COVID-19 has caused a tsunami of collateral damage to nearly every aspect of life. Universities and colleges have not been spared at all and have been thrown into very uncertain waters (eg, forced to close face-to-face classes and to convert to online-only courses). This has significantly affected the lives of medical students, clinical researchers and teachers alike.
Perspective of a 3rd year medical student
Medical students across Australia had their daily schedules shaken with the transition to 100% online learning, consisting of online lectures, tutorials, pre-recorded lectures, and several readings. In addition, clinical rotations were ceased until further notice to allow doctors to concentrate on the COVID-19 battle. This change brought a slew of challenges to housebound students. A decrease in physical commitments brought with it extra time, and to some, this was an opportunity to be productive, while for others it was easy to lose discipline. Therefore, this was the time to commit to a strict schedule to establish a new “normal” with a healthy balance of study, leisure, exercise, a healthy diet, and contact with family and friends.
There are several concerns students have regarding the ramifications of this pandemic. Cessation of clinical rotations, clinical skills classes, and anatomy tutorials meant that students lost opportunities to learn and hone vital skills. Luckily, circumstances in Australia seem to be improving, thereby potentially allowing schools to reopen. The same cannot be said for schools overseas. Moreover, modalities and timings of assessment have changed to online invigilated exams using software such as ProctorU. Some schools in the US have even conducted online Objective Structured Clinical Examinations (OSCE) that students were not ready for. Furthermore, there is a significant population of international medical students in Australia, and financial concerns are prevalent among them. With the reduction in job availability and fear of additional time in school as a result of the pandemic, international students are concerned about tuition fees, which can be upwards of $80 000 AUD per year. Lastly, international students may experience enrolment problems due to visa and border restrictions and may therefore miss in-person sessions when they start again.
With the additional stress of this pandemic along with regular stresses of medical school, emotional wellbeing is a big concern. Isolation can be a period of amotivation, loneliness and worry, which can have a major impact on both mental health and productivity. Nevertheless, students have been strong in supporting each other.
For instance, University of Queensland medical students have access to peer mentors, counselling services, student advisors and the university’s Medical Student Support Team. Students and staff have also created a plethora of online events such as book clubs, tutoring, review sessions, live music, cooking classes, and online exercise sessions. In fact, the medical cohort really came together through the “Caremongering Society”, an incentive developed by medical students shortly after the cessation of clinical rotations to support students in isolation to get groceries, provide online activities, and mutual support.
Despite the effects of COVID-19, medical students have to keep sane through this unpredictable time. Even though medical students may not be ready to fight in the frontlines, they should continue to do their part by offering mutual support through the avenues available at their schools.
Perspective of a PhD student and clinical researcher
The world smells like 70% alcohol hand sanitiser, favourite spots in shopping malls were silent and for a while there were no sports or cultural events to distract us from the constant concern that is hanging in the air. The world as we knew it came to a halt.
Researchers across various levels, from those in medical school to specialist schemes and post-graduate researchers, are searching for justification to continue with research projects many now see as “non-essential” in this COVID-19 crisis. Cancelled conferences and grant schemes made hours of work redundant. Milestone agreements and ethics processes were all severely influenced. While most frontline services stand up to prepare and plan for a fight against this unseen enemy, many of those activities that clinical medical researchers feel passionate about were sacrificed.
Those in clinical roles in a hospital are conflicted between the responsibilities of continued frontline hospital work and research. Continued manuscript submission, online presentation and data analysis are essential to keep some semblance of normal life. The potential to conduct research defines civilised society. The value of researchers should not be underestimated. Many COVID-19-related questions remain unanswered: transmission risk during the incubation period; exact mortality; incidence of pre-symptomatic infectiousness; and the potential effect of weather on transmission rate. Ongoing data collection, analysis and clinical research will be essential to inform effective decision making and public health policy in the search to find answers. However, other non-COVID-19-related research (even though lower on the current priority list) should not be discarded. Once things settle into a “new normal” these questions will still need answers.
There is, however, ground for cautious optimism. The silver lining can be found in a variety of support systems and remembering lessons from past pandemics. Many of those previously involved in minor disagreements, now stand together in solidarity against a common enemy. Group chats allow members of departments to remain in contact and offer support and relief to one another. Other online document sharing facilities and a fantastic peer support program provide information and avenues for academic and emotional support. Lessons learnt from Hong Kong, Toronto and Singapore during the severe acute respiratory syndrome (SARS) epidemic of 2002–2003, became very useful. Careful mitigation (ie, social distancing and contact tracing) and effective prevention regulation (ie, against mass gatherings and the provision of economic business support) made Australia one of the most successful countries in this fight against the spread of COVID-19’s first wave. Residents can be proud to be a part of this success so far.
On another level, one must appreciate this opportunity for reflection with discussions about those things in life that really matter, opportunities for improving online learning platforms, academic and emotional support and increasing respect for those caring for patients. When this period subsides, it is important to ensure that the achievements and awareness that were developed are remembered in the long term.
Perspective of a university faculty member
Besides teaching and guiding medical students, professors, university faculty and senior researchers alike have many duties:
- supervising PhD-students;
- supervising ongoing research projects and articles; and
- preparing new research (designing and writing protocols, submission to ethics review boards, and submission of articles, including correspondence).
Supervision and study preparation continue despite the current crisis this pandemic has caused. In addition, as a reviewer, it is apparent that scientific journals cannot keep abreast with the daily events COVID-19 causes. There are so many articles written recently on this topic that the journals (and publishers) are overwhelmed because of this unprecedented volume of articles received.
COVID-19 disrupted the typical hospital processes, relevant to patient care as well as to support teaching. Shortages of consumables and personal protective equipment supplies, protecting limited resources (staff, equipment, drugs), prioritising patient care to those in most urgent need, and limiting the risk for further human-to-human transmission of the disease forced hospitals to limit the presence of staff attending to essential services and allow many to work from home. Congruent to government’s quest that people should apply social isolation and refrain from having physical contact, the decision was taken for medical students not to attend hospitals at this time and therefore reduce contact with patients and staff. As such, medical specialists could focus on patient care and pandemic preparedness rather than on teaching. Furthermore, it has been demonstrated that health care workers are at an increased risk of becoming infected themselves. Safety of essential staff and doctors’ and nurses’ health and wellbeing are of pivotal importance during a pandemic and ensure the functionality of a hospital.
Even though these incentives reduce the risks to medical students during the current time, their training is essential as they are the medical carers of the future. Their free time can be used to complete medical courses online, but also to attend education sessions about infection prevention, how to avoid virus transmission, containment strategies, different infection risk zones (hot–cold) in a hospital, simulated skills (donning, doffing and disposal of contaminated waste, crisis management simulation and good communication; ie, briefing and debriefing). These opportunities would equip medical students for the future, when they will need to be involved in patient care in the “new” hospital world.
Many research activities can be supported by researchers who work from home; however, direct patient contact is essential to enable quality research and to train those medical students and clinicians responsible for the medical care for future generations. Hopefully, in the new post-COVID-19 era, medical students, PhD students and researchers will still play a pivotal role in health care. Without them, there will be a grim future for medicine.
Jaisil Punnasseril is a 3rd-year medical student and scholarship awarded research student at the University of Queensland.
Dr Michelle Roets is a consultant specialist anaesthetist, lead of the intraoperative cell salvage service at the Royal Brisbane and Women’s Hospital, and Senior Lecturer and PhD student at the University of Queensland.
Professor André Van Zundert is a consultant anaesthetist at Royal Brisbane and Women’s Hospital and Chairman of the Discipline of Anaesthesiology at the University of Queensland, Chair of the Centre for Excellence and Innovation in Anaesthesia, and Chair of the Burns, Trauma, Critical Care Research Centre.
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.