Hospital Center for Emergency Preparedness
During this time, the hospital was primarily focused on centralized communication, educating and training staff about the virus and proper safety precautions, allocation of personal protective equipment (PPE), and surge planning. Each school was making their own decisions regarding student safety and suspending students from clinical involvement. From the hospital’s perspective, removing students was not something being considered during the early stages of surge planning. However, as COVID patients began to outnumber other patients, and there were still questions regarding how COVID was being spread, the hospital realized that removing students from clinical rotations would be necessary to decrease transmission rate, reduce PPE burn rate, and increase safety for both students and patients. Everyone in the hospital including physicians, nurses, students, technicians, and environmental services were pieces of the patient care puzzle. Students have some training and can be important contributors to patient care. However, our main goal in the hospital was preserving patient lives, not educating students, and so taking students off the front line made the most sense for this goal. Ultimately, the decision to remove students from the hospital was made by the medical school. While there were some discussions about involving students in non-clinical ways, it was challenging to coordinate student involvement across the multiple Rutgers entities such as the medical, dental, and nursing schools.
Medical School Administration
As the pandemic slowly started to unfold, the most important priority was maintaining student safety. As COVID rates escalated nationwide, and so much was still unknown about the spread of the virus early on, we were concerned with our ability to adequately protect our students, even with sufficient personal protective equipment (PPE). At the time, the risks of students remaining on clinical rotations outweighed the benefits. During this whirlwind of a time, knowledge regarding COVID-19 was rapidly evolving and changing, and in response, critical decisions related to education and student safety were at the forefront of our decision making. We wear many hats: clinicians, administrators, residency program directors, and medical school educators. Balancing these can be a challenge, especially with the understanding that graduating medical students are an essential component for the next class of residents.
The medical school leadership was triaging and prioritizing the needs by each class of medical students with priorities initially to ensure that our 4th years would fulfill graduation requirements, 1st year students could transition to an entirely remote organ system curriculum, and create a hybrid model of remote learning with planned clinical make-up at a later time for 3rd year students. The 2nd year class had already completed their organ system curriculum and were studying for USMLE Step 1.
During the early stages, we were primarily concerned about the quality of our education and our safety, and the degree to which we were being exposed to the virus by attending lectures or clinical rotations. There were mixed opinions on the severity of the virus and the justification for suspending educational experiences, especially clinical rotations. Some of us wanted to be immediately released from clinical duties, while others were more skeptical about the need for such a drastic response, and some even felt that this was a once-in-a-lifetime medical educational experience. Such ambiguity was not unique to NJMS .
Students already rotating on the hospital floors, regardless of their opinion of the necessity of canceling rotations, were united in their dismay and disappointment at such a development. Layered on this sadness was a pervasive sense of anxiety, especially for second and third year students approaching steps 1 and 2 licensing exams, as this was uncharted territory, and we had no idea how this would affect our exams, graduation requirements, or the residency process. Information from AAMC, LCME, and NBME, and even our school administration seemed to be evolving on a daily basis. For many, volunteering was a distant thought in the face of these pressing personal concerns.
As the pandemic wave began to surge (and in-person education was deferred seemingly indefinitely), priorities changed. For students already living or moving back home, many daily decisions were now filtered through the lens of protecting medically vulnerable family members. For others, new-found time and the desire to use the skills and resources we had led to the brainstorming of ways in which we could help healthcare workers or the community despite being removed from clinical roles. Individual creativity snowballed in the age of social media, and groups of strangers in campuses spread across the country began to share and implement plans .