 52 was the final count — to move ahead. ...

No one can say with certainty what they will be called to do. They are joining legions of essentials in serving an empire of need. “I’m signing up,” Dr. [Allison] Horan said, “with the understanding that I’m here to help and to serve, however is needed.”

Forbes, Doctors In Training Are Dying, And We Are Letting Them Down:

With the expanding reach of coronavirus throughout the world and the number of victims rising exponentially, all members of the healthcare system have been put under significant strain in recent months. However, those in training, residents and fellows, face unique challenges when compared to other types of healthcare workers in a hospital, or even people in other industries outside the hospital, for that matter.

It is well known that among hospital workers, residents and fellows work the most hours, for the least amount of pay per hour – all while shouldering large amounts of oppressive student loan debt. Many residents and fellows log 80 working hours or more in any given week. Those hours are spent doing everything from answering telephone calls from patients and operating to administrative tasks, and they see much more face time with patients than those who supervise them. At the major academic hospitals in this country, trainees are the workhorses that keep them running.

However, during the COVID-19 pandemic, conditions for residents and fellows have worsened immensely. Working regular shifts at the hospital now bear significant personal risks, as increasingly more reports of doctor deaths around the world continue to surface.  This past week, several residents passed away. ...

The culture of residency and fellowship programs makes it difficult to remove oneself from the work pool without causing more work or hardship for colleagues, since everyone is, at baseline, stretched so thin. In many programs, residents and fellows have no control over the amount of personal risk they take on during the COVID-19 pandemic, and they are in a poor position to speak up about it. In the end, most trainees cannot walk away from their programs without causing significant damage to their career, even if they are literally putting their lives at risk by staying.

The concept of unionizing was brought up with several of the residents I have spoken to, but to date, very few residency programs have successful unionized, likely due to fear of retribution and the intensely vulnerable position that trainees are placed in as soon as they finish medical school. ...

Some of these issues can be remedied. Above all, residents and fellows want protection with adequate PPE and they want equal ability to get tested for coronavirus if they suspect exposure.

They should also have some control over their schedules and rotations, as well as input into major decisions that affect their department and training. There needs to be a culture of transparency during the coronavirus crisis, as well as one of leniency, so that if trainees do not feel comfortable working, for any reason, they will be given opportunities to speak up or rearrange their work hours without punishment or judgement. ...

All medical professionals have demonstrated enormous amounts of selfless work and perseverance during this pandemic. Residents and fellows are no different. They have dug in even deeper as they have been deployed to the frontlines. Appreciation and recognition are wonderful, but they should only be the beginning. Fair and equitable job environments will only be obtained once hospitals and national physician organizing bodies change the culture and system of how we train our doctors – especially in the midst of health care crises.

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