Medical education during the COVID-19 pandemic
Welcome to the clinic. I'm Dr Sanjay Caca across the world. One of the biggest changes forced by the COVID nineteen pandemic was in the field of education. Really all programs were rapidly moved to a distance learning module, online and remote instruction has his own unique challenges, and that was certainly true here at Mayo. Clinic joining us to discuss education that time of covid nineteen is the Dean for Student Affairs in the? Mayo, Clinic Alex School. School of Medicine in Minnesota Dr Alexandra will key spinner welcome to the program Dr Spinner. Thank you very much Dr Car happy to be here so pre covid nineteen. Tell us about what medical school education was like. Interestingly, medical education has not changed very much over one hundred years of back in nineteen ten Dr Flex. Producer, report described how medical education should be optimized so before that we thought of the. Apprenticeship model where medical students or other individuals who were trained to become doctors were essentially at the bedside of the patient together with the doctor, and so they learned through modeling and demonstration. But he determined that it was important to establish some foundational principles and so medical school from that point on became what it is currently today two years of. Scientific foundations so within the classroom anatomy dissection. Pathology G. and just essentially the main sort of organ systems, and then the following two years, or actually at the bedside, so the clinical portion of the training where students are now learning really side by side with physicians, so traditionally She said this full years. How many medical students are actually involved in classroom? Education also hospital rotations. So within the Mayo Clinic, we actually have a relatively small medical school as you know, we do have three campuses campus in Arizona and a campus in Florida is well. The Florida campus is a two year campus, a clinical campus so years three and four. The Arizona campus is a full for your campus and he'll be graduating class in twenty twenty one so if you include a at all individuals within the school we have. have roughly one hundred, two hundred and eight medical students per year multiply that by four within the Minnesota campus we have roughly fifty four students per year, and so years one and two at one hundred and ten individuals in the classroom, and the same amount within clinical rotation, so either in the outpatient clinics or in the hospitals. Clearly, that's a lot of students across not just in in Rochester Minnesota or across the country. And that takes a lot of organization to ensure their educational needs met S, and then march happened, and so tell us what happened there to ensure air education was done safely quite early on the. C. Which is the Accrediting Association of Medical Colleges which oversees medication United States, and in Canada essentially released some recommendations, and they felt that it was important doctrine poll medical students from clinical rotations to essentially a optimize their safety in the setting of Colbert, especially in a very fluid situation where issues such as P P or becoming problematic. And so we did in fact, follow suit, and so early on about mid-march students were pulled from clinical rotations, and subsequently students who actually hold as well from the on campus, large classrooms, fifty plus individuals all huddled together setting because of the potential risks associated with that, it was quite incredible to see Zillions of our faculty of our students of our administrative staffing of everyone, our leadership in the medical school. We just sort of all pulled together, and made it happen, and so our dean of Academic Affairs Dr Darcy read quickly transitioned all of their learning. Virtually some explain what that meant. The first two years where most of the education is within the classroom setting essentially lectures were taught through blackboard or zoom, and our faculty really stepped up. They were extraordinary and so exams could be delivered obviously remotely that kind of thing for students who were in clinical rotations as I stated they were polled, and then it quickly what we What the the academic affairs brands able to do is develop virtual alternatives. So for example there was a model that was created regarding Kobe, and so, what aspects of Medical Education were important to occupy continent setting. Typically. Those who are at the bedside were consistent with what we call hybrid rotations where they were going to do a portion virtually, and as soon as the clinics were opened, the rest was going to be completed at the bedside is one I wanNA make about? The majority of medical schools across the country to continue advancing the student, and their curriculum switched to all virtual learning, which meant that a large number of medical students really never may have had that clinical exposure to some core rotations, but we at the Mayo Clinic Alex Kroll of medicine. The leadership disgusted and we felt that our priorities were twofold. One was to really prepare students to be to be a well prepared physicians so to make sure that we did not decrease. Decrease those core educational opportunities to make very competent and second is to keep the students safe. We were happy to to to find out that extra students are returning to the clinic in June and so now having completed for example few weeks of psychiatry virtually. They're going to be going to the bedside. Currently We think that that will advantage them as well in our match up more importantly that it's preparing them to be competent physician a great point that you make. In terms of the hands on education is critical, not only for the students, but the patients themselves. I think the patients really enjoy that and as a practice is opening up safely as we've seen as you said through June. The students will be back. I think that's a that's a welcome relief for them. Tell us. Education can be stressful and you know. Wellness is an important part of how a students go through their training, or what have you done in the medical school to ensure the wellness of our students? We built program a few years ago called the Thrive Program which essentially is an acronym that stands for training medical students to become a humanistic. A professional individuals who are resilient and healthy. Who are! Innovative DOT leaders. And who also experienced individualized success to people casually excellent, and so we don't view our responsibility to end when they graduated, responsibility is to launch them in their careers I wish I had been taught self care when I was going through medical school and residency and fellowship, and so we feel that knowledge and procedures are important, but at concept of how do you balance? South here so that you can actually be more effective as a physician and decrease the chances of of burnout, which we know is associated with inferior patient outcomes. Were lucky because we already had a strong program in place, and so what we did is we just transitioned it to being virtual? So, we created opportunities for check INS on zoom for our students. We have a program called seawall student wellness activities where students can apply for two hundred fifty dollars to participate in wellness activities, and they've been very creative from baking, too. You Know Basketball tournaments to dragon racing up in the cities which I admit I had up. It's boat race I didn't know that was, but now they're doing it virtually, so they're buying online games that they can then engage with one another and check INS. Were they all order a cookbook and the recipe together at the same time? Time we also make sure to be interfacing with them, so we have virtual hours where they can connect with us. Town halls class meetings where everybody comes together, because that's social support is so important especially during cove where people feel isolated it's interesting you mention that about the social distancing and things like that, but as you said, everybody has innovated, and actually now the touch points in human connection through technology and virtual learning is actually probably enhance their education as opposed to previously where you're sort of all pigeonholed and doing several things at the same time. It's so true. You bring up a related on I. Think what we've discovered with. Medical Education is there are pearls and silver linings to be aimed, and we've planned to continue to implement those going forward a you mentioned Lansky spinner about the match. Can you tell people about what the the the match archly is? Many may not be familiar with that sure, so the match essentially is referring to a a process through which a senior medical students choose a specialty and then go through. Application process and interview process to eventually match into residency. So. Medical School is foundational, but then and is essentially the same for all students within a school, but then they decide what they want to become. They want to be north of Pitas such as yourself do. They want to be a hematologist? Such as myself could Cetera, and so there's obviously many specialties they can pick from, and so that is what the match I to and The actual matching process occurs in March when they find out where they're going to be going now. That takes a lot of traveling as you can imagine a traveling for electives to explore programs what we call additional electives, especially in competitive surgical fields impeded surgery plastics, etc. The second dimension is traveled for interviews. And so once again the WGC to their credit as well as other accrediting bodies have stated that they do not recommend any in-person abuse. They're going to be virtual and they have also recommended that there'd be no at a distance if you will audition electives, and so we are having to strategize, and ways were so lucky that our students are at Mayo because they can easily extend their training time within the specialty in fourth year from one month to two months. We have the capacity. We have top programs in all specialties. It's harder for smaller institutions who may be rely on community, hospitals or Affiliates who perhaps do not welcome medical students, because they're dealing with their own crises during Kovin, and so it's different. Students are nervous. We don't know what's going to be were still we're building. Bridges were walking across it this year, but as you said, this may be something that's here to stay into a hybrid program where you have a little bit of virtual, but also face to face connection, because as you said the travel aspect, the time aspect that that's dedication for the students to come back and forth and expensive. Student spend over five thousand dollars during the interview process well. Alex anything else that we should talk about that. We didn't touch upon. I'll just say that it has been a learning experience for all of us I. think that we have gone through the four stages of grief during. Kobe. I'm glad to say that I feel that we're on the other side. And, we're looking at how we can actually thrive through this I think that four students for all children and teenagers who are having to adjust to virtual learning They've learned to be more reliant self reliant They've learned to be more self accountable and I think that it's taught them. A tremendous amount of resilience which I think ultimately leads to better. Health. And more more joy and happiness in life so again, perhaps another silver lining thanks to dog tags on underwear, lansky spinner Dean for Student Affairs at the Mayo Clinic Alex School of Medicine in Minnesota who's been talking today about how innovative measures have been taken to protect US students and ensure their wellbeing their education dot Alexander Will Lansky, spinner, thank you for joining us. Thank you for having me today. Mayo Clinic Q., and A. IS A. 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